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Loh SM, Moloantoa T, Yende N, Variava E, Niaura R, Golub JE, Martinson N, Elf JL. A cross-sectional study of attitudes and behaviors of snuff use and cessation among people with and without HIV in South Africa. Tob Use Insights 2023; 16:1179173X231193890. [PMID: 37577008 PMCID: PMC10422901 DOI: 10.1177/1179173x231193890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/25/2023] [Indexed: 08/15/2023] Open
Abstract
Background Despite a high (48%) prevalence of snuff use among women with HIV in South Africa, little is known of the attitudes and behaviors of use, strategies for cessation, and potential health risks. Methods In a cross-sectional study, a questionnaire was administered to adults (≥18 years) with (HIV+) and without HIV (HIV-) who self-reported current snuff use to collect information on demographics, snuff use and cessation attempts, preferred strategies for cessation, other substance use, history of respiratory illness, and mental health. Results 150 (74 HIV+, 76 HIV-) participants were enrolled; 115 (77%) were daily snuff users, 6 (4%) were current smokers, and 17 (11%) former smokers. Top reasons for current snuff use included improving health (n = 48, 32%), reducing stress (n = 26, 16%), and "being a habit" (n = 38, 25%). Participants believed snuff use to have mostly positive (n = 68, 46%) or no (n = 54, 36%) health impacts, and 57 (38%) participants believed snuff cures headaches. 103 (69%) participants reported a previous quit attempt, and 110 (73%) indicated high interest in quitting snuff. Although 105 (70%) participants indicated that advice from a healthcare provider would aid them in quitting snuff, only 30 (20%) reported ever receiving that advice. A majority of participants (n = 141, 94%) suffer from moderate to high levels of perceived stress, and overall few differences were seen by HIV status. Conclusions Education on negative impacts of snuff, advice to quit from healthcare providers, and nicotine replacement therapy should be considered in the development of a snuff cessation program.
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Affiliation(s)
- Samantha M. Loh
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | | | | | - Ebrahim Variava
- Department of Internal Medicine, Klerksdorp Tshepong Hospital Complex, Matlosana, South Africa
| | - Raymond Niaura
- Department of Epidemiology; Department of Social and Behavioral Sciences, New York University, New York, NY, USA
| | - Jonathan E. Golub
- Department of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Jessica L. Elf
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
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Caspersen IH, Trogstad L, Galanti MR, Karvonen S, Peña S, Shaaban AN, Håberg SE, Magnus P. Current tobacco use and SARS-CoV-2 infection in two Norwegian population-based cohorts. BMC Public Health 2023; 23:846. [PMID: 37165385 PMCID: PMC10170041 DOI: 10.1186/s12889-023-15822-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/05/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Clear evidence of an increased risk for SARS-CoV-2 infection among smokers has not been established. We aimed to investigate associations between cigarette smoking or use of snus (snuff) and other nicotine-containing products and a positive SARS-CoV-2 test, taking test behavior into account. METHODS Current tobacco use and testing behavior during the pandemic were recorded by adult participants from the Norwegian Mother, Father and Child Cohort Study and The Norwegian Influenza Pregnancy Cohort. SARS-CoV-2 infection status was obtained from The Norwegian Surveillance System for Communicable Diseases (MSIS) in May 2021 (n = 78,860) and antibody measurements (n = 5581). We used logistic regression models stratified by gender and adjusted for age, education, region, number of household members, and work situation. RESULTS Snus use was more common among men (26%) than women (9%) and more prevalent than cigarette smoking. We found no clear associations between cigarette smoking or snus and a COVID-19 diagnosis among men. Associations among women were conflicting, indicating that cigarette smoke was negatively associated with a diagnosis (OR 0.51, 95% CI 0.35, 0.75), while no association was found for snus use (OR 1.07, 95% CI 0.86, 1.34). Compared with non-users of tobacco, both cigarette smokers and snus users had increased odds of being tested for SARS-CoV-2. CONCLUSIONS Cigarette smoking, but not snus use, was negatively associated with SARS-CoV-2 infection in women. The lack of an association between snus use and SARS-CoV-2 infection in this population with prevalent snus use does not support the hypothesis of a protective effect of nicotine.
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Affiliation(s)
- Ida Henriette Caspersen
- Centre for Fertility and Health, Norwegian Institute of Public Health, Postbox 222 Skøyen, N-0213, Oslo, Norway.
| | - Lill Trogstad
- Department of Infectious Disease Epidemiology and Modelling, Norwegian Institute of Public Health, Postbox 222 Skøyen, N-0213, Oslo, Norway
| | - Maria Rosaria Galanti
- Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Region, Solnavägen 1E (Torsplan), 113 65, Stockholm, Sweden
| | - Sakari Karvonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Postbox 30, 00271, Helsinki, Finland
| | - Sebastián Peña
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Postbox 30, 00271, Helsinki, Finland
| | - Ahmed Nabil Shaaban
- Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Siri E Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Postbox 222 Skøyen, N-0213, Oslo, Norway
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Postbox 222 Skøyen, N-0213, Oslo, Norway
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Zahir R, Khan ZA, Aleem B, Ahmad S, Ali A, Issrani R, Alruwaili MK, Iqbal S, Alghumaiz SF, Alanazi SH, Umer MF, Ullah I, Sumera, Ganji KK. Association of High Immunohistochemical Expression of Minichromosome Maintenance 3 with Human Oral Squamous Cell Carcinoma-A Preliminary Study. Diagnostics (Basel) 2022; 13. [PMID: 36611359 DOI: 10.3390/diagnostics13010061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/06/2022] [Accepted: 11/10/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Oral squamous cell carcinoma (OSCC) may arise from premalignant oral lesions (PMOL) in most cases. Minichromosome maintenance 3 (MCM3) is a proliferative marker that has been investigated as a potential diagnostic biomarker in the diagnosis of oral cancer. OBJECTIVES To evaluate the association of MCM3 expression, its clinicopathologic parameters and to identify snuff (also called naswar) as a potential risk factor for changes in MCM3 expression in PMOL and OSCC. METHODOLOGY Immunohistochemistry (IHC) of MCM3 was performed on 32 PMOL, 32 OSCC and 16 normal controls after optimization of IHC methodology. Histoscore (0-300) was used as a scoring system and seven different cut-offs were identified for analyses. Data were analyzed using various statistical tests. RESULTS Among the seven cutoffs, 40% strong positive cells were found to be a better cut-off as they were associated with many pathological variables (Broder's grade, Aneroth's grade, and mitotic activity). The differential MCM3 expression in oral lesions (PMOL and OSCC) was statistically significant (p = 0.03). Moreover, MCM3 expression is raised with increased duration and frequency of snuff use. CONCLUSION High MCM3 expression is associated with disease progression and is a potential indicator of malignant transformations from PMOL to OSCC. Moreover, the use of snuff is associated with MCM3 over-expression.
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Skogsdal Y, Karlsson J, Tydén T, Patil S, Backman H. The association of smoking, use of snuff, and preconception alcohol consumption with spontaneous abortion: A population-based cohort study. Acta Obstet Gynecol Scand 2022; 102:15-24. [PMID: 36222196 PMCID: PMC9780718 DOI: 10.1111/aogs.14470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/29/2022] [Accepted: 09/20/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION It is unclear whether tobacco in early pregnancy and alcohol use preceding pregnancy are associated with spontaneous abortion. The purpose was to investigate if use of tobacco and/or alcohol is associated with spontaneous abortion among women attending antenatal care, and if age and body mass index (BMI) attenuate the risk. MATERIAL AND METHODS A population-based cohort study based on data from the Swedish Pregnancy Register. All pregnant women having had the first antenatal visit from January 2014 to July 2018 were included (n = 525 604). The register had information about smoking and use of snuff before and in early pregnancy, as well as data on alcohol habits before pregnancy, measured by the Alcohol Use Disorders Identification Test (AUDIT), a validated questionnaire. Logistic regression analysis was used to estimate the association between lifestyle factors and spontaneous abortion, and multiple imputation was used to impute missing data. RESULTS In total, 34 867 (6.6%) pregnancies ended in a spontaneous abortion after the first visit to maternal health care. At the first maternal healthcare visit, daily smoking was reported by 24 214 (5.1%), and 6403 (1.2%) used snuff. For 19 837 (4.2%) women, a high alcohol score was reported for the year preceding pregnancy. After adjusting for potential confounders and multiple imputation, use of tobacco was associated with spontaneous abortion; smoking 1-9 cigarettes/day (adjusted odds ratio [aOR] 1.11, 95% confidence interval [CI] 1.04-1.18), smoking 10 or more cigarettes/day (aOR 1.12, 95% CI 1.-1.26), and use of snuff (aOR 1.20, 95% CI 1.06-1.37). Higher AUDIT scores were not significantly associated with spontaneous abortion (AUDIT 6-9: aOR 1.03, 95% CI 0.97-1.10 and AUDIT 10 or more: aOR 1.07, 95% CI 0.94-1.22). Increasing maternal age showed the highest risk of spontaneous abortion from the age of 35, and BMI of 30 kg/m2 or more increased the risk. There were interactions between different lifestyle factors associated with spontaneous abortion that could either increase or decrease the risk of spontaneous abortion. CONCLUSIONS Smoking and use of snuff were associated with an increased risk of spontaneous abortion. The AUDIT scores preceding pregnancy were not associated with an increased risk of spontaneous abortion, which contradicts the results from previous studies.
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Affiliation(s)
- Yvonne Skogsdal
- Maternal Health Care Unit, Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
| | - Jan Karlsson
- University Health Care Research CenterFaculty of Medicine and Health, Örebro UniversityÖrebroSweden
| | - Tanja Tydén
- Department of Women's and Children's HealthAkademiska SjukhusetUppsalaSweden
| | - Snehal Patil
- Clinical Epidemiology and Biostatistics, School of Medical SciencesÖrebro UniversityÖrebroSweden
| | - Helena Backman
- Department of Obstetrics and Gynecology, Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
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5
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Kimblad A, Ollvik G, Lindh CH, Axelsson J. Decreased sperm counts in Swedish users of oral tobacco. Andrology 2022; 10:1181-1188. [PMID: 35642735 PMCID: PMC9543234 DOI: 10.1111/andr.13198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/29/2022] [Accepted: 05/06/2022] [Indexed: 11/29/2022]
Abstract
Background Smoke‐free tobacco via moist oral snuff (snus) is used daily in more than 20% of Swedish men. Negative effects of cigarette smoking on sperm parameters are well documented, unlike for snuff, despite relevance also for other smoke‐free nicotine products. Objectives We wanted to investigate whether reproductive parameters differed between users and non‐users of snuff, and whether the amount of snuff and nicotine exposure mattered. Materials and methods Men (n = 613) from the general population, recruited 2000–2010, were physically examined, answered questions on smoking and snuff use, and delivered urine, blood and semen samples. Sperm concentration, total sperm count, semen volume, percent morphologically normal and progressively motile sperm, and DNA fragmentation index (by the Sperm Chromatin Structure Assay) and reproductive hormones were analysed. Nicotine exposure was measured through urinary levels of cotinine. We used general linear models, with adjustments including cigarette smoking, and for semen parameters also abstinence time. Results After adjustments, total sperm count was 24% lower (P = 0.03) and testosterone 14% higher (P < 0.001) in 109 users of snuff than in non‐users, whereas cotinine was positively associated with testosterone and oestradiol (P < 0.001). Numbers of boxes of snuff used per week were associated with testosterone and FSH (P < 0.001). Discussion Applied to the general population, the consumption of smoke‐free tobacco by the use of snuff was associated with a lower sperm count and a higher testosterone, for which the extent seemed to play a role. Conclusions Independent of smoking, consumption of snuff was associated with lower total sperm count and different hormone levels. Applying these results to a reported association between sperm count and the chance of pregnancy, men who used snuff would have about a 10% lower chance of fathering a child.
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Affiliation(s)
- Agnes Kimblad
- Reproductive Medicine Centre, Skåne University Hospital Malmö, Sweden.,Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Gustav Ollvik
- Reproductive Medicine Centre, Skåne University Hospital Malmö, Sweden.,Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Jonatan Axelsson
- Reproductive Medicine Centre, Skåne University Hospital Malmö, Sweden.,Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden.,Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
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Sæther SMM, Askeland KG, Pallesen S, Erevik EK. Smoking and snus use among Norwegian students: Demographic, personality and substance use characteristics. Nordisk Alkohol Nark 2022; 38:141-160. [PMID: 35310004 PMCID: PMC8899072 DOI: 10.1177/1455072520980219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/23/2020] [Indexed: 12/23/2022] Open
Abstract
Background and aim: Smoking rates are decreasing in Norway while the use of snus has increased.
We aimed to investigate the co-occurrence of, and the socio-demographics,
personality and substance use characteristics associated with, student
smoking and snus use. Methods: Survey data were collected among students in higher education in Bergen,
Norway in 2015 (N = 11,236, response rate 39.4%).
Multinomial regression analyses comparing snus users and smokers to
non-users and non-smokers, respectively, on demographic, personality and
substance use variables were conducted. Regression analyses comparing
current dual users to current smokers and current snus users and comparing
daily smokers to daily snus users, on demographic, personality and substance
use variables were also conducted. Results: In total 67.9% of ever snus users identified themselves as non-smokers (past
and current). Several demographic, personality and substance use
characteristics associated with smoking and snus use were identified (all =
p < .05), some of which were common for both (e.g.,
use of cannabis) and some which were exclusively associated with either
smoking (e.g., neuroticism) or snus use (e.g., extroversion). Conclusion: The current study contributes with several novel findings regarding traits
associated with smoking and snus use. Though limited by a cross-sectional
design, the current findings may suggest that the group of students using
snus consists of a combination of previous smokers, students who would have
smoked if snus was not available and a new segment who may not have used
nicotine if snus was not available.
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Affiliation(s)
| | - Kristin Gärtner Askeland
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Ståle Pallesen
- University of Bergen, Bergen, Norway; and Optentia, the Vaal Triangle Campus of the North-West University, Vanderbijlpark, South-Africa
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7
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Nilsson D, Ohlsson B. Gastrointestinal Symptoms and Irritable Bowel Syndrome Are Associated With Female Sex and Smoking in the General Population and With Unemployment in Men. Front Med (Lausanne) 2021; 8:646658. [PMID: 34540857 PMCID: PMC8440854 DOI: 10.3389/fmed.2021.646658] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 07/12/2021] [Indexed: 12/12/2022] Open
Abstract
Background: The influence of daily life exposure on the gastrointestinal tract is not fully understood. This study aimed to examine associations between functional gastrointestinal symptoms and sociodemographic status and lifestyle habits in the general population. Methods: The Malmö Offspring Study (MOS) included 2,648 participants from the general population who had answered a questionnaire about sociodemographic status, lifestyle habits, medical health, and self-reported irritable bowel syndrome (IBS). The visual analog scale for IBS (VAS-IBS) was completed to assess gastrointestinal symptoms the past 2 weeks. Subjects with organic gastrointestinal diseases were excluded. Presence of self-reported IBS and gastrointestinal symptoms the past 2 weeks were used as dependent variables to study the associations with age, sex, body mass index, education, occupation, marital status, smoking, snuff using, alcohol drinking frequency, alcohol amount per drinking occasion, physical activity at work, and physical activity during leisure time, using logistic regression and generalized linear model. Results: Self-reported IBS was associated with gastrointestinal symptoms the past 2 weeks (p < 0.001). There was an association between IBS and female sex (p < 0.001), former smoking (p < 0.001), present smoking (p < 0.001), and an inverse association with drinking 3-4 standard glasses per occasion (p = 0.038). Gastrointestinal symptoms were associated with age 50-59 years (p = 0.009), ≥60 years (p = 0.004), female sex (p < 0.001), studying (p = 0.036), unemployment (p = 0.009), former smoking (p = 0.001), and present smoking (p = 0.012). In men, IBS was associated with middle-age and both IBS and gastrointestinal symptoms were associated with unemployment (p < 0.001 and p = 0.001, respectively). In women, IBS was associated with present smoking (p = 0.022), and gastrointestinal symptoms were associated with former smoking and inversely associated with higher age (p = 0.006) and intermediate physical activity at work (p = 0.008). No associations were found with BMI, education, marital status, or snuff using. Conclusion: Self-reported IBS in the general population shows strongest association with female sex and smoking, whereas gastrointestinal symptoms also are associated with unemployment and inversely associated with higher age. In men, both IBS and gastrointestinal symptoms are associated with unemployment. In women, both IBS and gastrointestinal symptoms are associated with smoking, whereas symptoms are inversely associated with higher age and intermediate physical activity.
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Affiliation(s)
| | - Bodil Ohlsson
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
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8
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Gossin M, Gmel G, Studer J, Saubade M, Clair C. The Association between Type and Intensity of Sport and Tobacco or Nicotine Use-A Cross-Sectional Study among Young Swiss Men. Int J Environ Res Public Health 2020; 17:ijerph17228299. [PMID: 33182675 PMCID: PMC7696790 DOI: 10.3390/ijerph17228299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/01/2020] [Accepted: 11/04/2020] [Indexed: 11/16/2022]
Abstract
The objective of this study was to assess the association between tobacco/nicotine use and type and intensity of sport. Data were drawn from the second follow-up of the Cohort Study on Substance Use Risk Factors. Young Swiss men completed a questionnaire about tobacco/nicotine use (cigarette, vaping, snus, snuff), type and intensity of sport and other demographic and medical variables. Among the 5414 included participants (mean age 25.5), 3434 (63.4%) reported regularly practicing a sport. They had a lower rate of cigarette smoking (32.3%) compared with participants not practicing a sport (44.6%) but a higher rate of snus use (15.0% vs. 10.0%). In adjusted models, individual-sport participants were less likely to use snus and snuff (OR = 0.63, 95% CI = 0.51–0.77 and OR = 0.73, 95% CI = 0.61–0.88), compared with team-sport participants. The association was inversed for vaping users (OR = 1.54, 95% CI = 1.03–2.30). Furthermore, participants who practiced high-intensity sports had a lower likelihood to smoke cigarettes (OR = 0.63, 95% CI = 0.52–0.78) compared with low-intensity sports. Our findings suggest that type and intensity of sport are associated with tobacco/nicotine use. Youth who practice an individual sport are less likely to use snus or snuff and more likely to vape compared with a team sport. This could help better target smoking prevention in young people
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Affiliation(s)
- Marine Gossin
- Department of Training, Research and Innovation, Center for Primary Care and Public Health (Unisanté), University of Lausanne, 1010 Lausanne, Switzerland;
- Correspondence:
| | - Gerhard Gmel
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; (G.G.); (J.S.)
- Research Department, Addiction Switzerland, 1001 Lausanne, Switzerland
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON M5S 2S1, Canada
- Department of Health and Social Sciences, University of the West of England, Bristol BS16 1QY, UK
| | - Joseph Studer
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; (G.G.); (J.S.)
| | - Mathieu Saubade
- Swiss Olympic Medical Center, Division of Physical and Rehabilitation Medicine, University Hospital of Lausanne, 1011 Lausanne, Switzerland;
- Department of Prevention and Public Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne, 1010 Lausanne, Switzerland
| | - Carole Clair
- Department of Training, Research and Innovation, Center for Primary Care and Public Health (Unisanté), University of Lausanne, 1010 Lausanne, Switzerland;
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9
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Almahdi HM, Ali RW, Nasir EF. Exposure to the advertisement of toombak at the point-of-sale among adolescents in Khartoum State, Sudan: A cross-sectional study. Tob Prev Cessat 2020; 6:19. [PMID: 32548356 PMCID: PMC7291888 DOI: 10.18332/tpc/115800] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/08/2019] [Accepted: 12/23/2019] [Indexed: 11/27/2022]
Abstract
INTRODUCTION This study aimed to assess the association between toombak (smokeless tobacco) advertisement at point-of-sale (PoS) and its use among adolescents in Sudan. METHODS A cross-sectional school-based and self-administered questionnaire study was conducted. Schools were randomly selected using a one-stage stratified sampling procedure, during 2013–2014, as part of a larger research project focusing on the use of toombak among secondary school students in Khartoum State, Sudan. The sample size was 1526 students. Data were collected on exposure to toombak advertisement, social acceptability, perceived accessibility to toombak, susceptibility, and toombak use. RESULTS A total of 41.8% of the adolescents were exposed to an advertisement at PoS, while 12.5% perceived direct access to toombak, 5.3% reported that they were susceptible to use toombak, and 10.9% were ever toombak users. Exposure to the advertisement of toombak at PoS was found to be associated with the older age group (44.3%) (p≤0.05). Males were more than females (45.2% vs 38.8%; p≤0.05). Those exposed to toombak advertisements at PoS reported more social acceptability towards toombak (48.9% vs 37.6%; p≤0.001) and direct accessibility to toombak (68.8% vs 47.2%; p≤0.05). Ever toombak users reported higher exposure to advertisements than non-users (54.5% vs 40.3%; p≤0.001). CONCLUSIONS Exposure to toombak advertisements at PoS was found to be high and associated with increased toombak use in Khartoum State, Sudan, in addition to increasing social acceptability to its use and perceived easy accessibility. The current law, which bans toombak advertisement and promotion at PoS, needs to be enforced.
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Affiliation(s)
- Hatim M Almahdi
- Oral and Maxillofacial Surgery Department, College of Dentistry, King Faisal University, Al-Ahsa, Saudi Arabia.,Faculty of Dentistry, University of Science and Technology, Omdurman, Sudan
| | - Raouf W Ali
- Faculty of Dentistry, University of Science and Technology, Omdurman, Sudan.,Department of Preventive Dentistry, College of Dentistry, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Elwalid F Nasir
- Faculty of Dentistry, University of Science and Technology, Omdurman, Sudan.,Department of Preventive Dentistry, College of Dentistry, King Faisal University, Al-Ahsa, Saudi Arabia
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10
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Khan SZ, Farooq A, Masood M, Shahid A, Khan IU, Nisar H, Fatima I. Smokeless tobacco use and risk of oral cavity cancer. Turk J Med Sci 2020; 50:291-297. [PMID: 31655504 PMCID: PMC7165244 DOI: 10.3906/sag-1809-11] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 08/07/2019] [Indexed: 12/26/2022] Open
Abstract
Background/aim Smokeless tobacco has been associated with oral cavity cancer for several decades. The incidence of oral cavity cancer is higher in some parts of the world especially South and South-East Asia including Pakistan. The aim of current study was to evaluate the risk of oral cavity cancer among smokeless tobacco users in our country. Materials and methods A case-control study was conducted between November 2016 and September 2017. Patients diagnosed with oral cavity cancer receiving treatment were included as cases and the attendants of various cancer patients visiting the hospital during the study period were included in the study as controls. Odds ratios (OR) and 95% confidence intervals (CI) were calculated and all reported P-values were considered significant at < 0.05. Results The crude OR for the “ever smokeless tobacco users” among cases and controls came out to be 4.98 (95%CI; 2.76–9.01). The OR for snuff users among cases and controls was 4.82 (95%CI; 2.37–9.80) and that for betel leaf users was 4.42 (95%CI; 1.66–11.91) after adjusting for smoking and age. Conclusion Our study provided strong evidence for snuff and betel leaf to be independent risk factors for oral cavity cancer.
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Affiliation(s)
- Shah Zeb Khan
- Institute of Nuclear Medicine and Oncology (INMOL), Lahore, Pakistan
| | - Ahmed Farooq
- Institute of Nuclear Medicine and Oncology (INMOL), Lahore, Pakistan
| | - Misbah Masood
- Institute of Nuclear Medicine and Oncology (INMOL), Lahore, Pakistan
| | - Abubaker Shahid
- Institute of Nuclear Medicine and Oncology (INMOL), Lahore, Pakistan
| | - Irfan Ullah Khan
- Institute of Nuclear Medicine and Oncology (INMOL), Lahore, Pakistan
| | - Hasan Nisar
- Faculty of Medicine, Pakistan Institute of Engineering and Applied Sciences (PIEAS), Nilore, Islamabad, Pakistan
| | - Ismat Fatima
- Institute of Nuclear Medicine and Oncology (INMOL), Lahore, Pakistan
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11
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Wang L, Stanfill S, Valentin-Blasini L, Watson CH, Bravo Cardenas R. LC-MS/MS Analysis of Sugars, Alditols, and Humectants in Smokeless Tobacco Products. Beitr Tab Int 2019; 28:203-13. [PMID: 32327867 DOI: 10.2478/cttr-2019-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Globally, smokeless tobacco (ST) includes a wide array of chemically diverse products generally used in the oral cavity. Although ST has been widely investigated, this study was undertaken to determine the levels of sugars (mono- and di-saccharides), alditols, and humectants present in major ST categories/subcategories by using high performance liquid chromatography coupled with a triple quadrupole mass spectrometer (HPLC-MS/MS). The products studied included chewing tobacco (loose leaf, plug, twist), US moist snuff, Swedish snus, creamy snuff, dry snuff, dissolvable tobacco products, and tobacco-coated toothpicks. The highest mean sugar level was detected in chewing tobacco (9.3-27.5%, w/w), followed by dissolvable tobacco (2.1%); all other products were lower than 1%. Creamy snuff had the highest mean alditol levels (22.6%), followed by dissolvable tobacco (15.4%); all others had levels lower than 1%. The detected mean humectant levels ranged from non-detectable to 5.9%. This study demonstrates the broad chemical diversity among ST. This research may aid researchers and public health advocates investigating the exposures and risks of ST. [Beitr. Tabakforsch. Int. 28 (2019) 203-213].
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Dandona R, Mathur MR, Kumar GA, Dandona L. Improving Utility of Data on Cancer Mortality Risk Associated with Smokeless Tobacco: Recommendations for Future Research. Asian Pac J Cancer Prev 2019; 20:581-588. [PMID: 30803225 PMCID: PMC6897011 DOI: 10.31557/apjcp.2019.20.2.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: We analyzed in detail the studies utilized in most recent global systematic review of risk of cancer mortality with smokeless tobacco (SLT) use to report challenges in the available data that limit the understanding of association between SLT use and cancer mortality. Methods: For each study, we documented study design, reporting of mortality risk by type of SLT variant, SLT use frequency, and sex of SLT user for oral, oesophageal, pharyngeal, laryngeal and orolaryngeal cancers. These findings are discussed within the context of prevalence of SLT use by geographic regions and sex. Results: Majority of studies reported mortality risk for oral (70.6%) followed by oesophageal cancer (38.2%). The availability of population-based evidence was low (35.3%). The geographic distribution of studies did not reflect the geographic distribution of countries with high SLT consumption; 61.8% of the studies were from India followed by Sweden (20.6%). Hospital-based (84.2%) studies reported risk with chewing tobacco and the population-based studies (61.5%) with non-chewing tobacco. Hardly any study reported on a particular type of SLT. Definition of SLT use as current, ever or former was limited without consideration of the wide variations in frequency and duration of use within these patterns. Mortality risk reporting for males dominated all cancers other than oral (50% males). Conclusions: Unless the methodological and generalizability challenges identified in this review are addressed in future research to develop a stronger scientific basis of the association of SLT use and cancer mortality, we would continue to face significant challenges in monitoring the health effects of SLT.
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Affiliation(s)
- Rakhi Dandona
- Public Health Foundation of India, Gurugram, National Capital Region, India.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA.
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Campbell BR, Sanders CB, Netterville JL, Sinard RJ, Rohde SL, Langerman A, Mannion K, Kim YJ, Murphy BA, Lewis JS, Warner JL, Smith DK, Lang Kuhs KA. Early onset oral tongue squamous cell carcinoma: Associated factors and patient outcomes. Head Neck 2019; 41:1952-1960. [PMID: 30633435 DOI: 10.1002/hed.25650] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 11/15/2018] [Accepted: 12/21/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Incidence of oral tongue squamous cell carcinoma (OTC) is rising among those under age 50 years. The etiology is unknown. METHODS A total of 395 cases of OTC diagnosed and/or treated at Vanderbilt University Medical Center between 2000 and 2017 were identified. Of those, 113 (28.6%) were early onset (age < 50 years). Logistic regression was used to identify factors associated with early onset OTC. Cox proportional hazards models evaluated survival and recurrence. RESULTS Compared to typical onset patients, patients with early onset OTC were more likely to receive multimodality treatment (surgery and radiation; adjusted odds ratio [aOR], 2.7; 95% confidence interval [CI], 1.2-6.3) and report a history of snuff use (aOR, 5.4; 95% CI, 1.8-15.8) and were less likely to report a history of cigarette use (aOR, 0.5; 95% CI, 0.2-0.9). Early onset patients had better overall survival (adjusted hazard ratio, 0.6). CONCLUSIONS This is the largest study to evaluate factors associated with early onset OTC and the first to report an association with snuff.
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Affiliation(s)
| | | | - James L Netterville
- Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, Tennessee, USA
| | - Robert J Sinard
- Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, Tennessee, USA
| | - Sarah L Rohde
- Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, Tennessee, USA
| | - Alexander Langerman
- Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, Tennessee, USA
| | - Kyle Mannion
- Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, Tennessee, USA
| | - Young J Kim
- Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, Tennessee, USA
| | - Barbara A Murphy
- Vanderbilt University Medical Center, Department of Medicine, Division of Hematology and Oncology, Nashville, Tennessee, USA
| | - James S Lewis
- Vanderbilt University Medical Center, Department of Pathology, Microbiology, and Immunology, Nashville, Tennessee, USA
| | - Jeremy L Warner
- Vanderbilt University Medical Center, Department of Medicine, Division of Hematology and Oncology, Nashville, Tennessee, USA
| | - Derek K Smith
- Vanderbilt University Medical Center, Department of Biostatistics, Nashville, Tennessee, USA
| | - Krystle A Lang Kuhs
- Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, Tennessee, USA
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Chaffee BW, Couch ET, Urata J, Gansky SA, Essex G, Cheng J. Predictors of Smokeless Tobacco Susceptibility, Initiation, and Progression Over Time Among Adolescents in a Rural Cohort. Subst Use Misuse 2019; 54:1154-1166. [PMID: 30694094 PMCID: PMC6483853 DOI: 10.1080/10826084.2018.1564330] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Use of smokeless tobacco (ST, moist snuff and chewing tobacco) is elevated among male rural youth, particularly participants in certain sports, including baseball. OBJECTIVES This study aimed to assess factors associated with adolescent male athletes' ST-related behaviors over time, including: baseline use, initiation, and progression in use intensity in a school-based longitudinal cohort. METHODS Baseline and one-year follow-up questionnaires assessed sociodemographic characteristics, environmental factors, and tobacco-related perceptions and behaviors among 9- to12th-grade interscholastic baseball players in 36 rural California schools. Population characteristics were compared among ST use categories (never, experimental, and experienced users). Multivariable models using generalized estimating equations were estimated for outcomes among baseline ST never-users (ST susceptibility and future initiation) and experimenters (ST expectations and progression in ST use). RESULTS Of 594 participants, over half (57%) had ever tried a tobacco product and the most common products tried were ST (36%) and electronic cigarettes (36%). Being older, perceiving less ST harm, being Non-Hispanic White, using alcohol or other tobacco products, having family or friends who use ST, and being receptive to advertising were associated with greater baseline ST use. Baseline alcohol consumption, lower perceived ST harm, peer use, and susceptibility and expectations were predictive of ST initiation and/or progression at one-year follow-up. Conclusion/Importance: Certain environmental, socio-demographic, cognitive, and behavioral factors predict ST susceptibility and later initiation and progression in use. Interventions addressing these factors have potential to prevent ST uptake and continued use within this high-risk adolescent population.
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Affiliation(s)
- Benjamin W Chaffee
- a Department of Preventive and Restorative Dental Sciences , University of California , San Francisco , CA , USA
| | - Elizabeth T Couch
- a Department of Preventive and Restorative Dental Sciences , University of California , San Francisco , CA , USA
| | - Janelle Urata
- a Department of Preventive and Restorative Dental Sciences , University of California , San Francisco , CA , USA
| | - Stuart A Gansky
- a Department of Preventive and Restorative Dental Sciences , University of California , San Francisco , CA , USA
| | - Gwen Essex
- a Department of Preventive and Restorative Dental Sciences , University of California , San Francisco , CA , USA
| | - Jing Cheng
- a Department of Preventive and Restorative Dental Sciences , University of California , San Francisco , CA , USA
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Singh I, Singh A, Kour R, Singh A, Singh R, Bali A. Is Sodium Carbonate in Snuff a Causative Factor for Oral Mucosal Lesions: A Cross-sectional Analysis. J Int Soc Prev Community Dent 2018; 8:339-342. [PMID: 30123767 PMCID: PMC6071358 DOI: 10.4103/jispcd.jispcd_134_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 05/08/2018] [Indexed: 11/20/2022] Open
Abstract
Aims and Objectives: Nicotine absorption through the mucous membrane is directly proportional to pH, so the snuff is buffered to pH of 8–9 by adding sodium carbonate. The objective of the present study is to assess the impact of various forms of sodium carbonate in snuff on mucosal conditions. Materials and Methods: The present cross-sectional study was conducted on 284 participants. Snuff users adding sodium carbonate were further splitted into two groups, that is, one group using sodium carbonate in premixed form, that is, (already mixed within pouches) and other group adding sodium carbonate separately (freshly mixed). The parametric one-way (ANOVA) of variance, stepwise regression analysis, and multiple logistic regression analysis have been done to narrate the relationship between variables of different forms of sodium carbonate in snuff and different oral conditions. Results: The statistics of our study reveals highly significant relationship between snuff users using sodium carbonate in freshly mixed (0.001**) form than that of premixed form (P = 0.030*). Conclusion: The present study narrates that there seems to be liaison between the use of sodium carbonate in snuff and oral mucosal lesions.
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Affiliation(s)
- Iqbal Singh
- Department of Public Health Dentistry, Indira Gandhi Dental College and Hospital, Jammu, India
| | - Amarpreet Singh
- Department of Public Health Dentistry, Himachal Dental College and Hospital, Sundar-Nagar, Himachal Pradesh, India
| | - Robindera Kour
- Department of General Surgery, Government Hospital Sarwal, Jammu, India
| | - Abhiroop Singh
- Department of Oral and Maxillofacial Surgery, Dav Dental College, Yamuna-Nagar, Haryana, India
| | - Romesh Singh
- Department of Periodontology, Indira Gandhi Dental College, Jammu, India
| | - Ashish Bali
- Department of Periodontology, Himachal Dental College and Hospital, Sundar-Nagar, Himachal Pradesh, India
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Al-Hebshi NN, Alharbi FA, Mahri M, Chen T. Differences in the Bacteriome of Smokeless Tobacco Products with Different Oral Carcinogenicity: Compositional and Predicted Functional Analysis. Genes (Basel) 2017; 8:genes8040106. [PMID: 28333122 PMCID: PMC5406853 DOI: 10.3390/genes8040106] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/17/2017] [Accepted: 03/17/2017] [Indexed: 01/12/2023] Open
Abstract
Smokeless tobacco (ST) products vary significantly in their oral carcinogenicity. Much is known about the differences in the chemical, but not the bacterial, constituents of these products. In this study, we explored the composition and function of the bacteriome in ST products from four countries using quantitative polymerase chain reaction (qPCR) and 16S rRNA-based next generation sequencing. The bacterial load (16S rRNA copies/gram) was lowest in Swedish snus (3.4 × 106) and highest in Yemeni shammah (6.6 × 1011). A total of 491 species-level taxa, many of which are potentially novel, belonging to 178 genera and 11 phyla were identified. Species richness and diversity were highest for Swedish snus and lowest for Yemeni shammah. Bacillus, Paenibacillus, and Oceanobacillus spp. were the most abundant in American snuff; species of Pseudomonas, Massilia, Propionibacterium, Puniceispirillum, and Gloeothece predominated in Swedish snus. In Sudanese toombak, Facklamia, Desemzia, Atopostipes, and Lysinibacillus spp. accounted for the majority of the bacteriome. Yemeni shammah exclusively contained Bacillus spp. Functional prediction by phylogenetic investigation of communities by reconstruction of unobserved states (PICRUSt) showed that genes encoding cadmium/zinc and nickel transport systems were enriched in the presumptively “high carcinogenicity” products. The bacteriome of ST products thus differed qualitatively, quantitatively, and functionally. The relevance of these differences, particularly with respect to nickel and cadmium, to oral carcinogenesis warrants further investigation.
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Affiliation(s)
- Nezar Noor Al-Hebshi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, 45142 Jazan, Saudi Arabia.
- Kornberg School of Dentistry, Temple University, 3223 N Board Street, Philadelphia, PA 19140, USA.
| | - Fahd Ali Alharbi
- Otolaryngology-Head and Neck Surgery Department, Faculty of Medicine, Jazan University, 45142 Jazan, Saudi Arabia.
| | - Mohammed Mahri
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, 45142 Jazan, Saudi Arabia.
| | - Tsute Chen
- Department of Microbiology, Forsyth Institute, Cambridge, MA 02142, USA.
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Abstract
OBJECTIVE Tobacco smoking is a risk factor for gastroesophageal reflux, but whether other tobacco products increase the risk is unclear. The aim of this study was to investigate if snus increases the risk of gastroesophageal reflux symptoms (GERS). MATERIAL AND METHODS The study was based on the third Nord-Trøndelag health study (HUNT3), a population-based study of all adult residents in Nord-Trøndelag County, Norway, performed in 2006-2009. The association between self-reported severe heartburn/regurgitation and snus use was assessed by logistic regression. RESULTS Compared to never snus users, daily snus users had a reduced risk of GERS (OR 0.77, 95% confidence interval [CI] 0.64-0.93), while previous snus users and those using <2 boxes of snus/month had an increased risk (OR 1.20, 95% CI 1.00-1.46 and OR 1.41, 95% CI 1.02-1.96, respectively). There was no association between age when starting using snus and GERS. Snus users who started using snus to quit or cut down on cigarette smoking, who started using both snus and cigarettes or cigarettes alone had an increased risk of GERS. Snus users <30 years of age had an increased risk of GERS (OR 1.49, 95% CI 1.02-2.16), while those aged between 50-60 and 60-70 years had a reduced risk (OR 0.67, 95% CI 0.49-0.93 and OR 0.51, 95% CI 0.28-0.94, respectively). CONCLUSIONS Daily snus users had a reduced risk of GERS. However, previous snus users and subgroups of snus users had an increased risk of GERS indicating reverse causality, such that snus use could increase the risk of GERS.
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Affiliation(s)
- Tina Malene Lie
- a Department of Medical Gastroenterology S , Odense University Hospital , Odense C , Denmark
| | - Maria Bomme
- a Department of Medical Gastroenterology S , Odense University Hospital , Odense C , Denmark
| | - Kristian Hveem
- b HUNT Research Center, Department of Public Health and General Practice , NTNU, Norwegian University of Science and Technology , Levanger , Norway
| | - Jane Møller Hansen
- a Department of Medical Gastroenterology S , Odense University Hospital , Odense C , Denmark
| | - Eivind Ness-Jensen
- b HUNT Research Center, Department of Public Health and General Practice , NTNU, Norwegian University of Science and Technology , Levanger , Norway.,c Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery , Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden.,d Department of Medicine , Levanger Hospital, Nord-Trøndelag Hospital Trust , Levanger , Norway
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Wyss AB, Hashibe M, Lee YCA, Chuang SC, Muscat J, Chen C, Schwartz SM, Smith E, Zhang ZF, Morgenstern H, Wei Q, Li G, Kelsey KT, McClean M, Winn DM, Schantz S, Yu GP, Gillison ML, Zevallos JP, Boffetta P, Olshan AF. Smokeless Tobacco Use and the Risk of Head and Neck Cancer: Pooled Analysis of US Studies in the INHANCE Consortium. Am J Epidemiol 2016; 184:703-716. [PMID: 27744388 PMCID: PMC5141945 DOI: 10.1093/aje/kww075] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 02/25/2016] [Indexed: 01/14/2023] Open
Abstract
Previous studies on smokeless tobacco use and head and neck cancer (HNC) have found inconsistent and often imprecise estimates, with limited control for cigarette smoking. Using pooled data from 11 US case-control studies (1981-2006) of oral, pharyngeal, and laryngeal cancers (6,772 cases and 8,375 controls) in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium, we applied hierarchical logistic regression to estimate odds ratios and 95% confidence intervals for ever use, frequency of use, and duration of use of snuff and chewing tobacco separately for never and ever cigarette smokers. Ever use (versus never use) of snuff was strongly associated with HNC among never cigarette smokers (odds ratio (OR) = 1.71, 95% confidence interval (CI): 1.08, 2.70), particularly for oral cavity cancers (OR = 3.01, 95% CI: 1.63, 5.55). Although ever (versus never) tobacco chewing was weakly associated with HNC among never cigarette smokers (OR = 1.20, 95% CI: 0.81, 1.77), analyses restricted to cancers of the oral cavity showed a stronger association (OR = 1.81, 95% CI: 1.04, 3.17). Few or no associations between each type of smokeless tobacco and HNC were observed among ever cigarette smokers, possibly reflecting residual confounding by smoking. Smokeless tobacco use appears to be associated with HNC, especially oral cancers, with snuff being more strongly associated than chewing tobacco.
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Affiliation(s)
- Annah B. Wyss
- Correspondence to Dr. Annah B. Wyss, Epidemiology Branch, National Institute of Environmental Health Sciences, P.O. Box 12233, MD A3-05, Research Triangle Park, NC 27599 (e-mail: )
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Abstract
OBJECTIVE Restricting tobacco marketing is a key element in the US Food and Drug Administration's (FDA) public health framework for regulating tobacco. Given the dearth of empirical data on direct marketing, the objective of this study was to assess the reach and impact of promotions on sales through snuff websites. METHODS Nine brands of snuff, representing more than 90% of market share, were monitored for content of coupons, sweepstakes, contests, and other promotions on their respective websites. Monthly sales data and website traffic for the 9 brands, corresponding to the 48-month period of January 2011 through December 2014, were obtained from proprietary sources. A time-series analysis, based on the autoregressive, integrated, moving average (ARIMA) method, was employed for testing the relationships among sales, website visits, and promotions. RESULTS Website traffic increased substantially during the promotion periods for most brands. Time-series analyses, however, revealed that promotion periods for 5 of 7 brands did not significantly correlate with monthly snuff sales. CONCLUSIONS The success in attracting tobacco consumers to website promotions demonstrates the marketing reach of snuff manufacturers. This form of direct marketing should be monitored by the FDA given evidence of adolescents' exposure to cigarette brand websites.
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Dahlin S, Gunnerbeck A, Wikström AK, Cnattingius S, Edstedt Bonamy AK. Maternal tobacco use and extremely premature birth - a population-based cohort study. BJOG 2016; 123:1938-1946. [PMID: 27411948 DOI: 10.1111/1471-0528.14213] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To study the associations of maternal tobacco use (smoking or use of snuff) and risk of extremely preterm birth, and if tobacco cessation before antenatal booking influences this risk. To study the association between tobacco use and spontaneous or medically indicated onset of delivery. DESIGN Population-based cohort study. SETTING Sweden. POPULATION All live singleton births, registered in the Swedish Medical Birth Register, 1999-2012. METHODS Odds ratios (OR) with 95% confidence intervals (CI) were calculated using multiple logistic regression analysis. MAIN OUTCOME MEASURES Extremely preterm birth (<28 weeks of gestation), very preterm birth (28-31 weeks), moderately preterm birth (32-36 weeks). RESULTS Maternal snuff use (OR 1.58; 95% CI: 1.14-2.21) and smoking (OR 1.61; 95% CI: 1.39-1.87 and OR 1.91; 95% CI: 1.53-2.39 for moderate and heavy smoking, respectively) were associated with an increased risk of extremely preterm birth. When cessation of tobacco use was obtained there was no increased risk of preterm birth. Snuff use was associated with a twofold risk increase of medically indicated extremely preterm birth, whereas smoking was associated with increased risks of both medically indicated and spontaneous extremely preterm birth. CONCLUSIONS Snuff use and smoking in pregnancy were associated with increased risks of extremely preterm birth. Women who stopped using tobacco before the antenatal booking had no increased risk. These findings indicate that nicotine, the common substance in cigarettes and snuff, is involved in the mechanisms behind preterm birth. The use of nicotine should be minimized in pregnancy. TWEETABLE ABSTRACT Tobacco use increases risk of extremely preterm birth. Cessation is preventive. Avoid nicotine in pregnancy.
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Affiliation(s)
- S Dahlin
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - A Gunnerbeck
- Neonatal Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden. .,Astrid Lindgren's Children Hospital, Karolinska University Hospital, Stockholm, Sweden.
| | - A-K Wikström
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - S Cnattingius
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - A-K Edstedt Bonamy
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Neonatal Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
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Pandey V, Salam SA, Moda A, Agarwal P, Nath S, Pulikkotil SJ. Effect of the use of snuff on the levels of interleukin-1 β and interleukin-8 in the gingival crevicular fluid of periodontitis patients. Dent Res J (Isfahan) 2015; 12:461-8. [PMID: 26604961 PMCID: PMC4630711 DOI: 10.4103/1735-3327.166222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Use of smokeless tobacco in the form of moist snuff placed in the oral cavity is popular in rural India. The aim of the present cross-sectional study was to determine the effect of snuff on periodontitis by assessing interleukin (IL)-1 β and IL-8 levels in gingival crevicular fluid. Materials and Methods: A total of 60 subjects were selected for this study. 40 subjects presented with periodontitis, which included 20 snuff users (SP) and 20 nonsnuff users (NS). 20 periodontally healthy patients formed the controls (healthy control: HC). The clinical parameters recorded were gingival index (GI), plaque index, calculus index, bleeding on probing (BOP), probing depth (PD), recession (RC), and clinical attachment level (CAL). The IL-1 β and IL-8 levels were assessed through enzyme-linked immunosorbent assay (Quantikine®). Analysis of variance (ANOVA), post-hoc Tukey's, Kruskal-Walli's ANOVA and Mann-Whitney test was used for comparison among groups and P > 0.05 was considered statistically significant. Results: No significant difference was seen in levels of IL-1 β and IL-8 between SP and NS groups (P = 0.16, 0.97). However, both the periodontitis groups (SP and NS) had increased IL-β levels when compared to HC group (P = 0.01, 0.001). The snuff users showed significant increase in GI, BOP, RC, and CAL when compared with NS (P = 0.002, 0.001, 0.012, 0.002) whereas NS group had significant increase in PD (P = 0.003). Conclusion: Within the limitations of this study, use of snuff does not affect the host inflammatory response associated with periodontitis and leads to RC and increased CAL due to local irritant effect.
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Affiliation(s)
- Vijayendra Pandey
- Department of Periodontology, Vananchal Dental College, and Hospital, Farathiya, Garhwa, Jharkhand, India
| | - Sharib Abdus Salam
- Department of Periodontology, Vananchal Dental College, and Hospital, Farathiya, Garhwa, Jharkhand, India
| | - Aman Moda
- Department of Pedodontics, Goenka Research Institute of Dental Sciences, Gandhinagar, Gujarat, India
| | - Preeti Agarwal
- Department of Periodontics, Triveni Institute of Dental Sciences, Hospital and Research Centre, Bilaspur, Chhattisgarh, India
| | - Sonia Nath
- Department of Periodontology, Vananchal Dental College, and Hospital, Farathiya, Garhwa, Jharkhand, India
| | - Shaju Jacob Pulikkotil
- Department of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
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Pärn T, Grau Ruiz R, Kunovac Kallak T, Ruiz JR, Davey E, Hreinsson J, Wånggren K, Salumets A, Sjöström M, Stavreus-Evers A, Ortega FB, Altmäe S. Physical activity, fatness, educational level and snuff consumption as determinants of semen quality: findings of the ActiART study. Reprod Biomed Online 2015; 31:108-19. [PMID: 25999214 DOI: 10.1016/j.rbmo.2015.03.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 03/06/2015] [Accepted: 03/10/2015] [Indexed: 12/15/2022]
Abstract
In this study, the association between physical activity and other potential determinants, objectively measured by accelerometry, was examined. Sixty-two men attending an infertility clinic participated in the study. Obese men (body mass index ≥ 30) and those with a waist circumference 102 cm or more had lower semen volume than the other men (P < 0.05). Higher values in sperm parameters were observed in participants who completed university studies and those who did not consume snuff, compared with the other participants (P < 0.05). Finally, men who spent an average number of 10 min-bouts of moderate-to-vigorous physical activity had significantly better semen quality than those who engaged in low or high numbers of bouts of activity (P < 0.05). No associations were found for sedentary or moderate-to-vigorous physical activity time when it was not sustained over 10 min, i.e. not in bouts. Men who have average levels of physical activity over sustained periods of 10 min are likely to have better semen quality than men who engage in low or high levels of such activity. Similarly, high levels of total and central adiposity, low educational level and snuff consumption are negatively related to semen quality.
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Affiliation(s)
- Triin Pärn
- Department of Biosciences and Nutrition, Karolinska Institutet, Hälsovägen 7-9, NOVUM Huddinge, 14183 Stockholm, Sweden
| | - Raúl Grau Ruiz
- PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, School of Sport Sciences, Carretera Alfacar s/n, University of Granada, 18071 Granada, Spain
| | - Theodora Kunovac Kallak
- Department of Women's and Children's Health, Uppsala University, Akademiska Sjukhuset, 751 85 Uppsala, Sweden
| | - Jonatan R Ruiz
- Department of Biosciences and Nutrition, Karolinska Institutet, Hälsovägen 7-9, NOVUM Huddinge, 14183 Stockholm, Sweden; PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, School of Sport Sciences, Carretera Alfacar s/n, University of Granada, 18071 Granada, Spain
| | - Eva Davey
- Department of Women's and Children's Health, Uppsala University, Akademiska Sjukhuset, 751 85 Uppsala, Sweden
| | - Julius Hreinsson
- Department of Women's and Children's Health, Uppsala University, Akademiska Sjukhuset, 751 85 Uppsala, Sweden
| | - Kjell Wånggren
- Department of Women's and Children's Health, Uppsala University, Akademiska Sjukhuset, 751 85 Uppsala, Sweden
| | - Andres Salumets
- Competence Centre on Health Technologies, Tiigi 61b, 50410 Tartu, Estonia; Women's Clinic, University of Tartu, Puusepa 8, 51014 Tartu, Estonia
| | - Michael Sjöström
- Department of Biosciences and Nutrition, Karolinska Institutet, Hälsovägen 7-9, NOVUM Huddinge, 14183 Stockholm, Sweden
| | - Anneli Stavreus-Evers
- Department of Women's and Children's Health, Uppsala University, Akademiska Sjukhuset, 751 85 Uppsala, Sweden
| | - Francisco B Ortega
- Department of Biosciences and Nutrition, Karolinska Institutet, Hälsovägen 7-9, NOVUM Huddinge, 14183 Stockholm, Sweden; PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, School of Sport Sciences, Carretera Alfacar s/n, University of Granada, 18071 Granada, Spain
| | - Signe Altmäe
- Competence Centre on Health Technologies, Tiigi 61b, 50410 Tartu, Estonia; Department of Paediatrics, School of Medicine, University of Granada, Avda. de Madrid, 11, 18012 Granada, Spain.
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Misra M, Leverette RD, Cooper BT, Bennett MB, Brown SE. Comparative in vitro toxicity profile of electronic and tobacco cigarettes, smokeless tobacco and nicotine replacement therapy products: e-liquids, extracts and collected aerosols. Int J Environ Res Public Health 2014; 11:11325-47. [PMID: 25361047 PMCID: PMC4245615 DOI: 10.3390/ijerph111111325] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 10/16/2014] [Accepted: 10/24/2014] [Indexed: 02/04/2023]
Abstract
The use of electronic cigarettes (e-cigs) continues to increase worldwide in parallel with accumulating information on their potential toxicity and safety. In this study, an in vitro battery of established assays was used to examine the cytotoxicity, mutagenicity, genotoxicity and inflammatory responses of certain commercial e-cigs and compared to tobacco burning cigarettes, smokeless tobacco (SLT) products and a nicotine replacement therapy (NRT) product. The toxicity evaluation was performed on e-liquids and pad-collected aerosols of e-cigs, pad-collected smoke condensates of tobacco cigarettes and extracts of SLT and NRT products. In all assays, exposures with e-cig liquids and collected aerosols, at the doses tested, showed no significant activity when compared to tobacco burning cigarettes. Results for the e-cigs, with and without nicotine in two evaluated flavor variants, were very similar in all assays, indicating that the presence of nicotine and flavors, at the levels tested, did not induce any cytotoxic, genotoxic or inflammatory effects. The present findings indicate that neither the e-cig liquids and collected aerosols, nor the extracts of the SLT and NRT products produce any meaningful toxic effects in four widely-applied in vitro test systems, in which the conventional cigarette smoke preparations, at comparable exposures, are markedly cytotoxic and genotoxic.
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Affiliation(s)
- Manoj Misra
- Lorillard Tobacco Company, A.W. Spears Research Center, 420 North English Street, Greensboro, North Carolina 27405, USA.
| | - Robert D Leverette
- Lorillard Tobacco Company, A.W. Spears Research Center, 420 North English Street, Greensboro, North Carolina 27405, USA.
| | - Bethany T Cooper
- Lorillard Tobacco Company, A.W. Spears Research Center, 420 North English Street, Greensboro, North Carolina 27405, USA.
| | - Melanee B Bennett
- Lorillard Tobacco Company, A.W. Spears Research Center, 420 North English Street, Greensboro, North Carolina 27405, USA.
| | - Steven E Brown
- Lorillard Tobacco Company, A.W. Spears Research Center, 420 North English Street, Greensboro, North Carolina 27405, USA.
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Agaku IT, King BA. Validation of self-reported smokeless tobacco use by measurement of serum cotinine concentration among US adults. Am J Epidemiol 2014; 180:749-54. [PMID: 25125690 DOI: 10.1093/aje/kwu182] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although investigators have assessed the relationship between self-reported cigarette smoking and biomarker levels, the validity of self-reported information on smokeless tobacco (SLT) use is uncertain. We used aggregated data from the 2003-2004, 2005-2006, 2007-2008, and 2009-2010 administrations of the National Health and Nutrition Examination Survey (NHANES) to compare self-reported SLT use with serum concentrations of cotinine, a metabolite of nicotine, among US adults aged ≥18 years. Receiver operating characteristic analysis was used to determine the optimal serum cotinine cutpoint for discriminating SLT users from nonusers of tobacco, and concordance analysis was used to compare self-reported SLT use with cotinine levels. Among the 30,298 adult respondents who completed the NHANES during 2003-2010, 418 reported having exclusively used SLT and no other type of tobacco (cigarettes, cigars, or pipes) during the past 5 days, while 23,457 reported not using any tobacco. The optimal cotinine cutpoint for discriminating SLT users from non-tobacco users was 3.0 ng/mL (sensitivity=97.0%, specificity=93.0%), which was comparable to a revised cutpoint recommended for identifying adult cigarette smokers. Concordance with cotinine was 96.4% and 93.7% for self-reported SLT use and tobacco nonuse, respectively. These findings indicate that self-reported SLT use among adults correlates highly with serum cotinine levels and that the optimal cutpoint for minimizing misclassification of self-reported use is a serum cotinine concentration of 3.0 ng/mL.
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25
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Rolandsson M, Wagnsson S, Hugoson A. Tobacco use habits among Swedish female youth athletes and the influence of the social environment. Int J Dent Hyg 2014; 12:219-25. [PMID: 24382360 DOI: 10.1111/idh.12065] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2013] [Indexed: 11/28/2022]
Abstract
AIM This study examined the prevalence of tobacco habits and the influence of the social environment among Swedish female athletes representing both individual and team sports in Sweden. MATERIAL AND METHOD A self-reported cross-sectional survey was performed with 791 female athletes 15-24 years old representing ten of the most common sports in Sweden. The questions related to the participants' involvement in sports and their tobacco habits. RESULTS Findings revealed that a large proportion of the female athletes had never smoked (65%) or used snus (74%). However, a considerable portion of the participants had tried smoking (27%) or using snus (20%), especially those involved in team sports. Results also showed statistically significant associations between female athletes' smoking habits and those of both their mothers and their peers, but not with the tobacco habits of their coaches, indicating that coaches do not influence the female athletes' use of tobacco. CONCLUSION In conclusion, this study indicated that the vast majority of female athletes did not use tobacco. A significant portion had sometimes tried tobacco, especially members of team sports, but this behaviour did not seem to be influenced by the tobacco habits of their coaches.
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Affiliation(s)
- M Rolandsson
- Department of Health Sciences, Oral Health, Karlstad University, Karlstad, Sweden
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26
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Hedström AK, Ryner M, Fink K, Fogdell-Hahn A, Alfredsson L, Olsson T, Hillert J. Smoking and risk of treatment-induced neutralizing antibodies to interferon β-1a. Mult Scler 2013; 20:445-50. [PMID: 23924603 DOI: 10.1177/1352458513498635] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Neutralizing antibodies (NAbs) to interferon β (IFNβ) products that develop during treatment are associated with a loss of clinical efficacy. OBJECTIVES The aim of this study was to investigate the influence of smoking habits on the risk of developing NAbs to IFNβ, in the treatment of multiple sclerosis (MS). METHODS This report is based on 695 MS patients treated with IFNβ-1a, included in two Swedish case-control studies that collected information on smoking habits. Using logistic regression, the development of NAbs to IFNβ-1a among current smokers was compared with that of non-smokers, by calculating the odds ratio (OR) with a 95% confidence interval (CI). RESULTS Current smokers showed an increased risk of developing NAbs to IFNβ-1a, compared with non-smokers (OR 1.9; 95% CI 1.3-2.8; p = 0.002). There were no gender differences. We observed no association between past smoking and the risk of developing NAbs to IFNβ-1a. CONCLUSIONS The finding that current smokers have an increased risk of developing NAbs to IFNβ-1a has implications, both for the practical care and the treatment of MS; it also provides an interesting perspective of the lungs as an immune-reactive organ, reacting upon irritation.
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Affiliation(s)
- Anna Karin Hedström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Abstract
OBJECTIVE To assess patterns and correlates of spit [smokeless tobacco (ST)] use among high school males in rural California. METHODS An 18-item, self-administered questionnaire was used to assess ST use among young males in 41 randomly selected high schools in 21 rural counties in California. To ensure confidentiality, students were instructed to seal their completed questionnaire in an attached envelope prior to returning it to the questionnaire administrator. RESULTS Overall prevalence of ST use was 9.8 percent, significantly increasing with year in school from 5 percent among freshmen to 15 percent among seniors. ST use was highest among rodeo athletes at 42 percent compared with <6 percent among nonathletes; ST use was significantly higher among smokers (32 percent) who were 2.5-30 times more likely to use ST compared with nonsmokers, depending on race/ethnicity as a result of a significant race/ethnicity x smoking interaction of degree/magnitude. In addition, students who believed there was no, or slight risk of, harm from ST use were significantly more likely to use ST than students perceiving moderate or great risk, depending on race/ethnicity (odds ratios 3.6-13). Among all ST users, 40 percent used ST on at least 5 days in the previous week, 80 percent of those reporting a brand used the brand Copenhagen, and 41 percent (189) used ST within 30 minutes of waking. CONCLUSION Dental public health practitioners, scholars, and policy-makers need to promote dental health through organized community efforts targeting high school male subgroups in rural areas that are at risk for ST-associated adverse health effects.
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Affiliation(s)
- Stuart A Gansky
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, CA 94143-1361, USA
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