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Liu DW, Haq Z, Yang D, Stewart JM. Association between smoking history and optical coherence tomography angiography findings in diabetic patients without diabetic retinopathy. PLoS One 2021; 16:e0253928. [PMID: 34242286 PMCID: PMC8270137 DOI: 10.1371/journal.pone.0253928] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/15/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose To investigate any associations between cigarette smoking and retinal microvascular changes in diabetic patients without visible retinopathy. Design Retrospective, cross-sectional study. Participants 1099 eyes from 1099 diabetic patients with no clinical evidence of diabetic retinopathy (DR) were included in this study. Methods Diabetic patients underwent optical coherence tomography angiography (OCTA) scanning at Zuckerberg San Francisco General Hospital and Trauma Center between April 2018 and September 2019. Patient demographic and clinical information was collected. Standard bivariate statistics and multivariate linear regression were performed. Main outcome measures OCTA parameters included metrics related to the foveal avascular zone (FAZ; area, perimeter, circularity), perfusion density (PD; full, center, inner), and vessel length density (VLD; full, center, inner). Results The study population included 750 non-smokers and 349 smokers. FAZ perimeter was the only OCTA parameter that was significantly different between the two groups on uncontrolled analysis (P = 0.033). Multivariate regression analyses revealed significant associations between lower VLD full (β = -0.31, P = 0.048), lower VLD inner (β = -0.35, P = 0.046) and a history of smoking. No significant associations between cigarette smoking and either FAZ or PD were detected. Conclusions Our results suggest that smoking is likely associated with deleterious changes in the retinal microvasculature of patients with a history of diabetes and no visible DR. Based on these findings, diabetic patients with a history of smoking may benefit from higher prioritization in terms of ophthalmic screening.
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Affiliation(s)
- Dong-Wei Liu
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, United States of America
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zeeshan Haq
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, United States of America
| | - Daphne Yang
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, United States of America
| | - Jay M. Stewart
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, United States of America
- * E-mail:
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Christensen SF, Scherber RM, Mazza GL, Dueck AC, Brochmann N, Andersen CL, Hasselbalch HC, Mesa RA, Geyer HL. Tobacco use in the Myeloproliferative neoplasms: symptom burden, patient opinions, and care. BMC Cancer 2021; 21:691. [PMID: 34112113 PMCID: PMC8194237 DOI: 10.1186/s12885-021-08439-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 06/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients with Philadelphia-negative Myeloproliferative Neoplasms (MPN) suffer from numerous symptoms and decreased quality of life. Smoking is associated with an increased symptom burden in several malignancies. The aim of this study was to analyze the association between smoking and MPN-related symptom burden and explore MPN patients' opinions on smoking. METHODS A total of 435 patients with MPN participated in a cross-sectional internet-based survey developed by the Mayo Clinic and the Myeloproliferative Neoplasm Quality of Life Group. Patients reported their demographics, disease characteristics, tobacco use, and opinions on tobacco use. In addition, MPN-related symptoms were reported via the validated 10-item version of the Myeloproliferative Neoplasms Symptom Assessment Form. RESULTS Current/former smokers reported worse fatigue (mean severity 5.6 vs. 5.0, p = 0.02) and inactivity (mean severity 4.0 vs. 3.4, p = 0.03) than never smokers. Moreover, current/former smokers more frequently experienced early satiety (68.5% vs. 58.3%, p = 0.03), inactivity (79.9% vs. 71.1%, p = 0.04), and concentration difficulties (82.1% vs. 73.1%, p = 0.04). Although not significant, a higher total symptom burden was observed for current/former smokers (mean 30.4 vs. 27.0, p = 0.07). Accordingly, overall quality of life was significantly better among never smokers than current/former smokers (mean 3.5 vs. 3.9, p = 0.03). Only 43.2% of the current/former smokers reported having discussed tobacco use with their physician, and 17.5% did not believe smoking increased the risk of thrombosis. CONCLUSION The current study suggests that smoking may be associated with increased prevalence and severity of MPN symptoms and underscores the need to enhance patient education and address tobacco use in the care of MPN patients.
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Affiliation(s)
- Sarah F. Christensen
- Department of Hematology, Zealand University Hospital, Roskilde, Vestermarksvej 9, 4000 Roskilde, Denmark
| | - Robyn M. Scherber
- Department of Hematology and Oncology, UT Health San Antonio MD Anderson Cancer Center, 7979 Wurzbach Rd, San Antonio, TX 78229 USA
- Hematologic Malignancies, Incyte Corporation, Wilmington, Delaware, USA
| | - Gina L. Mazza
- Department of Health Sciences Research, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259 USA
| | - Amylou C. Dueck
- Department of Health Sciences Research, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259 USA
| | - Nana Brochmann
- Department of Hematology, Zealand University Hospital, Roskilde, Vestermarksvej 9, 4000 Roskilde, Denmark
| | - Christen L. Andersen
- Department of Hematology, University Hospital of Copenhagen at Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Hans C. Hasselbalch
- Department of Hematology, Zealand University Hospital, Roskilde, Vestermarksvej 9, 4000 Roskilde, Denmark
| | - Ruben A. Mesa
- Department of Hematology and Oncology, UT Health San Antonio MD Anderson Cancer Center, 7979 Wurzbach Rd, San Antonio, TX 78229 USA
| | - Holly L. Geyer
- Department of Hematology and Medical Oncology, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259 USA
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Kobayashi K, Kamekura R, Kato J, Kamiya S, Kamiya T, Takano K, Ichimiya S, Uhara H. Cigarette Smoke Underlies the Pathogenesis of Palmoplantar Pustulosis via an IL-17A-Induced Production of IL-36γ in Tonsillar Epithelial Cells. J Invest Dermatol 2021; 141:1533-1541.e4. [PMID: 33188781 DOI: 10.1016/j.jid.2020.09.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/24/2020] [Accepted: 09/09/2020] [Indexed: 02/08/2023]
Abstract
Palmoplantar pustulosis (PPP) is characterized by sterile pustules on the palms and soles. A strong association between PPP and tobacco smoking has been reported, and it has been speculated that the IL-17A pathway may play an important role in PPP. Recent studies have suggested that IL-36 plays a pivotal role in the pathogenesis of psoriasis and its subtypes. The relationships among IL-36, smoking, and PPP have not been examined. Here, we investigated the relationships among the smoking index, severity of the clinical condition of PPP, and in vitro dynamics of IL-36 in human tonsillar epithelial cells under the condition of exposure to a cigarette smoke extract. The results demonstrated that the Palmoplantar Pustulosis Area and Severity Index was strongly and positively correlated with the smoking index in female patients. Immunohistochemical examinations showed that IL-36γ was highly expressed in tonsillar epithelial cells from patients with PPP but not in those from patients with recurrent tonsillitis without PPP. The in vitro study revealed that IL-17A synergistically induced a release of IL-36γ under cigarette smoke extract exposure. These results suggest that local production of IL-36γ by epithelial cells induced by cigarette smoke exposure plays an important role in the pathogenesis of PPP.
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Affiliation(s)
- Keiju Kobayashi
- Department of Dermatology, School of Medicine, Sapporo Medical University, Sapporo, Japan; Department of Human Immunology, Research Institute for Frontier Medicine, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Ryuta Kamekura
- Department of Human Immunology, Research Institute for Frontier Medicine, School of Medicine, Sapporo Medical University, Sapporo, Japan; Department of Otolaryngology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Junji Kato
- Department of Dermatology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Shiori Kamiya
- Department of Dermatology, School of Medicine, Sapporo Medical University, Sapporo, Japan; Department of Human Immunology, Research Institute for Frontier Medicine, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Takafumi Kamiya
- Department of Dermatology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Kenichi Takano
- Department of Otolaryngology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Shingo Ichimiya
- Department of Human Immunology, Research Institute for Frontier Medicine, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Hisashi Uhara
- Department of Dermatology, School of Medicine, Sapporo Medical University, Sapporo, Japan.
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Cruz Castellanos P, Sánchez Cabrero D, Esteban MI, de Castro J. [Retrospective study of lung carcinoid: experience in a third level Spanish hospital]. Rev Esp Patol 2021; 54:85-91. [PMID: 33726895 DOI: 10.1016/j.patol.2020.04.004] [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] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/04/2020] [Accepted: 04/25/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Pulmonary carcinoids are relatively rare neuroendocrine neoplasms, accounting for only 1-2% of malignant thoracic tumours. We describe our experience in the management and follow-up of such an infrequent tumour, with special emphasis on possible problems that might arise. PATIENTS AND METHODS We present a descriptive retrospective study of all patients diagnosed with carcinoid tumour between January 2013 and January 2018. Demographic, histological and clinical data were collected and analyzed. Survival was recorded. SPSS version 21 was used for the statistical analysis. RESULTS 42 patients with an average age of 66.26 years were included. The mean period of follow-up was 60 months and the average survival 59.12 months. The only statistically significant factor related to an improved survival time was tumour stage at diagnosis. CONCLUSION Carcinoid tumours are infrequent, which makes the objective collecting of data difficult. For this reason, we hope that the present study will contribute to a better understanding of their evolution.
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Affiliation(s)
| | | | | | - Javier de Castro
- Servicio de Oncología Médica, Hospital Universitario La Paz, Madrid, España
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Chen X, Jansen L, Guo F, Hoffmeister M, Chang-Claude J, Brenner H. Smoking, Genetic Predisposition, and Colorectal Cancer Risk. Clin Transl Gastroenterol 2021; 12:e00317. [PMID: 33646204 PMCID: PMC7925134 DOI: 10.14309/ctg.0000000000000317] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/27/2021] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Smoking and genetic predisposition are established risk factors for colorectal cancer (CRC). We aimed to assess and compare their individual and joint impact on CRC risk using the novel approach of genetic risk equivalent (GRE). METHODS Data were extracted from the Darmkrebs: Chancen der Verhütung durch Screening study, a large population-based case-control study in Germany. A polygenic risk score (PRS) based on 140 CRC-related single nucleotide polymorphisms was derived to quantify genetic risk. Multiple logistic regression was used to estimate the individual and joint impact of smoking and PRS on CRC risk, and to quantify the smoking effect in terms of GRE, the corresponding effect conveyed by a defined difference in PRS percentiles. RESULTS There were 5,086 patients with CRC and 4,120 controls included. Current smokers had a 48% higher risk of CRC than never smokers (adjusted odds ratio 1.48, 95% confidence interval 1.27-1.72). A PRS above the 90th percentile was significantly associated with a 3.6-, 4.3-, and 6.4-fold increased risk of CRC in never, former, and current smokers, respectively, when compared with a PRS below the 10th percentile in never smokers. The interaction between smoking and PRS on CRC risk did not reach statistical significance (P = 0.53). The effect of smoking was equivalent to the effect of having a 30 percentile higher level of PRS (GRE 30, 95% confidence interval 18-42). DISCUSSION Both smoking and the PRS carry essentially independent CRC risk information, and their joint consideration provides powerful risk stratification. Abstinence from smoking can compensate for a substantial proportion of genetically determined CRC risk.
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Affiliation(s)
- Xuechen Chen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Feng Guo
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jenny Chang-Claude
- Unit of Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Genetic Tumor Epidemiology Group, University Medical Center Hamburg-Eppendorf, University Cancer Center Hamburg, Hamburg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
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McRobbie HJ, Phillips-Waller A, El Zerbi C, McNeill A, Hajek P, Pesola F, Balmford J, Ferguson SG, Li L, Lewis S, Courtney RJ, Gartner C, Bauld L, Borland R. Nicotine replacement treatment, e-cigarettes and an online behavioural intervention to reduce relapse in recent ex-smokers: a multinational four-arm RCT. Health Technol Assess 2020; 24:1-82. [PMID: 33270009 PMCID: PMC7750867 DOI: 10.3310/hta24680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Relapse remains an unresolved issue in smoking cessation. Extended stop smoking medication use can help, but uptake is low and several behavioural relapse prevention interventions have been found to be ineffective. However, opportunistic 'emergency' use of fast-acting nicotine replacement treatment or electronic cigarettes may be more attractive and effective, and an online behavioural Structured Planning and Prompting Protocol has shown promise. The present trial aimed to evaluate the clinical effectiveness and cost-effectiveness of these two interventions. DESIGN A randomised controlled trial. SETTING English stop smoking services and Australian quitlines, Australian social media and St Vincent's Hospital Melbourne, Fitzroy, VIC. PARTICIPANTS Ex-smokers abstinent for at least 4 weeks, with some participants in Australia also recruited from 1 week post quit date. The planned sample size was 1400, but the trial was curtailed when 235 participants were recruited. INTERVENTIONS Participants were randomised in permuted blocks of random sizes to (1) oral nicotine replacement treatment/electronic cigarettes to use if at risk of relapse, plus static text messages (n = 60), (2) the Structured Planning and Prompting Protocol and interactive text messages (n = 57), (3) oral nicotine replacement treatment/electronic cigarettes plus the Structured Planning and Prompting Protocol with interactive text messages (n = 58) or (4) usual care plus static text messages (n = 59). OUTCOME MEASURES Owing to delays in study set-up and recruitment issues, the study was curtailed and the primary outcome was revised. The original objective was to determine whether or not the two interventions, together or separately, reduced relapse rates at 12 months compared with usual care. The revised primary objective was to determine whether or not number of interventions received (i.e. none, one or two) affects relapse rate at 6 months (not biochemically validated because of study curtailment). Relapse was defined as smoking on at least 7 consecutive days, or any smoking in the last month at final follow-up for both the original and curtailed outcomes. Participants with missing outcome data were included as smokers. Secondary outcomes included sustained abstinence (i.e. no more than five cigarettes smoked over the 6 months), nicotine product preferences (e.g. electronic cigarettes or nicotine replacement treatment) and Structured Planning and Prompting Protocol coping strategies used. Two substudies assessed reactions to interventions quantitatively and qualitatively. The trial statistician remained blinded until analysis was complete. RESULTS The 6-month relapse rates were 60.0%, 43.5% and 49.2% in the usual-care arm, one-intervention arm and the two-intervention arm, respectively (p = 0.11). Sustained abstinence rates were 41.7%, 54.8% and 50.9%, respectively (p = 0.17). Electronic cigarettes were chosen more frequently than nicotine replacement treatment in Australia (71.1% vs. 29.0%; p = 0.001), but not in England (54.0% vs. 46.0%; p = 0.57). Of participants allocated to nicotine products, 23.1% were using them daily at 6 months. The online intervention received positive ratings from 63% of participants at 6 months, but the majority of participants (72%) completed one assessment only. Coping strategies taught in the Structured Planning and Prompting Protocol were used with similar frequency in all study arms, suggesting that these are strategies people had already acquired. Only one participant used the interactive texting, and interactive and static messages received virtually identical ratings. LIMITATIONS The inability to recruit sufficient participants resulted in a lack of power to detect clinically relevant differences. Self-reported abstinence was not biochemically validated in the curtailed trial, and the ecological momentary assessment substudy was perceived by some as an intervention. CONCLUSIONS Recruiting recent ex-smokers into an interventional study proved problematic. Both interventions were well received and safe. Combining the interventions did not surpass the effects of each intervention alone. There was a trend in favour of single interventions reducing relapse, but it did not reach significance and there are reasons to interpret the trend with caution. FUTURE WORK Further studies of both interventions are warranted, using simpler study designs. TRIAL REGISTRATION Current Controlled Trials ISRCTN11111428. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 68. See the NIHR Journals Library website for further project information. Funding was also provided by the National Health and Medical Research Council, Canberra, ACT, Australia (NHMRC APP1095880). Public Health England provided the funds to purchase the nicotine products in England.
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Affiliation(s)
- Hayden J McRobbie
- Health and Lifestyle Research Unit, Queen Mary University of London, London, UK
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | | | - Catherine El Zerbi
- Cancer Prevention Group, School of Cancer & Pharmaceutical Sciences, Faculty of Medicine and Life Sciences, King's College London, London, UK
| | - Ann McNeill
- Cancer Prevention Group, School of Cancer & Pharmaceutical Sciences, Faculty of Medicine and Life Sciences, King's College London, London, UK
| | - Peter Hajek
- Health and Lifestyle Research Unit, Queen Mary University of London, London, UK
| | - Francesca Pesola
- Cancer Prevention Group, School of Cancer & Pharmaceutical Sciences, Faculty of Medicine and Life Sciences, King's College London, London, UK
| | - James Balmford
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Stuart G Ferguson
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Lin Li
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Sarah Lewis
- Clinical Sciences Building, University of Nottingham, Nottingham City Hospital, Nottingham, UK
| | - Ryan J Courtney
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Coral Gartner
- School of Public Health, Faculty of Medicine, University of Queensland, St Lucia, QLD, Australia
| | - Linda Bauld
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Ron Borland
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
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Benzian-Olsson N, Dand N, Chaloner C, Bata-Csorgo Z, Borroni R, Burden AD, Cooper HL, Cornelius V, Cro S, Dasandi T, Griffiths CEM, Kingo K, Koks S, Lachmann H, McAteer H, Meynell F, Mrowietz U, Parslew R, Patel P, Pink AE, Reynolds NJ, Tanew A, Torz K, Trattner H, Wahie S, Warren RB, Wright A, Barker JN, Navarini AA, Smith CH, Capon F. Association of Clinical and Demographic Factors With the Severity of Palmoplantar Pustulosis. JAMA Dermatol 2020; 156:1216-1222. [PMID: 32936291 PMCID: PMC7495329 DOI: 10.1001/jamadermatol.2020.3275] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/19/2020] [Indexed: 01/10/2023]
Abstract
Importance Although palmoplantar pustulosis (PPP) can significantly impact quality of life, the factors underlying disease severity have not been studied. Objective To examine the factors associated with PPP severity. Design, Setting, and Participants An observational, cross-sectional study of 2 cohorts was conducted. A UK data set including 203 patients was obtained through the Anakinra in Pustular Psoriasis, Response in a Controlled Trial (2016-2019) and its sister research study Pustular Psoriasis, Elucidating Underlying Mechanisms (2016-2020). A Northern European cohort including 193 patients was independently ascertained by the European Rare and Severe Psoriasis Expert Network (2014-2017). Patients had been recruited in secondary or tertiary dermatology referral centers. All patients were of European descent. The PPP diagnosis was established by dermatologists, based on clinical examination and/or published consensus criteria. The present study was conducted from October 1, 2014, to March 15, 2020. Main Outcomes and Measures Demographic characteristics, comorbidities, smoking status, Palmoplantar Pustulosis Psoriasis Area Severity Index (PPPASI), measuring severity from 0 (no sign of disease) to 72 (very severe disease), or Physician Global Assessment (PGA), measuring severity as 0 (clear), 1 (almost clear), 2 (mild), 3 (moderate), and 4 (severe). Results Among the 203 UK patients (43 men [21%], 160 women [79%]; median age at onset, 48 [interquartile range (IQR), 38-59] years), the PPPASI was inversely correlated with age of onset (r = -0.18, P = .01). Similarly, in the 159 Northern European patients who were eligible for inclusion in this analysis (25 men [16%], 134 women [84%]; median age at onset, 45 [IQR, 34-53.3] years), the median age at onset was lower in individuals with a moderate to severe PGA score (41 years [IQR, 30.5-52 years]) compared with those with a clear to mild PGA score (46.5 years [IQR, 35-55 years]) (P = .04). In the UK sample, the median PPPASI score was higher in women (9.6 [IQR, 3.0-16.2]) vs men (4.0 [IQR, 1.0-11.7]) (P = .01). Likewise, moderate to severe PPP was more prevalent among Northern European women (57 of 134 [43%]) compared with men (5 of 25 [20%]) (P = .03). In the UK cohort, the median PPPASI score was increased in current smokers (10.7 [IQR, 4.2-17.5]) compared with former smokers (7 [IQR, 2.0-14.4]) and nonsmokers (2.2 [IQR, 1-6]) (P = .003). Comparable differences were observed in the Northern European data set, as the prevalence of moderate to severe PPP was higher in former and current smokers (51 of 130 [39%]) compared with nonsmokers (6 of 24 [25%]) (P = .14). Conclusions and Relevance The findings of this study suggest that PPP severity is associated with early-onset disease, female sex, and smoking status. Thus, smoking cessation intervention might be beneficial.
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Affiliation(s)
| | - Nick Dand
- Department of Medical and Molecular Genetics, King's College London, London, United Kingdom
- Health Data Research UK, London, United Kingdom
| | - Charlotte Chaloner
- Department of Medical and Molecular Genetics, King's College London, London, United Kingdom
| | - Zsuzsa Bata-Csorgo
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Riccardo Borroni
- Humanitas Clinical and Research Center, IRCCS, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - A. David Burden
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom
| | - Hywel L. Cooper
- Portsmouth Dermatology Unit, Portsmouth Hospitals Trust, Portsmouth, United Kingdom
| | - Victoria Cornelius
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Suzie Cro
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Tejus Dasandi
- St John's Institute of Dermatology, King's College London, London, United Kingdom
| | - Christopher E. M. Griffiths
- Dermatology Centre, National Institute for Health Research Manchester Biomedical Research Centre, University of Manchester, Manchester, United Kingdom
| | - Külli Kingo
- Dermatology Clinic, Tartu University Hospital, Department of Dermatology, University of Tartu, Tartu, Estonia
| | - Sulev Koks
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch and Perron Institute for Neurological and Translational Science, Murdoch University, Nedlands, Western Australia, Australia
| | - Helen Lachmann
- National Amyloidosis Centre, University College London, Royal Free Campus, London, United Kingdom
| | - Helen McAteer
- The Psoriasis Association, Northampton, United Kingdom
| | - Freya Meynell
- St John's Institute of Dermatology, King's College London, London, United Kingdom
| | - Ulrich Mrowietz
- Psoriasis Center at the Department of Dermatology, University Medical Center, Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Richard Parslew
- Department of Dermatology, Royal Liverpool Hospitals, Liverpool, United Kingdom
| | - Prakash Patel
- St John's Institute of Dermatology, King's College London, London, United Kingdom
| | - Andrew E. Pink
- St John's Institute of Dermatology, King's College London, London, United Kingdom
| | - Nick J. Reynolds
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Dermatology and National Institute for Health Research Newcastle Biomedical Research Centre, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Adrian Tanew
- Department of Dermatology, Medical University of Vienna, Austria
| | - Kaspar Torz
- Psoriasis Center at the Department of Dermatology, University Medical Center, Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Hannes Trattner
- Department of Dermatology, Medical University of Vienna, Austria
| | - Shyamal Wahie
- Department of Dermatology, University Hospital of North Durham, Durham
| | - Richard B. Warren
- The Dermatology Centre, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Andrew Wright
- Department of Dermatology, St Lukes Hospital, Bradford, United Kingdom
| | - Jonathan N. Barker
- St John's Institute of Dermatology, King's College London, London, United Kingdom
| | - Alexander A. Navarini
- Department of Dermatology & Allergy, University Hospital of Basel, Basel, Switzerland
| | - Catherine H. Smith
- St John's Institute of Dermatology, King's College London, London, United Kingdom
| | - Francesca Capon
- Department of Medical and Molecular Genetics, King's College London, London, United Kingdom
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Everard CD, Silveira ML, Kimmel HL, Marshall D, Blanco C, Compton WM. Association of Electronic Nicotine Delivery System Use With Cigarette Smoking Relapse Among Former Smokers in the United States. JAMA Netw Open 2020; 3:e204813. [PMID: 32501492 PMCID: PMC7275247 DOI: 10.1001/jamanetworkopen.2020.4813] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
IMPORTANCE Relapse to smoking among former smokers is a serious clinical concern, and use of electronic nicotine delivery systems (ENDS) has been proposed as a new risk factor for relapse. Understanding the specificity of this risk can help guide clinical practice and lead to improved health outcomes. OBJECTIVE To assess the associations of ENDS use with cigarette smoking relapse among adult former cigarette smokers. DESIGN, SETTING, AND PARTICIPANTS This cohort study examined data from the Population Assessment of Tobacco and Health Study, waves 1 to 4 (2013-2018). Cox proportional hazards models were developed. This is an ongoing, nationally representative, longitudinal cohort study in the US. Participants included adult (≥18 years) former cigarette smokers who reported no tobacco product use at wave 1 (unweighted n = 2273), separated into recent former cigarette smokers (last smoked ≤12 months previously) and long-term former smokers (last smoked >12 months previously). Data analysis was conducted from July to August 2019. EXPOSURES Self-reported use of cigarettes, ENDS, and other tobacco products (ie, cigars, pipe tobacco, hookah, snus tobacco, other smokeless tobacco, and dissolvable tobacco) was assessed. MAIN OUTCOMES AND MEASURES Self-reported current (every day or some days) use of cigarettes at follow-up interviews. RESULTS Of 2273 adult former cigarette smokers, 51.8% (95% CI, 49.7%-53.8%) were women, 65.0% (95% CI, 62.6%-67.4%) were older than 50 years, and 79.5% (95% CI, 77.8%-81.2%) were non-Hispanic white participants. Use of ENDS was associated with significant risk of cigarette smoking relapse among recent former smokers (adjusted hazard ratio [AHR], 1.63; 95% CI, 1.04-2.53; unweighted n = 304) and among long-term former smokers (AHR, 3.79; 95% CI, 1.75-8.20; unweighted n = 1554). Use of other tobacco products was also associated with significant risk for cigarette smoking relapse among recent former smokers (AHR, 1.97; 95% CI, 1.27-3.05) and among long-term former smokers (AHR, 3.82; 95% CI, 1.91-7.66). CONCLUSIONS AND RELEVANCE In this study, use of ENDS and other tobacco products was associated with increased risk of cigarette smoking relapse among former cigarette smokers who did not use any tobacco product at wave 1 of the PATH Study. For clinicians treating former smokers who have successfully quit all nicotine products, the implications are that use of ENDS products should be discouraged, just as use of all other tobacco products is discouraged.
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Affiliation(s)
- Colm D. Everard
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | - Marushka L. Silveira
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | - Heather L. Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Daniela Marshall
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Wilson M. Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
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Brewer N, Teng A, Atkinson J, Guilford P, Print C, Blakely T. An estimate of limited duration cancer prevalence in New Zealand using 'big' data. N Z Med J 2020; 133:49-62. [PMID: 32379739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
AIMS Increases in cancer survival may increase cancer prevalence and demand for healthcare. We aimed to estimate cancer prevalence in the New Zealand population. METHODS We used national linked health, social and census datasets from the Stats NZ Integrated Data Infrastructure to identify the number of New Zealand residents who had at least one cancer diagnosis in New Zealand. We included all primary cancers recorded on the New Zealand Cancer Registry from January 1995 to June 2013, and used the 2013 census for demographic and socioeconomic data. RESULTS On 30 June 2013, 140,600 of 4,438,900 (3.2%) New Zealand residents had been diagnosed with cancer in the last 18.5 years. In ≥15 year olds, the age-standardised prevalence of cancer diagnosed 0 to ≤1 year, and >1 to ≤5 years, prior to 30 June 2013 was 0.4% and 1.1% in men and 0.3% and 0.9% in women, respectively. Over the 18.5-year period prevalence was greatest in the oldest ages, European/Other, highest qualified, highest income, least deprived, ex-smokers, and Canterbury, Bay of Plenty and Nelson/Marlborough District Health Boards (age-standardised). CONCLUSIONS Groups with the highest survival and the greatest access to healthcare had the highest cancer prevalences.
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Affiliation(s)
- Naomi Brewer
- Research Officer, Department of Public Health, University Of Otago, Wellington, and Centre for Public Health Research, Massey University, Wellington
| | - Andrea Teng
- Senior Research Fellow, Department of Public Health, University Of Otago, Wellington
| | - June Atkinson
- Senior Analyst, Department of Public Health, University Of Otago, Wellington
| | - Parry Guilford
- Research Professor, Department of Biochemistry, University Of Otago, Dunedin
| | - Cristin Print
- , Faculty of Medical and Health Sciences, The University of Auckland, Auckland
| | - Tony Blakely
- Research Professor, Department of Public Health, University Of Otago, Wellington, and Melbourne School of Population and Global Health, The University of Melbourne, Australia
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Lee YB, Lee JH, Lee SY, Yu DS, Han KD, Park YG. Association between vitiligo and smoking: A nationwide population-based study in Korea. Sci Rep 2020; 10:6231. [PMID: 32277157 PMCID: PMC7148336 DOI: 10.1038/s41598-020-63384-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/26/2019] [Accepted: 03/18/2020] [Indexed: 01/23/2023] Open
Abstract
No study has examined the associations between vitiligo and smoking. The purpose of this study was to investigate the incidence of vitiligo according to smoking status. We used clinical data from individuals aged over 20 years who received a health examination in the National Insurance Program between 2009 and 2012 (n = 23,503,807). We excluded individuals with pre-existing vitiligo who had ever been diagnosed with vitiligo before the index year (n = 35,710) or who were diagnosed with vitiligo within a year of the index year (n = 46,476). Newly diagnosed vitiligo was identified using claims data from baseline to date of diagnosis or December 31, 2016 (n = 22,811). The development of vitiligo was compared according to self-reported smoking status by a health examination survey. The hazard ratio of vitiligo in current smokers was 0.69 (95% confidence interval; 0.65-0.72) with a reference of never-smokers after adjustment for age, sex, regular exercise, drinking status, body mass index, diabetes mellitus, hypertension, dyslipidemia, history of stroke, and history of ischemic heart diseases. The decreased risk of vitiligo in current smokers persisted after subgroup analysis of sex and age groups. The results suggested there are suppressive effects of smoking on the development of vitiligo. Further studies are needed to evaluate the mechanism of smoking on the development of vitiligo.
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Affiliation(s)
- Young Bok Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Hyun Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Soo Young Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Soo Yu
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Gyu Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Perski O, Garnett C, Shahab L, Brown J, West R. Associations between smoking status and bodily pain in a cross-sectional survey of UK respondents. Addict Behav 2020; 102:106229. [PMID: 31862683 PMCID: PMC6959457 DOI: 10.1016/j.addbeh.2019.106229] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/12/2019] [Accepted: 11/18/2019] [Indexed: 11/01/2022]
Abstract
BACKGROUND Research indicates that ex- and current smokers report increased levels of bodily pain compared with never smokers. This could be secondary to smoking-related disease or psychological characteristics of smokers, or it could be a neurological or vascular effect of a period of regular smoking. AIMS We compared self-reported levels of bodily pain in daily, never daily and former daily smokers stratified by age group and adjusting for a wider range of covariates than has been undertaken to-date, including health status, neuroticism, anxiety and depression. METHOD 223,537 UK respondents aged 16+ years were surveyed between 2009 and 2013 in the British Broadcasting Corporation (BBC) Lab UK Study. Respondents provided information on bodily pain, smoking status and a range of sociodemographic, health, behavioural and psychological characteristics. RESULTS After adjusting for all covariates, in 16-34-year-olds, reported levels of bodily pain in former daily smokers (Badj = 0.72, 95% CI = 0.30, 1.15, p < .001) and daily smokers (Badj = 0.50, 95% CI = 0.18, 0.82, p < .01) were higher than in never daily smokers. Reported levels of bodily pain were also higher in former daily smokers than in never daily smokers in those aged 35-64 (Badj = 1.04, 95% CI = 0.69, 1.38, p < .001) and 65 + years (Badj = 1.65, 95% CI = 0.07, 3.24, p < .05). CONCLUSIONS After adjusting for key characteristics, former daily smokers reported higher levels of bodily pain compared with never daily smokers at all ages. This raises the possibility that a period of smoking may have lasting effects on pain experiences.
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Affiliation(s)
- Olga Perski
- Research Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
| | - Claire Garnett
- Research Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Lion Shahab
- Research Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Jamie Brown
- Research Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Robert West
- Research Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
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Deal JA, Power MC, Palta P, Alonso A, Schneider AL, Perryman K, Bandeen-Roche K, Sharrett AR. Relationship of Cigarette Smoking and Time of Quitting with Incident Dementia and Cognitive Decline. J Am Geriatr Soc 2020; 68:337-345. [PMID: 31675113 PMCID: PMC7002272 DOI: 10.1111/jgs.16228] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 04/15/2019] [Revised: 08/30/2019] [Accepted: 09/16/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Understanding how dementia risk is impacted by timing of smoking cessation has public health implications for prevention efforts. We investigated the relationship of cigarette smoking and cessation with dementia risk and cognitive decline in the Atherosclerosis Risk in Communities (ARIC) study. DESIGN Ongoing prospective cohort study. SETTING Begun in 1987-1989, ARIC was conducted in four US communities. PARTICIPANTS A total of 13 002 men and women (25% African American) aged 52 to 75 years. MEASUREMENTS All-cause dementia was defined using standardized algorithms incorporating longitudinal cognitive data, proxy report, and hospital and death certificate dementia codes. Cognitive decline was measured using a composite cognitive score created from three tests measured at two time points (1996-1998 and 2011-2013). Smoking and cessation status were defined by self-report using data from 1987-1989 (visit 1) and 1996-1998 (visit 4). Incident dementia risk and differences in cognitive change by smoking status were estimated with Cox proportional hazards and linear regression models, respectively. To address smoking-related attrition, cognitive scores were imputed for living participants with incomplete cognitive testing. RESULTS The proportion of never, former, and current smokers was 44%, 41%, and 14%; 79% of former smokers quit 9 years or more before baseline. A total of 1347 participants developed dementia. After adjustment, compared with never smoking, the hazard ratio for all-cause dementia for current smoking was 1.33 (95% confidence interval [CI] = 1.12-1.59) and for recent quitting (<9 y before baseline) was 1.24 (95% CI = 1.01-1.52). Quitting 9 years or more before baseline was not associated with dementia. We found no differences in rates of cognitive decline by smoking status. CONCLUSION Although quitting at any time suggested benefit, dementia risk depended on time since smoking cessation. Our study highlights the importance of early midlife cessation to decrease dementia risk. J Am Geriatr Soc 68:337-345, 2020.
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Affiliation(s)
- Jennifer A. Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Melinda C. Power
- Department of Epidemiology and Biostatistics, George Washington University Milken Institute School of Public Health, Washington, DC
| | - Priya Palta
- Division of General Medicine, Department of Medicine, Columbia University Medical Center, New York, NY
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | - Kelly Perryman
- Neurosurgery, Florida Cancer Specialists and Research Institute, Palm Beach Gardens, FL
| | - Karen Bandeen-Roche
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - A. Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Oelsner EC, Balte PP, Bhatt SP, Cassano PA, Couper D, Folsom AR, Freedman ND, Jacobs DR, Kalhan R, Mathew AR, Kronmal RA, Loehr LR, London SJ, Newman AB, O'Connor GT, Schwartz JE, Smith LJ, White WB, Yende S. Lung function decline in former smokers and low-intensity current smokers: a secondary data analysis of the NHLBI Pooled Cohorts Study. Lancet Respir Med 2020; 8:34-44. [PMID: 31606435 PMCID: PMC7261004 DOI: 10.1016/s2213-2600(19)30276-0] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 06/27/2019] [Accepted: 07/09/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Former smokers now outnumber current smokers in many developed countries, and current smokers are smoking fewer cigarettes per day. Some data suggest that lung function decline normalises with smoking cessation; however, mechanistic studies suggest that lung function decline could continue. We hypothesised that former smokers and low-intensity current smokers have accelerated lung function decline compared with never-smokers, including among those without prevalent lung disease. METHODS We used data on six US population-based cohorts included in the NHLBI Pooled Cohort Study. We restricted the sample to participants with valid spirometry at two or more exams. Two cohorts recruited younger adults (≥17 years), two recruited middle-aged and older adults (≥45 years), and two recruited only elderly adults (≥65 years) with examinations done between 1983 and 2014. FEV1 decline in sustained former smokers and current smokers was compared to that of never-smokers by use of mixed models adjusted for sociodemographic and anthropometric factors. Differential FEV1 decline was also evaluated according to duration of smoking cessation and cumulative (number of pack-years) and current (number of cigarettes per day) cigarette consumption. FINDINGS 25 352 participants (ages 17-93 years) completed 70 228 valid spirometry exams. Over a median follow-up of 7 years (IQR 3-20), FEV1 decline at the median age (57 years) was 31·01 mL per year (95% CI 30·66-31·37) in sustained never-smokers, 34·97 mL per year (34·36-35·57) in former smokers, and 39·92 mL per year (38·92-40·92) in current smokers. With adjustment, former smokers showed an accelerated FEV1 decline of 1·82 mL per year (95% CI 1·24-2·40) compared to never-smokers, which was approximately 20% of the effect estimate for current smokers (9·21 mL per year; 95% CI 8·35-10·08). Compared to never-smokers, accelerated FEV1 decline was observed in former smokers for decades after smoking cessation and in current smokers with low cumulative cigarette consumption (<10 pack-years). With respect to current cigarette consumption, the effect estimate for FEV1 decline in current smokers consuming less than five cigarettes per day (7·65 mL per year; 95% CI 6·21-9·09) was 68% of that in current smokers consuming 30 or more cigarettes per day (11·24 mL per year; 9·86-12·62), and around five times greater than in former smokers (1·57 mL per year; 1·00-2·14). Among participants without prevalent lung disease, associations were attenuated but were consistent with the main results. INTERPRETATION Former smokers and low-intensity current smokers have accelerated lung function decline compared with never-smokers. These results suggest that all levels of smoking exposure are likely to be associated with lasting and progressive lung damage. FUNDING National Institutes of Health, National Heart Lung and Blood Institute, and US Environmental Protection Agency.
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Affiliation(s)
| | | | - Surya P Bhatt
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - David Couper
- University of North Carolina, Chapel Hill, NC, USA
| | | | - Neal D Freedman
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | | | | | | | | | - Stephanie J London
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
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Leavens ELS, Stevens EM, Brett EI, Hébert ET, Villanti AC, Pearson JL, Wagener TL. JUUL electronic cigarette use patterns, other tobacco product use, and reasons for use among ever users: Results from a convenience sample. Addict Behav 2019; 95:178-183. [PMID: 30933713 DOI: 10.1016/j.addbeh.2019.02.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [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: 10/08/2018] [Revised: 02/04/2019] [Accepted: 02/13/2019] [Indexed: 12/31/2022]
Abstract
INTRODUCTION JUUL, an e-cigarette from PAX Labs, has captured 70% of the e-cigarette market. The current study examines JUUL use patterns and reasons for initiation in a large convenience sample of U.S. adults. METHODS Respondents were 979 U.S. adults registered on Amazon Mechanical Turk (MTurk) who reported ever using JUUL. Items included frequency/quantity of JUUL use, reasons for trying JUUL, flavor preferences, and use of other tobacco products. RESULTS The majority of participants reported only trying JUUL once or twice (59.5%), 29.2% reported regular nondaily use and 10.3% reported daily use. The average quantity of JUUL pod use was low in the overall sample (4 pods per month). Daily users reported using ~10 pods per month and engaging in 4-9 separate vaping sessions per day. The most frequently reported reasons for JUUL use were because friends were using it (26.5%), curiosity (20.5%), and similarity to a cigarette (7.7%). Approximately 26% of current JUUL users reported current exclusive JUUL use, while 56% reported using JUUL and another e-cigarette. Of the entire sample, 37.1% were former smokers. Of those, 14.9% were daily JUUL users, 21.4% were nondaily JUUL users, and 63.8% were JUUL triers. CONCLUSIONS This is the first study to examine patterns and reasons for use of the most popular e-cigarette on the market. In this convenience sample, nearly 40% of those who ever tried JUUL reported current daily or daily use. JUUL use may be associated with limited puffing patterns compared to earlier generation e-cigarettes. Research is needed to investigate if JUUL puffing patterns result in decreased exposure to potentially harmful non-nicotine e-liquid constituents compared to other e-cigarettes.
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Affiliation(s)
- Eleanor L S Leavens
- Oklahoma Tobacco Research Center, Oklahoma City, OK, United States of America; Oklahoma State University, Department of Psychology, Stillwater, OK, United States of America
| | - Elise M Stevens
- Oklahoma Tobacco Research Center, Oklahoma City, OK, United States of America
| | - Emma I Brett
- Oklahoma State University, Department of Psychology, Stillwater, OK, United States of America
| | - Emily T Hébert
- Oklahoma Tobacco Research Center, Oklahoma City, OK, United States of America
| | - Andrea C Villanti
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT, United States of America
| | - Jennifer L Pearson
- Division of Social and Behavioral Health/Health Administration, Policy, School of Community Health Sciences, University of Nevada, Reno, United States of America
| | - Theodore L Wagener
- Oklahoma Tobacco Research Center, Oklahoma City, OK, United States of America; University of Oklahoma Health Science Center, Department of Pediatrics, Oklahoma City, OK, United States of America.
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Abstract
IMPORTANCE In 2006, US District Judge Gladys Kessler ordered tobacco companies to make corrective statements through paid advertisements informing the public of their deceptive practices. This landmark ruling and its subsequent execution represent the first time the tobacco industry sponsored a nationwide corrective advertising campaign against its own products. OBJECTIVE To assess the reach of the court-ordered antismoking advertisements within the US adult population, stratified by demographic characteristics and tobacco use. DESIGN, SETTING, AND PARTICIPANTS This nationally representative, population-based cross-sectional survey of US adults included respondents to the 2018 Health Information National Trends Survey 5, Cycle 2. Respondents were representatives of households selected by equal-probability sampling of the Marketing Systems Group database of addresses that included all nonvacant US residential addresses. Data collection was conducted from January to May 2018, and analysis took place from December 2018 to April 2019. MAIN OUTCOMES AND MEASURES Self-reported exposure to court-ordered antismoking advertisements. RESULTS The overall sample of 3484 respondents included 2054 women (weighted percentage, 50.8%), 1976 non-Hispanic white respondents (weighted percentage, 59.9%), 2952 respondents who lived in urban US areas (weighted percentage, 84.9%), and 450 current smokers (weighted percentage, 15.6%). Estimated exposure to court-ordered antismoking advertisements was 40.6% (95% CI, 37.5%-43.7%) among the full sample and 50.5% (95% CI, 41.4%-59.6%) among current smokers. Exposure was lowest among those aged 18 to 34 years (37.4%; 95% CI, 28.0%-46.8%), those with a high school education or less (34.5%; 95% CI, 29.3%-39.8%), and those with household annual income less than $35 000 (37.5%; 95% CI, 32.0%-42.9%). Among current smokers, Hispanic respondents had lower exposure rates (42.2%; 95% CI, 18.5%-65.9%) than non-Hispanic white respondents (51.7%; 95% CI, 40.4%-63.1%). As the advertising campaign's duration increased, exposure rates increased. Individuals with a high school education or less had lower odds of antismoking advertisement exposure than those with college or postgraduate degrees (adjusted odds ratio, 0.67; 95% CI, 0.48-0.94). Current smokers had higher odds of exposure than never smokers (adjusted odds ratio, 1.81; 95% CI, 1.17-2.80). Among those exposed to antismoking advertisements, 70.5% saw multiple antismoking messages. CONCLUSIONS AND RELEVANCE Approximately 1 of 2 smokers reported exposure to the federal court-ordered antismoking advertisements. However, exposure was relatively lower among several subgroups, including individuals aged 18 to 34 years, only one-third of whom reported exposure. Increasing the duration of antismoking advertisements as well as expanding their coverage to youth-oriented media may increase their potential public health impact.
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Affiliation(s)
| | - Robert K. Yu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston
| | - Israel Agaku
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Sanjay Shete
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston
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Jee Y, Jung KJ, Lee S, Back JH, Jee SH, Cho SI. Smoking and atherosclerotic cardiovascular disease risk in young men: the Korean Life Course Health Study. BMJ Open 2019; 9:e024453. [PMID: 31196897 PMCID: PMC6575821 DOI: 10.1136/bmjopen-2018-024453] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 02/16/2019] [Accepted: 02/21/2019] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To examine the effect of smoking on risk of atherosclerotic cardiovascular disease (ASCVD) in Korean young men and to examine whether serum total cholesterol levels could modify the effect of smoking on ASCVD. DESIGN A prospective cohort study within a national insurance system. SETTING Health screenings provided by national insurance in 1992 and 1994. PARTICIPANTS A total of 118 531 young men between 20 and 29 years of age and were followed up for an average of 23 years. OUTCOME MEASURE To assess the independent effects of smoking on the risk of ischaemic heart disease (IHD), stroke and ASCVD, Cox proportional hazards regression models were used, controlling for age, hypertension, diabetes, hypercholesterolaemia and alcohol drinking. RESULTS The total number of current smokers was 78 455 (66.2%), and 94 113 (79.7%) of the sample recorded a total cholesterol level <200 mg/dL measured at baseline. Between 1993 and 2015, 2786 cases of IHD (53/100 000 person year), 2368 cases of stroke (45.4/100 000 person year) and 6368 ASCVD (122.7/100 000 person year) occurred. The risk of IHD, stroke and total ASCVD events was found to increase for current smokers, with a HR with 95% CI of 1.5 (95% CI 1.3 to 1.6), 1.4 (95% CI 1.2 to 1.6) and 1.4 (95% CI 1.3 to 1.5), respectively. Furthermore, the risks above were also found throughout the range of serum levels of cholesterol. CONCLUSIONS Smoking among Korean young adult men was independently associated with increased risk of IHD, stroke and ASCVD. The concentration of cholesterol in Korean men did not modify the effect of smoking on ASCVD.
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Affiliation(s)
- Yongho Jee
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, The Republic of Korea
| | - Keum Ji Jung
- Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, The Republic of Korea
| | - Sunmi Lee
- Health Insurance Policy Research Institute, National Health Insurance Service, Wonju, Gangwon-do, The Republic of Korea
| | - Joung Hwan Back
- Wonju Gangwon-do, The Republic of Korea Wonju Gangwon-do, The Republic of Korea Health Insurance Policy Research Institute, National Health Insurance Service, Wonju Gangwon-do, The Republic of Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, The Republic of Korea
| | - Sung-Il Cho
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, The Republic of Korea
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Young JT, Puljević C, Love AD, Janca EK, Segan CJ, Baird D, Whiffen R, Pappos S, Bell E, Kinner SA. Staying Quit After Release (SQuARe) trial protocol: a randomised controlled trial of a multicomponent intervention to maintain smoking abstinence after release from smoke-free prisons in Victoria, Australia. BMJ Open 2019; 9:e027307. [PMID: 31167867 PMCID: PMC6561422 DOI: 10.1136/bmjopen-2018-027307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Smoke-free policies have been introduced in prisons internationally. However, high rates of relapse to smoking after release from prison indicate that these policies typically result in short-term smoking cessation only. These high rates of relapse, combined with a lack of investment in relapse prevention, highlight a missed opportunity to improve the health of a population who smoke tobacco at two to six times the rate of the general population. This paper describes the rationale and design of a randomised controlled trial, testing the effectiveness of a caseworker-delivered intervention promoting smoking cessation among former smokers released from smoke-free prisons in Victoria, Australia. METHODS AND ANALYSIS The multicomponent, brief intervention consists of behavioural counselling, provision of nicotine spray and referral to Quitline and primary care to promote use of government-subsidised smoking cessation pharmacotherapy. The intervention is embedded in routine service delivery and is administered at three time points: one prerelease and two postrelease from prison. Control group participants will receive usual care. Smoking abstinence will be assessed at 1 and 3 months postrelease, and confirmed with carbon monoxide breath testing. Linkage of participant records to survey and routinely collected administrative data will provide further information on postrelease use of health services and prescribed medication. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Corrections Victoria Research Committee, the Victorian Department of Justice Human Research Ethics Committee, the Department of Human Services External Request Evaluation Committee and the University of Melbourne Human Research Ethics Committee. Results will be submitted to major international health-focused journals. In case of success, findings will assist policymakers to implement urgently needed interventions promoting the maintenance of prison-initiated smoking abstinence after release, to reduce the health disparities experienced by this marginalised population. TRIAL REGISTRATION NUMBER ACTRN12618000072213; Pre-results.
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Affiliation(s)
- Jesse T Young
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, The University of Melbourne, Melbourne, Victoria, Australia
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Cheneal Puljević
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Health Services Research, University of Queensland, Brisbane, Queensland, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
| | - Alexander D Love
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Emilia K Janca
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Catherine J Segan
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Donita Baird
- Cancer Council Victoria, Melbourne, Victoria, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
| | | | - Stan Pappos
- Australian Community Support Organisation, Richmond, Victoria, Australia
| | - Emma Bell
- Australian Community Support Organisation, Richmond, Victoria, Australia
| | - Stuart A Kinner
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, The University of Melbourne, Melbourne, Victoria, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Mater Research Institute-UQ, The University of Queensland, Brisbane, Queensland, Australia
- Netherlands Institute for the Study of Crime and Law Enforcement, Amsterdam, The Netherlands
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18
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Bearez C, Puszkarek T, Couturier C, Rochoy M. [Are abdominal aortic aneurysm screening guidelines followed? Prospective study in Dunkerque's hospital emergency room]. Ann Cardiol Angeiol (Paris) 2019; 68:155-161. [PMID: 30691680] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 09/07/2018] [Indexed: 06/09/2023]
Abstract
AIM OF THE STUDY Are the recommendations issued by the Haute Autorité de santé in 2012 on screening for abdominal aortic aneurysm (AAA) being applied? METHOD We interviewed the target patients, ex. male patients aged 65 to 75, smokers or former smokers, or as young as 50 in the event of a family history of AAA in the parents or siblings, entering the emergency room of Dunkerque between May 7 and December 31, 2015. We asked them if they had had an abdominal aortic ultrasound, or an abdominal ultrasound, or an arterial Doppler ultrasound of the lower limbs, and when, to see if they had had an AAA test since November 2012. RESULTS We included 55 patients and excluded 5 of 180 eligible patients (31 %). It was not possible to conclude for 4 patients due to missing data. Thirteen of 46 patients (28.3 %, 95 % CI [16.0-43.5]) have had AAA ultrasound screening since November 2012; 33 have not (71.7 %, 95 % CI [56.5-84.0]) and no screening was offered. Of the 13 patients screened, 7 were screened by the attending physician (53.9 %, 95 % CI [25.1-80.8]) and 6 by another specialist (46.2 %, 95 % CI [19.2-74.9]). CONCLUSION AAA screening in our population is low. Physicians should be urged to publicize and implement the November 2012 French recommendations to reduce AAA-related mortality.
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Affiliation(s)
- C Bearez
- Département de médecine générale, faculté de médecine, Université Lille, 59000 Lille, France
| | - T Puszkarek
- Département de médecine générale, faculté de médecine, Université Lille, 59000 Lille, France
| | - C Couturier
- Service des urgences, centre hospitalier de Dunkerque, 130 avenue Louis Herbeaux, 59240 Dunkerque, France
| | - M Rochoy
- Département de médecine générale, faculté de médecine, Université Lille, 59000 Lille, France.
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Abstract
OBJECTIVES Recently, the Tokyo Metropolitan Assembly passed an ordinance prohibiting smoking in private homes and cars if children are present. However, no previous study has investigated existing, voluntary home and car smoke-free rules in Japan. Therefore, we examined prevalence and determinants of comprehensive home and car smoke-free rules. DESIGN A cross-sectional study. SETTING Internet survey data with adjustments using inverse probability weighting for 'being a respondent in an internet survey'. PARTICIPANTS 5600 respondents aged 15-69 years in 2015 were analysed to estimate weighted percentages and prevalence ratios (PRs) with 95% CIs of having comprehensive home and car smoke-free rules. MAIN OUTCOME MEASURES Respondents who answered 'smoking is never allowed' in their home and car were defined as having home and car smoke-free rules. RESULTS Overall, 47.0% (95% CI=45.8% to 48.3%) of respondents implemented comprehensive home and car smoke-free rules. People who agreed with 'smoking relieves stress' were less likely to have comprehensive smoke-free rules (PR=0.76, 0.71 to 0.82), especially among ever-users of electronic nicotine delivery systems (PR=0.49, 0.30 to 0.81). Higher education was significantly associated with higher PR for comprehensive smoke-free rules (PR=1.30, 1.19 to 1.41). Living with children was significantly associated with higher PR for smoke-free rules among current smokers than not living with children (PR=2.91, 1.99 to 4.27). CONCLUSIONS In Japan, about 50% of respondents had voluntary smoke-free rules in the home and car. Information on current voluntary smoke-free rules will be useful as baseline information on home and car smoke-free status before enforcement of the 2018 Tokyo home and car smoke-free legislation.
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Affiliation(s)
- Kensaku Shojima
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Osaka, Japan
- General Internal Medicine, Hashimoto Municipal Hospital, Hashimoto, Wakayama, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Osaka, Japan
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20
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Muller DC, Larose TL, Hodge A, Guida F, Langhammer A, Grankvist K, Meyer K, Cai Q, Arslan AA, Zeleniuch-Jacquotte A, Albanes D, Giles GG, Sesso HD, Lee IM, Gaziano JM, Yuan JM, Hoffman Bolton J, Buring JE, Visvanathan K, Le Marchand L, Purdue MP, Caporaso NE, Midttun Ø, Ueland PM, Prentice RL, Weinstein SJ, Stevens VL, Zheng W, Blot WJ, Shu XO, Zhang X, Xiang YB, Koh WP, Hveem K, Thomson CA, Pettinger M, Engström G, Brunnström H, Milne RL, Stampfer MJ, Han J, Johansson M, Brennan P, Severi G, Johansson M. Circulating high sensitivity C reactive protein concentrations and risk of lung cancer: nested case-control study within Lung Cancer Cohort Consortium. BMJ 2019; 364:k4981. [PMID: 30606716 PMCID: PMC6315896 DOI: 10.1136/bmj.k4981] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To conduct a comprehensive analysis of prospectively measured circulating high sensitivity C reactive protein (hsCRP) concentration and risk of lung cancer overall, by smoking status (never, former, and current smokers), and histological sub-type. DESIGN Nested case-control study. SETTING 20 population based cohort studies in Asia, Europe, Australia, and the United States. PARTICIPANTS 5299 patients with incident lung cancer, with individually incidence density matched controls. EXPOSURE Circulating hsCRP concentrations in prediagnostic serum or plasma samples. MAIN OUTCOME MEASURE Incident lung cancer diagnosis. RESULTS A positive association between circulating hsCRP concentration and the risk of lung cancer for current (odds ratio associated with a doubling in hsCRP concentration 1.09, 95% confidence interval 1.05 to 1.13) and former smokers (1.09, 1.04 to 1.14) was observed, but not for never smokers (P<0.01 for interaction). This association was strong and consistent across all histological subtypes, except for adenocarcinoma, which was not strongly associated with hsCRP concentration regardless of smoking status (odds ratio for adenocarcinoma overall 0.97, 95% confidence interval 0.94 to 1.01). The association between circulating hsCRP concentration and the risk of lung cancer was strongest in the first two years of follow-up for former and current smokers. Including hsCRP concentration in a risk model, in addition to smoking based variables, did not improve risk discrimination overall, but slightly improved discrimination for cancers diagnosed in the first two years of follow-up. CONCLUSIONS Former and current smokers with higher circulating hsCRP concentrations had a higher risk of lung cancer overall. Circulating hsCRP concentration was not associated with the risk of lung adenocarcinoma. Circulating hsCRP concentration could be a prediagnostic marker of lung cancer rather than a causal risk factor.
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Affiliation(s)
- David C Muller
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
- Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - Tricia L Larose
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
- KG Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Allison Hodge
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Florence Guida
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Arnulf Langhammer
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Levanger, Norway
| | - Kjell Grankvist
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | | | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Alan A Arslan
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA
- Department of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Anne Zeleniuch-Jacquotte
- Department of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Graham G Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Howard D Sesso
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Division of Aging, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - I-Min Lee
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - J Michael Gaziano
- Division of Aging, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Boston VA Medical Center, Boston, MA, USA
| | - Jian-Min Yuan
- UPMC Hillman Cancer Center, University of Pittsburgh, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, USA
| | - Judith Hoffman Bolton
- George W Comstock Center for Public Health Research and Prevention Health Monitoring Unit, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Julie E Buring
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Kala Visvanathan
- George W Comstock Center for Public Health Research and Prevention Health Monitoring Unit, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Loic Le Marchand
- Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii, Honolulu, HI, USA
| | - Mark P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Neil E Caporaso
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | | | - Per M Ueland
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | - Ross L Prentice
- Division of Public Health Sciences Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Victoria L Stevens
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - William J Blot
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Yong-Bing Xiang
- State Key Laboratory of Oncogene and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | | | - Kristian Hveem
- KG Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Levanger, Norway
| | - Cynthia A Thomson
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Mary Pettinger
- Division of Public Health Sciences Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Gunnar Engström
- Department of Clinical Science in Malmö, Lund University, Malmö, Sweden
| | - Hans Brunnström
- Pathology, Department of Clinical Sciences Lund, Laboratory Medicine Region Skåne, Lund University, Lund, Sweden
| | - Roger L Milne
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Meir J Stampfer
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Jiali Han
- Department of Epidemiology, Richard M Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
- Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, IN, USA
| | | | - Paul Brennan
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Gianluca Severi
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Italian Institute for Genomic Medicine (IIGM), Torino, Italy
- Centre de Recherche en Epidemiologie et Santé des Populations (CESP) UMR1018 Inserm, Facultés de Médicine Université Paris-Saclay, UPS, UVSQ, Villejuif, France
| | - Mattias Johansson
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
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Gavilán E, Moreno M, Pérez À, Castellano Y, Fernández E, Martínez C. Pre-surgical register of tobacco consumption. Med Clin (Barc) 2018; 151:315-319. [PMID: 29588061 DOI: 10.1016/j.medcli.2018.01.028] [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: 10/27/2017] [Revised: 01/05/2018] [Accepted: 01/11/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION AND OBJECTIVE Smoking cessation before surgery decreases the risk of complications. The aim of this study was to analyse the smoking register, associated variables and a short talk given to smokers in pre-surgical visits. MATERIAL AND METHOD Cross-sectional study. The pre-surgical records of 680 patients were assessed. We selected patient sociodemographic variables, surgical intervention characteristics, smoking status and consumption pattern. Logistic regression was used to study the variables association with smoking. RESULTS A percentage of 97.2 of the pre-surgical records include information on tobacco consumption. Overall 20% of surgical patients are smokers. The probability of smoking is higher among men (adjusted odds ratio [aOR] 2.6, 95% confidence interval [CI] 1.7-4.0) and≤60 years (aOR 5.4, 95% CI 3.2-9.1). None of the records had information regarding a short talk given to patients to give up smoking. CONCLUSION Smoking consumption was prevalent, but the characterisation of a smoker's profile and short talk given to patient before surgery was practically nonexistent. Ensuring that patients who smokes receives a short talk to give up smoking before surgery is necessary.
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Affiliation(s)
- Eva Gavilán
- Hospital General Vall d'Hebron, Barcelona, España; Facultad de Medicina y Ciencias de la Salud, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España; Unidad de Control de Tabaquismo, Programa de Prevención y Control del Cáncer, Institut Català d'Oncologia (ICO)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España
| | - Montse Moreno
- Servicio de Prevención, Hospital Sant Joan de Déu de Martorell, Martorell, Barcelona, España
| | - Àngels Pérez
- Control de la Infección, Hospital Sant Joan de Déu de Martorell, Martorell, Barcelona, España
| | - Yolanda Castellano
- Unidad de Control de Tabaquismo, Programa de Prevención y Control del Cáncer, Institut Català d'Oncologia (ICO)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España
| | - Esteve Fernández
- Unidad de Control de Tabaquismo, Programa de Prevención y Control del Cáncer, Institut Català d'Oncologia (ICO)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Grupo de Prevención y Control del Cáncer, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Departamento de Ciencias Clínicas, Facultad de Medicina y Ciencias de la Salud, Campus de Bellvitge, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
| | - Cristina Martínez
- Facultad de Medicina y Ciencias de la Salud, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España; Unidad de Control de Tabaquismo, Programa de Prevención y Control del Cáncer, Institut Català d'Oncologia (ICO)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Grupo de Prevención y Control del Cáncer, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Departamento de Salud Pública, Salud Mental y Perinatal, Facultad de Medicina y Ciencias de la Salud, Campus de Bellvitge, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España.
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Petrelli A, Giorgi Rossi P, Francovich L, Giordani B, Di Napoli A, Zappa M, Mirisola C, Gargiulo L. Geographical and socioeconomic differences in uptake of Pap test and mammography in Italy: results from the National Health Interview Survey. BMJ Open 2018; 8:e021653. [PMID: 30232106 PMCID: PMC6150150 DOI: 10.1136/bmjopen-2018-021653] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The Italian National Health Service instituted cervical and breast cancer screening programmes in 1999; the local health authorities have a mandate to implement these screening programmes by inviting all women aged 25-64 years for a Pap test every 3 years (or for an Human Papilloma Virus (HPV) test every 5 years) and women aged 50-69 years for a mammography every 2 years. However, the implementation of screening programmes throughout the country is still incomplete. This study aims to: (1) describe cervical and breast cancer screening uptake and (2) evaluate geographical and individual socioeconomic difference in screening uptake. METHODS Data both from the Italian National Health Interview Survey (NHIS) conducted by the National Institute of Statistics in 2012-2013 and from the Italian National Centre for Screening Monitoring (INCSM) were used. The NHIS interviewed a national representative random sample of 32 831 women aged 25-64 years and of 16 459 women aged 50-69 years. Logistic multilevel models were used to estimate the effect of socioeconomic variables and behavioural factors (level 1) on screening uptake. Data on screening invitation coverage at the regional level, taken from INCSM, were used as ecological (level 2) covariates. RESULTS Total 3-year Pap test and 2-year mammography uptake were 62.1% and 56.4%, respectively; screening programmes accounted for 1/3 and 1/2 of total test uptake, respectively. Strong geographical differences were observed. Uptake was associated with high educational levels, healthy behaviours, being a former smoker and being Italian versus foreign national. Differences in uptake between Italian regions were mostly explained by the invitation coverage to screening programmes. CONCLUSIONS The uptake of both screening programmes in Italy is still under acceptable levels. Screening programme implementation has the potential to reduce the health inequalities gap between regions but only if uptake increases.
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Affiliation(s)
- Alessio Petrelli
- Epidemiology Unit, National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, AUSL Reggio Emilia, Reggio Emilia, Italy
- Epidemiology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Lisa Francovich
- Direzione centrale delle statistiche socio-demografiche e ambientale, National Institute of Statistics (Istat), Rome, Lazio, Italy
| | - Barbara Giordani
- Epidemiology Unit, Local Health Authority TO3, Grugliasco, Piemonte, Italy
| | - Anteo Di Napoli
- Epidemiology Unit, National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | - Marco Zappa
- Institute for Cancer Research and Prevention (ISPO), Italian National Screening Monitoring Centre, Florence, Italy
| | - Concetta Mirisola
- Epidemiology Unit, National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | - Lidia Gargiulo
- Direzione centrale delle statistiche socio-demografiche e ambientale, National Institute of Statistics (Istat), Rome, Lazio, Italy
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Abstract
OBJECTIVES To examine the association between neighbourhood deprivation and lung cancer risk. DESIGN Nested case-control study. SETTING Southern Community Cohort Study of persons residing in 12 states in the southeastern USA. PARTICIPANTS 1334 cases of lung cancer and 5315 controls. PRIMARY OUTCOME MEASURE Risk of lung cancer. RESULTS After adjustment for smoking status and other confounders, and additional adjustment for individual-level measures of socioeconomic status (SES), there was no monotonic increase in risk with worsening deprivation score overall or within sex and race groups. There was an increase among current and shorter term former smokers (p=0.04) but not among never and longer term former smokers. There was evidence of statistically significant interaction by sex among whites, but not blacks, in which the effect of worsening deprivation on lung cancer existed in males but not in females. CONCLUSIONS Area-level measures of SES were associated with lung cancer risk in current and shorter term former smokers only in this population.
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Affiliation(s)
- Maureen Sanderson
- Department of Family and Community Medicine, Meharry Medical College, Nashville, Tennessee, USA
| | - Melinda C Aldrich
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Robert S Levine
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Barbara Kilbourne
- Department of Sociology, Tennessee State University, Nashville, Tennessee, USA
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - William J Blot
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
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Madiyal A, Ajila V, Babu SG, Hegde S, Kumari S, Madi M, Achalli S, Alva P, Ullal H. Status of thiocyanate levels in the serum and saliva of non-smokers, ex-smokers and smokers. Afr Health Sci 2018; 18:727-736. [PMID: 30603006 PMCID: PMC6307002 DOI: 10.4314/ahs.v18i3.31] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Use of tobacco is often implicated in the development of oral diseases. Questionable accuracy of the traditional questionnaires to assess cigarette exposure necessitates the use of biomarkers like thiocyanate which provide a definitive quantitative measure. OBJECTIVE To assess the rise in the level of thiocyanate for measurement of smoking behaviour in adults. MATERIALS AND METHODS Serum and salivary thiocyanate levels were estimated in 20 non-smokers, 20 ex-smokers and 40 smokers. Smokers were divided into two groups based on the presence or absence of oral mucosal lesions. RESULTS The mean serum and salivary thiocyanate levels were increased significantly in smokers when compared to non-smokers and ex-smokers. The levels were not significantly different between ex-smokers and non-smokers and between smokers with tobacco related oral mucosal lesions and those without. Statistically significant correlation was seen between the serum and salivary levels of thiocyanate. CONCLUSION This study highlights the high level of thiocyanate in the serum and saliva of smokers when compared to non-smokers and ex-smokers. Significant increase in thiocyanate level was also seen in saliva. Hence it can be stated that saliva can be used as a reliable, non-invasive tool to assess smoking behaviour in the population and its changes over time.
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Affiliation(s)
- Ananya Madiyal
- A. B. Shetty Memorial Institute of Dental Sciences, Nitte deemed to be University, Oral. Medicine and Radiology
| | - Vidya Ajila
- A. B. Shetty Memorial Institute of Dental Sciences, Nitte deemed to be University, Oral. Medicine and Radiology
| | - Subhas G Babu
- A. B. Shetty Memorial Institute of Dental Sciences, Nitte deemed to be University, Oral. Medicine and Radiology
| | - Shruthi Hegde
- A. B. Shetty Memorial Institute of Dental Sciences, Nitte deemed to be University, Oral. Medicine and Radiology
| | - Suchetha Kumari
- K. S. Hegde Medical Academy, Nitte deemed to be University, Biochemistry
| | - Medhini Madi
- Manipal College of Dental sciences, Manipal, Oral Medicine and Radiology
| | - Sonika Achalli
- A. B. Shetty Memorial Institute of Dental Sciences, Nitte deemed to be University, Oral. Medicine and Radiology
| | | | - Harshini Ullal
- K. S. Hegde Medical Academy, Nitte deemed to be University, Biochemistry
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25
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Nakano H, Ohira T, Maeda M, Yabe H, Ohtsuru A, Suzuki Y, Harigane M, Horikoshi N, Nagai M, Zhang W, Takahashi H, Yasumura S, Iso H, Kamiya K. Associations of disaster-related and psychosocial factors with changes in smoking status after a disaster: a cross-sectional survey after the Great East Japan Earthquake. BMJ Open 2018; 8:e018943. [PMID: 29961000 PMCID: PMC6135429 DOI: 10.1136/bmjopen-2017-018943] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Few studies have comprehensively examined changes in smoking status and related factors after a disaster. We examined these factors among residents of an evacuation area in Fukushima after the Great East Japan Earthquake. METHODS The study participants included 58 755 men and women aged ≥20 years who participated in the Fukushima Health Management Survey in 2012 after the disaster. Smoking status was classified as either current smokers or current non-smokers before and after the disaster. The participants were divided into the following groups: (1) non-smokers both before and after the disaster, (2) non-smokers before and smokers after the disaster, (3) smokers before and non-smokers after the disaster and (4) smokers both before and after the disaster. The adjusted prevalence ratios and 95% CIs of changes in smoking status for demographic, disaster-related and psychosocial factors were tested using logistic regression analysis that was stratified by smoking status before the disaster. RESULTS Among the 44 729 participants, who were non-smokers before the disaster, 634 (1.4%) began smoking after the disaster. Among the 14 025 smokers before the disaster, 1564 (11.1%) quit smoking after the disaster, and the proportion of smokers in the evacuation area consequently decreased from 21.2% to 19.6%. In the multivariable model, factors significantly associated with beginning smoking included being a male, being younger, having a lower education, staying in a rental house/apartment, house being damaged, having experienced a tsunami, change jobs and the presence of traumatic symptoms and non-specific psychological distress. On the contrary, factors associated with quitting smoking included being a female, being older, having a higher education and having a stable income. CONCLUSION The proportion of smokers slightly decreased among residents in the evacuation area. The changes in smoking statuses were associated with disaster-associated psychosocial factors, particularly changes in living conditions, having experienced a tsunami, change jobs and developing post-traumatic stress disorder.
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Affiliation(s)
- Hironori Nakano
- Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Disaster Psychiatry, Fukushima Medical University, Fukushima, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Akira Ohtsuru
- Department of Radiation Health Management, Fukushima Medical University, Fukushima, Japan
| | - Yuriko Suzuki
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Mayumi Harigane
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Naoko Horikoshi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Masato Nagai
- Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Wen Zhang
- Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
| | - Hideto Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Seiji Yasumura
- Department of Public Health, Fukushima Medical University, Fukushima, Japan
| | - Hiroyasu Iso
- Public Health Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
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