Escala de Resistencia a la Presión de Pares para el Consumo de Cigarro Convencional en estudiantes universitarios: adaptación y validación / Resistance to Peer Pressure for Cigarette Smoking in University Students: Scale Adaptation and Validation / Escala de resistência à pressão dos pares para o consumo de cigarros em universitários: adaptação e validação

Introducción: la influencia o presión de pares que fuman es uno de los principales factores por los que los estudiantes universitarios inician el consumo del cigarro convencional; sin embargo, no se ha encontrado un instrumento que evalúe este fenómeno. Por lo tanto, el objetivo fue adaptar y validar la Escala de Resistencia a la Presión de Pares para el Consumo de Cigarro Convencional. Materiales y métodos: participaron 237 estudiantes universitarios del estado de Nuevo León (México), de 18 a 24 años. Se realizó análisis factorial exploratorio, análisis de confiabilidad, correlación de Spearman y prueba de Kruskal-Wallis. Resultados: el 63.3 % de los estudiantes fueron mujeres y la media de edad fue de 19.66 años. Se identificaron dos factores con un total de 13 ítems. Se obtuvo un alfa de Cronbach de 0.81. Se encontraron diferencias estadísticamente significativas entre los distintos tipos de consumidores de cigarro convencional y los puntajes de la escala de resistencia a la presión de pares (H[4] = 23.85; p < 0.001). Conclusiones: la nueva versión de la Escala de Resistencia a la Presión de Pares para el Consumo de Cigarro Convencional evidenció adecuadas propiedades psicométricas para evaluar la presión que ejercen los pares en estudiantes universitarios para el consumo de cigarro convencional

Introduction: Influence or peer pressure is one of the leading factors in developing cigarette smoking habits in university students; however, no effective strategy to assess this phenomenon has been developed yet. This study aimed to adapt and validate the peer pressure resistance scale to conventional cigarette consumption. Materials and methods: A total of 237 university students from the Nuevo León State (Mexico), aged 18­24 years, were enrolled. Exploratory factor and reliability analyses, the Spearman correlation, and the Kruskal­Wallis test were performed. Results: 63.3% of the students were women, and the mean age was 19.66 years. The exploratory analysis extracted two factors with a total of 13 items. A Cronbach's Alpha of 0.81 was found. Statistically significant differences were found between the different types of conventional cigarette users and peer pressure resistance scale scores [H(4) = 23.85; p < .001] were found. Conclusions: The peer pressure resistance scale showed appropriate psychometric properties for assessing the peer pressure to smoke conventional cigarettes in university students.

Introdução: a influência ou pressão dos pares que fumam é um dos principais fatores que levam os universitários a começarem a fumar cigarros convencionais, porém não foi encontrado nenhum instrumento para avaliar esse fenômeno. Portanto, o objetivo do trabalho foi adaptar e validar a escala de resistência à pressão dos pares para o consumo de cigarro convencional. Materiais e métodos: participaram 237 estudantes universitários do estado de Nuevo León, México, de 18 a 24 anos. Foram realizadas análise fatorial exploratória, análise de confiabilidade, correlação de Spearman e teste de Kruskal-Wallis. Resultados: 63,3% dos alunos eram mulheres e a média de idade foi de 19,66 anos. Dois fatores foram identificados com um total de 13 itens. Obteve-se um alfa de Cronbach de 0,81. Diferenças estatisticamente significativas foram encontradas entre os diferentes tipos de usuários de cigarros convencionais e as pontuações na escala de resistência à pressão dos pares (H(4) = 23,85; p < 0,001). Conclusões: a nova versão da escala de resistência à pressão dos pares para o consumo de cigarros convencionais apresentou propriedades psicométricas adequadas para avaliar a pressão exercida pelos pares sobre os universitários para o consumo de cigarros convencionais

Electronic cigarettes: a new social practice and the challenge of tobacco control policies / Cigarros eletrônicos: uma nova prática social e o desafio das Políticas de controle do tabagismo

O tabagismo é uma doença crônica e é considerado um grave problema de saúde pública e tem sido alvo ao longo do tempo de muitas ações preventivas e de promoção à saúde. O produto do tabaco mais consumido entre adultos e jovens é o cigarro convencional, entretanto, o consumo de tabaco sem fumaça ou outros produtos do tabaco fumado, como os cigarros eletrônicos, tem sido observado de forma crescente no mundo. Os dispositivos eletrônicos para fumar (DEF), que têm despertado cada vez mais a atenção de consumidores jovens, envolvem diferentes equipamentos e tecnologias. Fundamentado no princípio da precaução, desde 2009, o Brasil proibiu a comercialização, importação e propaganda de todos os tipos de DEF que oferecessem a substituição de cigarro, cigarrilha, charuto, cachimbo e similares ou que objetivem alternativa ao tratamento do tabagismo, por meio da RDC n 46, de 28 de agosto de 2009. Mesmo proibido no Brasil, evidencia-se o uso dos cigarros eletrônicos como uma alternativa, revelando um novo desafio a ser enfrentado pelas políticas de controle do tabagismo. As lacunas de conhecimento inerentes a uma prática social nova, bem como da necessidade de construção de referenciais que contribuam para a melhor tomada de decisões, seja no âmbito da intervenção profissional ou da gestão das políticas públicas, com vistas a proteger a saúde da população, por si só já torna relevante a ampliação de conhecimentos acerca desta temática. Contudo, é necessário a compreensão de que as ações de prevenção, promoção e controle devem ser compreendidas de forma transversal e interdisciplinar, a fim de que se possa refletir sobre os processos que envolvem aspectos políticos, socioeconômicos e culturais que interagem diretamente com o processo saúde-doença. Deste modo, com base na problemática apresentada e considerando a relevância da temática em questão, como campo pouco enfrentado deste âmbito, destaca-se que a ampliação de investigações e o aprofundamento de discussões sobre ela, possibilitarão uma melhor compreensão e visibilidade do problema

Smoking is a chronic disease and is considered a serious public health problem and has been the target of many preventive and health promotion actions over time. The most consumed tobacco product among adults and young people is the conventional cigarette, however, the consumption of smokeless tobacco or other smoked tobacco products, such as electronic cigarettes, has been observed on an increasing basis in the world. Electronic smoking devices (EFD), which have increasingly attracted the attention of young consumers, involve different equipment and technologies. Based on the precautionary principle, since 2009, Brazil has prohibited the sale, importation and advertising of all types of DEF that offer the replacement of cigarettes, cigarillos, cigars, pipes and the like or that aim at an alternative to the treatment of smoking, through RDC n 46, of August 28, 2009. Even though it is prohibited in Brazil, the use of electronic cigarettes as an alternative is evident, revealing a new challenge to be faced by tobacco control policies. The knowledge gaps inherent to a new social practice, as well as the need to build references that contribute to better decision-making, whether in the scope of professional intervention or the management of public policies, with a view to protecting the health of the population, for itself already makes the expansion of knowledge about this theme relevant. However, it is necessary to understand that prevention, promotion and control actions must be understood in a transversal and interdisciplinary way, so that one can reflect on the processes that involve political, socioeconomic and cultural aspects that interact directly with the health process -illness. Thus, based on the problem presented and considering the relevance of the issue in question, as a field little faced in this area, it is emphasized that the expansion of investigations and the deepening of discussions about it, will allow a better understanding and visibility of the problem.

Addiction to Tobacco Smoking and Vaping

ABSTRACT The tobacco epidemic has been one of the biggest public health threats, and smoking is one of the world's largest preventable causes of premature death. An estimated 15.4% of all deaths in the world are attributable to tobacco smoking. The present review aims to describe addiction to tobacco smoking and vaping. Tobacco and vaping devices contain nicotine, a highly addictive drug, which explains why smoking is so prevalent and persistent. Electronic cigarettes are a group of novel nicotine or tobacco products that have rapidly gained popularity in recent years. Electronic cigarette devices allow for the use of other drugs, including THC, while the lax regulation may allow for the introduction of toxic compounds that can lead to acute or subacute toxicity, such as the e-cigarette- or vaping-associated lung injury that has been linked to vitamin E acetate. In addition, regular vapers and heated tobacco devices emit toxins, although at lower concentrations than burned tobacco. However, more and more side effects have been identified. No new effective treatment for nicotine addiction has been developed recently, despite its huge adverse impact on overall health and other outcomes. As for the primary line of medications, the last one started in 2006, the varenicline, demonstrating a low interest in developing new medications against smoking, an unacceptable state of affairs, given the huge impact of smoking on morbidity and mortality.

Morphological Effects of Cigarette Smoking on Respiratory System and Related Functions Based on AQPs Expression

SUMMARY: A great deal of attention of air pollution on respiratory health is increasing, particularly in relation to haze days. It is that exposure to cigarette smoke augments the toxicity of common air contaminants, thereby increasing the complexity of respiratory diseases. Although there are various mechanisms involved to respiratory diseases caused or worsen by cigarette smoking, in which the role of AQPs in the lung with regard to fluid homeostasis still remains elusive. In this paper, we copied the rat models based on smoke generator, and investigated the morphological changes of mucosa and related functions depending on the balance of lining liquid of alveoli via AQPs expression. Compared with normal group, weak labelling of AQP1 and AQP5 protein abundance were clearly detected in the corresponding part of smoke exposure groups compared with normal group. Hence, it is suggested that the contribution of AQPs in the lung is diminished, thereby causing perturbed balancing between resorptive and secretory fluid homeostasis under cigarette smoking.

Cada vez se presta más atención a la contaminación del aire en la salud respiratoria, particularmente, en relación con los días de neblina. En consecuencia la exposición al humo del cigarrillo aumenta la toxicidad de los contaminantes comunes del aire, lo que además aumenta la complejidad de las enfermedades respiratorias. Aunque existen varios mecanismos involucrados en las enfermedades respiratorias causadas o empeoradas por el tabaquismo, en las que el papel de las AQP en el pulmón respecto a la homeostasis de líquidos sigue siendo difícil de alcanzar. En este artículo, copiamos los modelos de rata basados en el generador de humo e investigamos los cambios morfológicos de la mucosa y las funciones relacionadas según el equilibrio del líquido de revestimiento de los alvéolos a través de la expresión de AQP. En comparación con el grupo normal, se detectó claramente un etiquetado débil de la abundancia de proteínas AQP1 y AQP5 en la parte correspondiente de los grupos de exposición al humo en comparación con el grupo control. Por lo tanto, se sugiere que la contribución de las AQP en el pulmón está disminuida, provocando así un equilibrio perturbado entre la homeostasis del líquido secretor y de reabsorción bajo el hábito de fumar cigarrillos.

Effect-of-cigarette-smoking-in-development-of-dental-caries-a-cross-sectional-study

Background: Cigarette smoking is a major public health challenge globally. It not only affects the general health but also impacts the oral health. It causes an array of oral health lesions including dental caries which causes pain and infection and can result in the requirement of the tooth to be extracted. The aim of the study is to investigate theAim: relationship of cigarette smoking and dental caries in the adult population in the city of Hyderabad. Materials and Methods: This study was conducted by OroGlee Solutions Private Limited, Hyderabad. A total of 1019 subjects aged 18 to 60 years were examined. Oral examination was done using intraoral camera, mouth mirror and torch. Results: Percentage of smokers having dental caries was 89.4% and percentage of non smokers having dental caries was 81.8%. Chi square test was used to determine the significance of difference between the prevalence of caries in smokers and prevalence of caries in non smokers. It showed a statistically significant correlation between dental caries and smoking cigarette. Smoking leads to multiple oral health problems including high incidence of dental caries. TheConclusion: incidence of dental caries further increases in presence of coexisting factors such as poor oral hygiene, food habits, limited preventive dental visits and old age.

Does bullying due to oral conditions influence cigarette smoking in adolescents? A structural equation modeling

Abstract This study aimed to explore the pathways that can influence cigarette smoking among adolescents. This population-based cohort followed a random sample of 12-year-old adolescents from southern Brazil for 6 years. Regular cigarette smoking was assessed through a self-reported question, previously used in the Brazilian National Survey of Scholar Health. We also gathered data on bullying, dental caries at baseline, incidence of caries, sex, friend network, and Sense of Coherence (SOC). Socioeconomic and demographic characteristics were also collected. Structural equation modeling was used to evaluate the pathways. Of the 1,134 adolescents examined at baseline, 768 were re-evaluated (67.7% retention rate). The prevalence of smoking was 37.6%. This prevalence was directly affected by low SOC (SC: -0.14, p < 0.01), low household income (SC: -0.12, p < 0.01), and male sex (SC: 0.15, p < 0.01). Presence of dental caries at baseline indirectly influenced the occurrence of dental bullying at follow-up via the incidence of dental caries (SC: 0.01, p < 0.05). Dental bullying indirectly influenced cigarettes consumption via SOC (SC: 0.62, p < 0.05). Friend network also indirectly influenced the consumption of cigarettes via SOC (SC: 0.32, p < 0.05). Psychosocial factors influence adolescent cigarette consumption through its higher direct and indirect effects (via bullying). In addition, behavioral, sociodemographic, and clinical factors also influence the occurrence of smoking.

Barriers to the provision of smoking cessation intervention/services: A mixed-methods study among health care workers in Zambezi region, Namibia

Background. Healthcare workers (HCWs) can play a significant role in tobacco prevention by delivering smoking cessation (SC) interventions to patients who smoke. Objective: To identify and explore the perceived barriers which prevent healthcare workers from delivering SC counselling to patients in Zambezi region, Namibia. Methods: A regional-based, concurrent mixed-methods study was conducted between March and October 2020 among HCWs of the 8 constituencies of Zambezi region, Namibia. In the study, 129 respondents, who had been residents of the selected constituencies for over 5 years and aged between 17 to 60 years, participated. Results: 129 respondents participated in the study. Majority of respondents were females (62.9% and 68.1%) compared to (37.1% and 31.9%) males. The mean age of respondents was 35.91 (SD=9.3) and 36.61 (SD=8.7) respectively and their ages ranged between 18 and 59 years. Key barriers were identified: (i) HCWs based barriers included lack of time to provide SC, inadequate training and insufficient knowledge on SC interventions; (ii) system-based barriers identified lack of SC guidelines and educational materials for patients, and specialists to refer patients; and (iii) patient/client-based barriers included lack of patient interest in SC information, patients not adhering to advise given on SC. Conclusions: This study showed that SC delivery in Zambezi region is inadequate. Barriers were identified regarding the delivery of SC intervention for the first time. Targeted SC interventions are required to combat these identified specific barriers. There is a crucial need to improve HCWs skills and knowledge in providing SC intervention.

The effect of smoking in the development of stroke in young patients 19 to 45 years old: A case-control study

Introduction@#The increasing incidence of stroke in young adults has been a growing concern, which is why research studies were generated to find out the risk factors contributing to the development of this disease. This study investigated the dose-dependent effect of smoking in the development of stroke in the young ages (19-45 years).@*Methods@#A case-control retrospective study was conducted using electronic and printed records of the patients admitted to Amang Rodriguez Memorial Medical Center last 2017-2018. There were 275 patients included in the study. The smoking status and pack-years cigarette smoking of the subjects were recorded and were correlated with the duration of hospitalization and the Modified Rankin Scale (MRS). Results were analyzed using student’s t-test, ANOVA, and Pearson’s Correlation.@*Result@#The prevalence of stroke was higher in men than in women. The ORs (95% CI) of stroke were significant in current cigarette smoking at 2.71 (CI: 1.6398 to 4.4943). Compared with non-smokers and those who smoked 1 to 9 pack years, the OR of stroke was significantly increased for those who smoked 10 to 19, and ≥ 20 cigarettes per day with OR of 14.0765 (4.10 to 48.35), and 31.5854 (1.82 to 548.97), respectively (p= 0.032 for linear trends). There was a weak positive linear correlation between pack years of cigarette smoking (1-9, 10-19, >20 pack years) and days of hospitalization (r= 0.28; p for trend = 0.0168). There was also a strong positive linear correlation between stroke outcome using the Modified Rankin Scale and pack years of cigarette smoking (r = 0.72; P for trend = 0.001). This study shows an increase in the odds of stroke in current cigarette smokers with a dose-dependent relationship in its outcome.@*Conclusion@#Smoking is a significant risk factor for stroke with a dose-dependent effect on its outcome. Furthermore, quitting smoking significantly decreases the risk of developing stroke.

Estudio cualitativo del uso de los cigarrillos electrónicos en los estudiantes universitarios / Qualitative Study of E-Cigarette Use in College Students

Objetivos: El propósito de esta investigación fue determinar el nivel de conocimiento, creencias, percepción y practicas asociadas al consumo de cigarrillos electrónicos en los estudiantes universitarios (UASD), recinto Santiago, República Dominicana. Cada estudiante firmó un consentimiento informado certificando que éste respondió cada pregunta realizada por el entrevistador de manera voluntaria. El método de recolección de los datos fue mediante entrevistas, las cuales fueron grabadas por los entrevistadores. La muestra fue de 53 entrevistas, 48 individuales y 5 grupos focales, la misma se tomó hasta alcanzar el punto de saturación de cada pregunta, es decir cuando todas las respuestas se tornaron repetitivas. Materiales y métodos: Se realizó un estudio cualitativo de tipo fenomenológico y de fuentes primarias en el período mayo-agosto del año 2019 en la universidad privada Pontificia Universidad Católica Madre y Maestra (PUCMM) y la universidad pública Universidad Autónoma de Santo Domingo. (UASD), campus Santiago, República Dominicana. El método de recolección de datos se realizó a través de entrevistas, las cuales fueron grabadas por los entrevistadores. Cada estudiante entrevistado firmó un consentimiento informado certificando que respondió voluntariamente a cada pregunta formulada por el entrevistador. La muestra estuvo compuesta por 53 entrevistas, 48 personas y cinco grupos focales. Las entrevistas se realizaron hasta llegar al punto de saturación de cada pregunta, que es cuando todas las respuestas se volvieron repetitivas. Resultados: El conocimiento que tiene los estudiantes universitarios sobre cigarrillo electrónico (CE), es pobre, desde su funcionamiento, partes, sustancias e incluso las posibles complicaciones que puede traer a la salud, tanto en la Pontificia Universidad Católica Madre y Maestra (PUCMM) como en la Universidad Autónoma de Santo Domingo (UASD), pero es más notable en la universidad pública. Por otro lado, muchos perciben el CE, como una alternativa del uso de tabaco, que posee diversidad de sabores, olor agradable, atractivo, práctico y capaz de ofrecer relajación. En cuanto a la actitud hacia el dispositivo, en PUCMM exhibe un mayor nivel de rechazo con respecto al uso. Es importante mencionar, que mayoría de los entrevistados son o alguna vez fueron usuarios de este, no obstante, no lo recomiendan en gran medida, ya que asumen que puede causar daño y ser adictivo, aunque en menor medida al cigarrillo convencional. La población más susceptible a su uso, son los jóvenes y el sexo masculino, aunque las féminas se han ido sumando de manera significativa. De igual modo, se logró apreciar las grandes influencias que mueven a los jóvenes a su consumo, incluyendo, las redes sociales, familia, amigos, en general el entorno en que se rodean. Conclusión: Concluimos que los estudiantes universitarios carecen de conocimiento con respecto al cigarrillo electrónico, tanto en el funcionamiento, sustancias y complicaciones para la salud. Muchos observan al cigarrillo electrónico como un dispositivo para fumar con un olor agradable, por lo cual puede ser muy atractivo para los usuarios. Se logró apreciar el importante papel que juegan las influencias sociales para el uso del dispositivo, promovido por las redes sociales y relaciones cercanas. Otro problema en la sociedad actual es el uso de CE en menores de edad. Según los resultados existe una gran necesidad de intervención y educación, principalmente en los jóvenes.

Objective: The purpose of this research was to determine the level of knowledge, beliefs, perception, and practices associated with consuming electronic cigarettes among university students. Materials and methods: A qualitative study of phenome-nological type and from primary sources was carried out in the period of May-August of the year 2019 at the private university Pontificia Universidad Católica Madre y Mae-stra (PUCMM) and the public university Universidad Autónoma de Santo Domingo (UASD), Santiago campus, Dominican Republic. The data collection method was done through interviews, which the interviewers recorded. Each student interviewed signed an informed consent cer-tifying that they answered voluntarily each question asked by the interviewer. The sample consisted of 53 interviews, 48 individuals, and five focus groups. Interviews were done until reaching the saturation point of each question, which is when all the answers became repetitive. Results: University students' knowledge regarding elec-tronic cigarettes (EC) is poor. Knowledge regarding its mechanism, parts, substances, and possible complications to one's health, is scarce both in PUCMM and the UASD, but this is more notable at the public university. Addition-ally, many perceive EC as an alternative to tobacco use, the former, as per our study population, having a variety of fla-vors, a pleasant smell, being attractive, practical, and capa-ble of offering relaxation. Regarding the attitude towards the device, PUCMM exhibits a higher level of rejection regarding its use. It is essential to mention that most inter-viewees were once users of EC. However, they do not rec-ommend it to a great extent since they assume that it can cause harm and be addictive, although to a lesser extent than conventional cigarettes. The population most suscep-tible to its use are young people, including minors and the male gender, although females have been significantly increasing its use. Similarly, it was possible to appreciate the influences that greatly evoke the younger population's consumption, including social networks, family, friends, and the surrounding environment. Conclusion: We concluded that university students have insufficient knowledge regarding electronic cigarettes, both in their mechanism, substances, and health compli-cations. Most see electronic cigarettes as smoking devices with a pleasant smell, which can be very attractive to users. It was possible to observe the critical role played by social influences on the use of the device, promoted by social networks and close relationships. Another problem in cur-rent society is the use of CE in minors. According to the results, there is a great need for intervention and educa-tion, mainly among the younger generation.

Effect of zinc and probiotics supplementation on IL-6 and tissue neutrophil levels in rats exposed to cigarette smoke

@#Introduction: Cigarette smoke exposure can cause inflammation, inducing the release of acute phase cytokines, such as IL-6, that will then trigger the recruitment of neutrophils, which are mostly phagocytic cells. Zinc and probiotics are known to have beneficial effects against inflammation. This study was conducted to investigate the effect of zinc and probiotics supplementation on IL-6 and tissue neutrophil levels in rats exposed to cigarette smoke. Methods: In a randomised, experimental study with post-test control group design, thirty 2 to 3-month-old male Wistar rats, each weighing 180-220 g, were divided into five groups: control group without treatment (C); exposed to cigarette smoke [C (-)]; exposed to cigarette smoke and received zinc (Z); exposed to cigarette smoke and received probiotics (P); and exposed to cigarette smoke and received a combination of zinc and probiotics (ZP). Results: Mean tissue neutrophil levels in Z, P, and ZP groups were 43.43±2.01, 34.67±1.32,and 29.77±5.05 cells, respectively. There were significant differences between supplementation intake and tissue neutrophil levels in each group compared to C (-) group (p<0.05). Meanwhile, only IL-6 level in the ZP group (6.02 pg/mL) decreased significantly compared to C (-) group (10.61 pg/mL). Conclusion: These results suggest that a combination of zinc and probiotics have an anti-inflammatory effect as measured by IL-6 and neutrophil levels.

High and low frequency repetitive transcranial magnetic stimulation in smoking cessation: A systematic review

Abstract@#Repetitive Transcranial Magnetic Stimulation is a non-invasive brain stimulation process popularly used to treat psychiatric disorders. Multiple evidence shows effectiveness of rTMS in treating addiction, particularly in tobacco or cigarette users. This study consisted of review of current published literatures on repetitive transcranial magnetic stimulation following predefined eligibility criteria. The studies included evaluated at least one of the epidemiological parameters: (i) the meaning of repetitive transcranial magnetic stimulation (ii) Effectiveness of the Repetitive Transcranial Magnetic Simulation Over Behavioral therapy (iii) rTMS-associated adverse events among tobacco users@*Methodology@#We included published studies discussing rTMS in smoking cessation which examined if these interventions were effective and identified whether it has a severe negative effect on the patients. A total of 104 related studies were identified through database searches (Pubmed, Elsevier, Cochrane). Of which, 53 duplicate studies were removed. Five studies were then excluded with more than 10 years in publication. A total of 28 papers were then included in the study.@*Conclusion@#We conclude that rTMS is more effective in treating addiction in terms of smoking compared to behavioral therapy and rTMS affects triggered desired circuit which may be crucial among tobacco users. Individual neuronal excitability in the specific region’s subsequent induction may impact the therapeutic outcomes. With this, the high-frequency rTMS sequentially applied to the left superior medial frontal cortex and dorsolateral prefrontal cortex may be an effective tool for improving the cessation rate.

Association between e-cigarette use and subjective cognitive decline among adults aged 45 and above / 上海预防医学

ObjectiveTo investigate the relationship between e-cigarette use and subjective cognitive decline. MethodsThis study included survey participants aged ≥45 years from the US Behavioral Risk Factor Surveillance System. The prevalence of subjective cognitive decline in people with different tobacco use conditions was estimated. Multivariate logistic regression was employed to determine the relationship between e-cigarette use and subjective cognitive decline， as well as the relationship between co-use of e-cigarette and combustible tobacco and subjective cognitive decline. ResultsA total of 204 032 participants were included in the study. The total prevalence of subjective cognitive decline was 11.46%， whereas among current e-cigarette users， the prevalence was 19.92%. After accounting for confounding factors， current e-cigarette use was identified as a risk factor for subjective cognitive decline compared to individuals who had never used e-cigarettes， with an OR of 1.46 （95%CI： 1.20‒1.77）. Meanwhile， occasional e-cigarette use showed a higher risk， with an OR of 1.54 （95%CI： 1.22‒1.95）. The highest risk was observed with the co-use of e-cigarette and combustible tobacco， with an OR of 1.69 （95%CI： 1.32‒2.16）， followed by current e-cigarette use and former combustible tobacco use， with an OR value of 1.38 （95%CI： 1.08‒1.78）. ConclusionThe use of e-cigarettes increases the risk of subjective cognitive decline， with occasional use demonstrating a more pronounced negative impact. In general， the risk of cognitive decline is greater among e-cigarette users compared to combustible tobacco users. Controlling the use of combustible tobacco， especially e-cigarette， will help reduce the incidence of subjective cognitive decline. Individuals currently using combustible tobacco are advised to explore smoking cessation methods other than transitioning to e-cigarettes.

Dendrobium Polysaccharides Mitigate CSE-induced Inflammatory Damage of Human Bronchial Epithelial Cells via TLR4/NF-κB Pathway / 中国实验方剂学杂志

ObjectiveTo observe the effects of Dendrobium polysaccharides on the secretion of inflammatory cytokines and Toll-like receptor 4 （TLR4）/nuclear factor （NF）-κB pathway in 16HBE cells exposed to cigarette smoke extract （CSE）. MethodThe 16HBE cells were classified into the control， CSE， and CSE+ Dendrobium polysaccharides （100， 200， 400 mg·L-1） groups. The cell-counting kit-8 （CCK-8） assay was employed to measure the cell viability， and a microscope was used to observe the cell morphology. The enzyme-linked immunosorbent assay was employed to measure the levels of interleukin （IL）-8， IL-1β， IL-4， IL-13， and transforming growth factor （TGF）-β in cell culture supernatants. Real-time PCR was carried out to determine the mRNA levels of Toll-like receptor 4 （TLR4）， nuclear factor-κB （NF-κB）， and IL-4. Western blot was employed to determine the protein levels of interleukin-4 receptor （IL-4R）， TLR4， myeloid differentiation primary response protein 88 （MyD88）， NF-κB， phosphorylated nuclear factor-κB （p-NF-κB）， and nucleoproteins nuclear factor-κB （NEs-NF-κB）. The immunofluorescence assay was employed to measure the nuclear translocation of NF-κB. ResultCompared with the control group， the CSE group showed elevated levels of IL-8， IL-1β， IL-4， IL-13， and TGF-β in the cell culture supernatants （P<0.05， P<0.01）， up-regulated expression levels of TLR4， MyD88， NF-κB， p-NF-κB， NEs-NF-κB， and IL-4 （P<0.01）， and significant nuclear translocation of NF-κB. Compared with the CSE group， Dendrobium polysaccharides increased the cell survival rate， recovered the cell activity， lowered the levels of IL-8， IL-1β， IL-4， IL-13， and TGF-β， down-regulated the expression of TLR4， MyD88， NF-κB， p-NF-κB， NEs-NF-κB， and IL-4 （P<0.05， P<0.01）， and reduced the nuclear translocation of NF-κB. ConclusionDendrobium polysaccharides showed significant protective effects on the 16HBE cells exposed to CSE by inhibiting the TLR4/NF-κB signaling pathway.

Investigation on e-cigarette use among middle school students in Ningbo City / 预防医学

Objective@# To investigate the e-cigarette use and its influencing factors among middle school students in Ningbo City, Zhejiang Province, so as to provide insights into e-cigarette control among adolescents.@*Methods@#Students of junior high schools, high schools and vocational high schools in Ningbo City were sampled using a multi-stage stratified cluster random sampling method from September to October 2021. Students' general information, cigarette and e-cigarette use and e-cigarette advertising exposure were collected using 2021 China Youth Tobacco Survey Questionnaire, and proportions of e-cigarette current use and attempt to use were analyzed. Factors affecting the attempt to use e-cigarettes were identified using a multivariable logistic regression model. @*Results@#Totally 1 591 questionnaires were allocated, and 1 574 valid questionnaires were recovered, with an effective rate of 98.93%. The respondents included 863 males (54.83%) and 711 females (45.17%); 787 junior high school students (50.00%), 535 high school students (33.99%) and 252 vocational high school students (16.01%). The proportion of current e-cigarette use was 1.91% and the proportion of attempt to use e-cigarettes was 6.61%. Multivariable logistic regression analysis identified males (OR=2.544, 95%CI: 1.438-4.501), living in rural areas (OR=2.084, 95%CI: 1.195-3.634), having close friends who were smokers (OR=4.828, 95%CI: 2.936-7.940), witnessing teachers smoking at school (OR=2.766, 95%CI: 1.642-4.659), e-cigarette advertising exposure (OR=2.155, 95%CI: 1.315-3.532), current cigarette use (OR=9.365, 95%CI: 2.610-33.603) and attempt to use cigarettes (OR=7.519, 95%CI: 4.115-13.737) as promoting factors for the attempt to use e-cigarette. @* Conclusions @#There are e-cigarette use behaviors among middle school students in Ningbo City. Having teachers or close friends who were smokers, cigarette use behaviors and e-cigarette advertising exposure may increase the risk of attempt to use e-cigarettes among middle school students.

Cognition of e-cigarettes and its influencing factors among secondary school personnel in Shanghai / 上海预防医学

ObjectiveTo investigate the cognition of e-cigarette compositions and hazards and its influencing factors among secondary school personnel （junior， senior and vocational high school） in Shanghai， so as to provide ideas for improving the cognition level of e-cigarettes among the school personnel and tobacco control efforts on campus in the future. MethodsA multi-stage stratified cluster random sampling method was used to conduct an anonymous online questionnaire survey among 1 767 secondary school personnel in Shanghai. ResultsThe proportion of school staff who had used e-cigarettes was 3.79%. The participants who were not sure whether the e-cigarette smoke was “mainly water vapor （incorrect）” and whether the e-cigarette smoke “contained nicotine （correct）” and “contained formaldehyde （correct）” accounted for 62.71%， 54.44% and 61.91%， respectively. Among them， 68.48%， 55.46% and 50.37%， respectively， agreed that e-cigarettes would be “addictive”， “harmful” and “that second-hand smoke was harmful”. Binary logistic regression analysis showed the following risk factors for the low level of school personnel’s awareness of e-cigarette compositions： age ≥40 years （OR=1.65， 95%CI： 1.32‒2.06）， working in junior high school （OR=1.37， 95%CI： 1.09‒1.73）， educational attainment level as junior college or below （OR=1.67， 95%CI： 1.02‒2.74）， and not having participated in tobacco control education activities （OR=1.37， 95%CI： 1.08‒1.73）. Meanwhile， working in junior （OR=1.43， 95%CI： 1.12‒1.83） or senior （OR=1.44， 95%CI： 1.08‒1.92） high school， educational attainment level as junior college or below（OR=2.10， 95%CI： 1.24‒3.56）， having used e-cigarettes （OR=2.98， 95%CI： 1.63‒5.42）， not having participated in tobacco control education activities （OR=1.49， 95%CI： 1.16‒1.92） and low level of awareness of e-cigarette compositions （OR=4.24， 95%CI： 3.44‒5.23） were risk factors for the low level of school personnel’s awareness of e-cigarette hazards. ConclusionsThe level of e-cigarette awareness among school personnel in Shanghai is low， especially those who are older， had low educational attainment level and had used e-cigarettes. In the future， tobacco control education for school personnel should be strengthened to improve their cognition and ability of tobacco control on campus.

E-cigarette use among middle school students in Hainan Province / 预防医学

Objective@#To investigate of e-cigarette use among middle school students in Hainan Province, so as to provide insights into tobacco control among adolescents.@*Methods@#Students were randomly sampled using a multistage stratified cluster random sampling method from three junior high schools, two high schools and one vocational high school in Hainan Province from July to October, 2021. Participants' basic features, use of e-cigarettes, e-cigarette advertising exposure were collected using the Questionnaire on Tobacco and Alcohol Prevalence among Chinese Adolescents in 2021 prepared by Chinese Center for Disease Control and Prevention. Following data weighting, students' use of e-cigarettes and exposure to e-cigarette advertisements were descriptively analyzed, and factors affecting current use of e-cigarettes were identified using a multivariable logistic regression model.@*Results@#A total of 8 561 questionnaires were allocated, and 8 538 valid questionnaires were recovered, with an effective recovery rate of 99.73%. The respondents included 4 470 boys (52.35%) and 4 068 girls (47.65%), and there 4 367 junior high school students (51.15%), 3 482 high school students (40.78%), and 689 vocational high school students (8.07%). The rate of e-cigarette use was 25.01% and the rate of current e-cigarette use was 4.68%. There were 2 728 respondents with exposure to e-cigarette advertising during the past 30 days, and the number of weighted individuals were 210 932 (32.60%). The route of e-cigarette advertising exposure mainly included point-of-sale (21.59%), stores (13.61%), and shopping websites (9.01%). Multivariable logistic regression analysis identified region (OR=0.610, 95%CI: 0.482-0.772), males (OR=1.332, 95%CI: 1.062-1.669), high school students (OR=0.376, 95%CI: 0.259-0.545), companion smoking (OR=6.645, 95%CI: 4.935-8.948) and advertising exposure (OR=3.229, 95%CI: 2.581-4.040) as factors affecting current use of e-cigarettes. @*Conclusions@#The use of e-cigarettes among middle school students is higher in Hainan Province than the national level, and exposure to e-cigarette advertisements may facilitate use of e-cigarettes. It is necessary to strengthen the supervision of e-cigarettes, strictly restrict e-cigarettes advertisements and promotions.

A qualitative study of user experience， knowledge and attitude of e-cigarette use in Shanghai / 上海预防医学

ObjectiveTo understand the experience， knowledge and attitudes of e-cigarette users in Shanghai， and to provide evidence for the development of intervention programs for e-cigarette use. MethodsThe Respondent-Driven Sampling （RDS） method was used to recruit 40 e-cigarette users for qualitative interviews from November 2020 to February 2021. NVivo （11.0） software was used to code interview records， and the thematic pattern and relationship analysis were conducted. ResultsIn terms of the reasons and user experience of e-cigarette use， most respondents used e-cigarettes for the first time after recommendation of friends； The reasons for the current use of e-cigarettes focus on the subjective feelings generated by the use of e-cigarettes （easy to use， replacing traditional tobacco， and having many flavors）. Compared with traditional tobacco use， respondents said e-cigarettes tasted good and had no physical impact （they could be used all the time without making them uncomfortable）. In terms of the awareness of e-cigarette use related knowledge， the respondents' opinions on whether e-cigarettes caused health risks were mostly based on their own experience of using them， and they said it was difficult to identify real information online. As for whether they were interested in relevant knowledge， most respondents said they wanted to learn about the professional knowledge related to e-cigarettes. Regarding the attitude related to the use of e-cigarettes， most respondents believed that e-cigarettes are addictive， e-cigarettes are not a safe alternative to traditional tobacco， ande-cigarettes couldn't help them quit smoking. Three out of ten respondents said they supported including e-cigarettes in the Regulation on Smoking Control in Public. ConclusionThere are certain characteristics of e-cigarette users' feelings， related knowledge and attitude towards e-cigarette use that should be targeted to carry out publicity， education and intervention.

Attempts to e cigarettes use and associated factors among junior middle school students from grade 1 to 4 in Macao / 中国学校卫生

Objective@#To understand the current status and influencing factors of attempts to e cigarettes use among Macao teenager, and to provide evidence for strategies to prevent and control the use of e cigarettes among teenager.@*Methods@#Research data was 2 683 valid questionnaires collected from the "Macao Youth Tobacco Use Survey 2021", representing 19 480 teenagers from grade 1 to 4 in junior middle schools in Macao after sample weighting. Multivariate Logistic regression analysis was used to analyze the factors that may influencing attempts to e cigarettes use.@*Results@#The total percent of attempt using e cigarettes was 11.3%(95% C =10.2%-12.6%), and male(12.1%) was higher than female(10.5%), the difference was statistically significant ( χ 2= 11.01 , P <0.01). Older adolescents (14-16, ≥17 years old), having more pocket money per week, believing e cigarettes to be less harmful, having been taught about the hazards of e cigarettes within 12 months, definitely believing that e cigarettes maked teenager more attractive, having been exposed to second hand smoke at home within 7 days, having seen tobacco advertisements on the Internet within 30 days, smoking by either parent, smoking among best friends were positively associated with attempts to e cigarettes use ( OR=1.48, 3.01, 1.79, 1.34, 1.67, 1.27, 1.33, 1.34, 1.58, 3.53, P <0.01).@*Conclusion@#Attempts to e cigarettes use is common among Macao teenagers, and there are many complex influencing factors. It is recommended to strengthen whole society cooperation and promote the prevention and control of teenager s use of e cigarettes through more targeted comprehensive measures.

Vaping and e-cigarettes: a new public health concern / Монголын Анагаах Ухаан

@#Electronic cigarettes are handheld electronic vaping devices which produce an aerosol by heating an e-liquid. The e-liquid typically contains humectants and flavorings, with or without nicotine; once vaporized by the atomizer, the aerosol (vapor) provides a sensation like tobacco also smoking the heating process can lead to the generation of new decomposition compounds that may be hazardous. Heavy metals, organic compounds, and particles smaller than PM2.5 were found on the puff of the electronic cigarette, also in 2012 International agency research cancer, introduced PM2.5 human carcinogen substance. Therefore, e-cigarette liquid products should be subjected to regulatory control to ensure consistent nicotine delivery. Global youth tobacco survey Mongolia 2019 asked about e-cigarette use status and 3.5% (95% CI: 2.6-4.6) of students currently used electronic cigarettes while one in ten students (10.1%, 95% CI: 8.3-12.2) had ever used electronic cigarettes. E-cigarette advertising is on television and radio in many countries that have long banned similar advertising for cigarettes and other tobacco products and may be indirectly promoting smoking conventional cigarettes. Smoke-free policies protect nonsmokers from exposure to toxins and encourage smoking cessation. Introducing e-cigarettes into clean air environments may result in population harm if use of the product reinforces the act of smoking as socially acceptable or if use undermines the benefits of smoke-free policies.

Serum bilirubin in workers exposed to tobacco dust and noise / 环境与职业医学

Background Exposure to tobacco dust or noise is associated with the risk of cardiovascular disease in workers, but there are few studies on their effects on workers' serum bilirubin levels. Objective To analyze the effects of combined exposure to tobacco dust and noise on workers' serum bilirubin levels. Methods We selected 824 employees from a large cigarette factory in Wuhan. According to the status of occupational hazards on site, we divided the participants into a control group (n=149), a tobacco dust exposure group (n=198), a noise exposure group (n=299), and a tobacco dust and noise combined exposure group (n=178). We collected general information of the participants. We collected blood samples and measured serum bilirubin. We used chi-square test to compare between-group categorical indicators. We used analysis of variance to compare measurement data. Taking the control group as the reference category, we used generalized linear regression model to analyze serum bilirubin concentration across the three exposure groups and the control group. Results The abnormal rates of serum indirect bilirubin concentrations in the control group, the tobacco dust exposure group, the noise exposure group, and the tobacco dust and noise combined exposure group were 6.04% (9/149), 12.63% (25/198), 13.38% (40/299), and 17.42% (31/178), respectively, showing a clear increasing trend (P<0.05). The mean concentrations of indirect bilirubin in the tobacco dust and noise combined exposure group were significantly higher than that in the tobacco dust and the noise groups (P<0.05). The serum indirect bilirubin concentrations in the tobacco dust exposure group, the noise exposure group, and the tobacco dust and noise combined exposure group were 1.833, 1.774, and 1.634 times higher than those of the control group (P<0.05). Conclusion Occupational exposure to tobacco dust or noise may associate with elevated serum total bilirubin concentration in cigarette factory workers, mainly indirect bilirubin concentration. Serum indirect bilirubin anomaly is higher among workers simultaneously exposed to tobacco dust and noise.