Performance of exhaled carbon monoxide measurement in smoking cessation clinics and its influence on patients' willingness and behavior for smoking cessation / 中华流行病学杂志

Objective: To evaluate the performance of exhaled carbon monoxide measurement in smoking cessation clinics and its influence on patients' willingness and behavior for smoking cessation in China. Methods: Data of 41 566 patients who visited 257 smoking cessation clinics equipped with exhaled carbon monoxide detectors from 2019 to 2021 were selected to study the relationship between exhaled carbon monoxide measurement and patients' willingness to quit smoking as well as smoking cessation rate in those who completed follow up. Results: Only 21 470 (51.7%) of the patients received exhaled carbon monoxide measurement in the first visit. Patients who had exhaled carbon monoxide measurement were 1.87 (95%CI: 1.78-1.96) times more likely to have stronger willingness to quit smoking. The follow up results indicated that the patients with exhaled carbon monoxide measurement in the first visit were 1.10 (95%CI: 1.05-1.16) times more likely to quit smoking one month later than those without the measurement, and 1.22 (95%CI: 1.17-1.29) times more likely to quit smoking three months later than those without measurement. Conclusions: Exhaled carbon monoxide measurement can improve patients' willingness to quit smoking and increase smoking cessation rate. However, the testing rate is low in smoking cessation clinics at present. It's important to promote the equipment and utilization of exhaled carbon monoxide detector in smoking cessation clinics.

Analysis of tobacco dependence level and its influencing factors on Tianjin residents / 中华流行病学杂志

Objective: To understand the prevalence and influencing factors of tobacco dependence among the population aged 15-69 in Tianjin to provide the basis for formulating targeted smoking control intervention policies and carrying out scientific smoking cessation intervention services. Methods: The data of this study comes from the 2018 Tianjin residents' health literacy monitoring survey. Probability-proportional-to-size sampling is adopted for sampling. SPSS 26.0 software was used for data cleaning and statistical analysis, and χ2 test and binary logistic regression were used to analyze the influencing factors. Results: A total of 14 641 subjects aged 15-69 were included in this study. After standardized, with a smoking rate of 25.5%, including 45.5% for men and 5.2% for women. Among the population aged 15-69, the prevalence of tobacco dependence was 10.7%; among current smokers, the prevalence rate of tobacco dependence is 40.1%, of which the prevalence rate of male tobacco dependence is 40.0%, and the prevalence rate of female tobacco dependence is 40.6%. According to multivariate logistic regression analysis, people who live in rural areas, have an education level of primary school or below, smoke every day, smoke the first cigarette ≤15 years old, smoke ≥21 cigarettes per day, and smoke for more than 20 packet years, people who report poor physical health are more likely to suffer from tobacco dependence (all P<0.05); age and smoking age did not affect the possibility of tobacco dependence (all P>0.05). Among current smokers, there was no significant difference in their willingness to quit smoking whether they had tobacco dependence (P>0.05). The proportion of people with tobacco dependence who have tried to quit smoking and failed is higher (P<0.001). Conclusions: The prevalence of tobacco dependence among smokers aged 15-69 in Tianjin is high, and the demand for quitting smoking is great. Therefore, smoking cessation publicity should be carried out for key groups, and smoking cessation intervention work in Tianjin should be continuously promoted.

Incidence of chronic obstructive pulmonary disease and risk factors in the Suzhou cohort / 中华流行病学杂志

Objective: To understand the incidence of chronic obstructive pulmonary disease (COPD) in the Suzhou cohort, and explore the risk factors for the development of COPD in Suzhou, and provide a scientific basis for COPD prevention. Methods: This study was based on the China Kadoorie Biobank project in Wuzhong District, Suzhou. After excluding individuals with airflow obstruction and self-reported chronic bronchitis, emphysema, or pulmonary heart disease at baseline, 45 484 individuals were finally included in the analysis. Cox proportional risk models were used to analyze risk factors of COPD and calculate hazard ratios and 95% confidence interval (CI) in the Suzhou cohort. The effect modifications of smoking on the association between other risk factors and COPD were evaluated. Results: Complete follow-up was available through December 31, 2017. Participants were followed up for a median of 11.12 years, and 524 individuals were diagnosed with COPD during the follow-up period; the incidence was 105.54 per 100 000 person-years. Multivariate Cox proportional risk regression models showed that age (HR=3.78, 95%CI:3.32-4.30), former smoking (HR=2.00, 95%CI:1.24-3.22), current smoking (<10 cigarettes/day, HR=2.14, 95%CI:1.36-3.35;≥10 cigarettes/day, HR=2.69, 95%CI:1.60-4.54), history of respiratory disease (HR=2.08, 95%CI:1.33-3.26), daily sleep duration ≥10 hours (HR=1.41, 95%CI:1.02-1.95) were associated with increased risk of COPD. However, education level of primary school and above (primary or junior high school, HR=0.65, 95%CI:0.52-0.81; high school and above, HR=0.54, 95%CI:0.33-0.87), consuming fresh fruit daily (HR=0.59, 95%CI:0.42-0.83) and consuming spicy food weekly (HR=0.71, 95%CI:0.53-0.94) were associated with reduced risk of COPD. Conclusions: The incidence of COPD is low in Suzhou. Older age, smoking, history of respiratory disease, and long sleep duration were risk factors for the development of COPD in the Suzhou cohort.

Prevalence of smoking in adults aged 40 years and above in China, 2019-2020 / 中华流行病学杂志

Objective: To understand the prevalence of smoking and its change in adults aged ≥40 years in China and provide evidence for the development of chronic obstructive pulmonary disease (COPD) prevention and control strategies. Methods: The data of this study were obtained from COPD surveillance in China during 2014-2015 and during 2019-2020. The surveillance covered 31 provinces (autonomous regions and municipalities). A multi-stage stratified cluster random sampling were used to select residents aged ≥40 years, and face-to-face interviews were conducted to collect the information about their tobacco use. After complex sampling weighting of the samples, the current smoking rate, average age to start smoking and average daily cigarette consumption of people with different characteristics during 2019-2020 were estimated, and the changes in the current smoking rate and average daily cigarette consumption were analyzed from 2014-2015 to 2019-2020. Results: During 2019-2020, the current smoking rate in adults aged ≥40 years was 27.2%, and the rate was much higher in men (52.1%) than in women (2.5%).The average age of the smokers to start smoking was 20.0 years old, and men usually started smoking at younger age (19.6 years) compared with women (27.9 years). The average daily cigarette consumption of daily smokers was 18.0 sticks, and the consumption of men (18.3 cigarettes) was higher than that of women (11.1 cigarettes). Compared with the surveillance results during 2014-2015, the current smoking rate had decreased by 2.8 percentage points in the general population, 4.1 percentage points in males, 1.6 percentage points in females, and the urban and rural areas fell by 3.1 percentage points and 2.5 percentage points, respectively. The average daily cigarette consumption decreased by 0.6 sticks. Conclusions: In recent years, the current smoking rate and average daily cigarette consumption in adults aged ≥40 years decreased in China, but smoking is still common in more than quarter of this population and more than half of men aged ≥40 years. It is necessary to take targeted tobacco control measures based on population and regional characteristics to further reduce the smoking level of the population.

Exposure to tobacco advertisements, promotions, and sponsorships among in­school adolescents in Lagos, Nigeria: A cross­sectional study

Background: The Nigerian government implemented the National Tobacco Control Act (NTCA) in 2015, which prohibits tobacco advertising, promotion, and sponsorship (TAPS) exposure to children under 18 years of age. This study was conducted to assess the prevalence of attitudes and exposure to TAPS among in school adolescents in Lagos State, Nigeria, 5 years after the implementation of the Act and to identify the factors associated with TAPS exposure among the adolescents. Materials and Methods: This cross-sectional study was conducted among 968 in school adolescents selected through multistage random sampling. The data were collected using self-administered questionnaires adapted from the Global Youth Tobacco Survey. Results: Overall, 77% had been exposed to at least one form of TAPS in the past 30 days. The most frequently reported channel of exposure was through product placements, with 62% reporting exposure in films, TV, and videos. Up to 15.2% and 12.6% were exposed to TAPS through promotional activities and sponsorships, respectively. The majority (82.3%) had pro tobacco attitudes, while about a third (33.1%) had pro TAPS attitudes. Factors associated with TAPS exposure were having pro TAPS attitudes (odds ratio [OR]: 3.5, 95% confidence interval [CI]: 2.3­5.3), being female (OR: 2, 95% CI: 1.4­2.7), and residing in a rural area (OR: 1.6, 95% CI: 1.2­2.3). Conclusion: Five years after implementing the NTCA, more than two thirds of the adolescents reported exposure to TAPS, mainly through films, TV, and videos. This suggests that the NTCA is poorly enforced. Efforts to ensure the effective implementation of comprehensive TAPS bans are warranted. Gender sensitive strategies that target adolescents' attitudes and school level factors should be emphasized.

Effect of heavy cigarette and water pipe smoking on antioxidants and lipids in Sudanese male smokers: a case-control study

Background: Tobacco smoking is a source of many toxins such as free radicals, mutagenic substances as well as cause for developing cardiovascular diseases (CVD), particularly atherosclerosis. This study aims to assess the impact of smoking on antioxidants in Sudanese male smokers. Methods: Cases were 85 and 48 men who smoke cigarettes (CS) and water pipe (WPS) respectively and they were compared with matching 50 non-smoking controls. Blood samples were collected and following parameters: Glutathione peroxidase, Superoxide dismutase, Total cholesterol, Triglyceride, LDL, HDL, Paraoxinase, and Malondialdehyde were measured. Results: There were no significant differences in biochemical parameters between light CS and WPS compared to controls. In heavy smokers of both WPS and CS, the TC, TG, LDL, and MDA were higher than controls (p>0.05), GPx, SOD, HDL, and PON were lower in smokers than controls (p>0.05). In both groups of smokers, HDL, GPx, SOD, and PON were inversely correlated with duration of smoking (p>0.05), also, HDL was positively correlated with SOD and GPx (p>0.05). Moreover, GPx and SOD were correlated with each other in both groups of smokers (p>0.05). Conclusion: In Sudanese male smokers' biochemical profile disturbances suggest that heavy smoking was leading to developing CVD, particularly WPS

O impacto das diversas formas de tabagismo nos acadêmicos da área da saúde / The impact of different forms of smoking on health academics

A Sociedade Brasileira de Pneumologia e Tisiologia (SBPT) define a Doença Pulmonar Obstrutiva Crônica (DPOC) como um distúrbio progressivo e irreversível. Nessa patologia ocorre um processo inflamatório crônico frente a exposição a gases tóxicos, principalmente advindos do tabaco. O cigarro é responsável por matar mais de 8 milhões de consumidores por ano, isso corresponde a 50% dos usuários. Objetivo: estimar a prevalência do tabagismo e possíveis doenças no sistema respiratório entre acadêmicos. Métodos: Trata-se de uma pesquisa observacional do tipo transversal em que se aplicou questionários aos alunos da área da saúde da Universidade Cesumar. Todos os participantes assinaram o Termo de Consentimento Livre e Esclarecido e eram maiores de 18 anos. A amostra foi composta por 336 estudantes, desta foram excluídas 43 respostas preenchidas de forma incorreta, restando 293 participantes. Os dados foram submetidos à estatística analítica e teste do qui-quadrado com nível de significância de 5%. Resultados: A prevalência do tabagismo foi de 26,96%, não fumantes são 62,46% e 10,58% são fumantes passivos. O dispositivo mais utilizado foi o cigarro eletrônico com 64,55% e o narguilé com 63,29%. Com relação a tentativa de suspender o uso, 36,71% relataram apresentar ansiedade. Os fumantes informaram ter infecções respiratórias frequentes, secreção, tosse e espirros com significância estatística (p<0,05). Pneumonia apresentou tendência crescente conforme maior tempo de tabagismo. Conclusão: Observou-se que a taxa de acadêmicos tabagistas é considerável, o tempo de uso varia de 3 a 5 anos e a maioria iniciou na adolescência sob influência de amigos

The Sociedade Brasileira de Pneumologia e Tisiologia (SBPT) defines Chronic Obstructive Pulmonary Disease (COPD) as a progressive and irreversible disorder. In this pathology, there is a chronic inflammatory process due to exposure to toxic gases, mainly from tobacco. Cigarettes are responsible for killing more than 8 million consumers a year, this corresponds to 50% of users. Objective: to estimate the prevalence of smoking and possible diseases of the respiratory system among students. Methods: This is a cross-sectional observational research in which questionnaires were applied to students in the health area of the University Cesumar. All participants signed the Informed Consent Form and were over 18 years of age. The sample consisted of 336 students, from which 43 incorrectly filled answers were excluded, leaving 293 participants. Data were submitted to analytical statistics and the chi-square test with a significance level of 5%. Results: The prevalence of smoking was 26.96%, non-smokers are 62.46% and 10.58% are passive smokers. The most used device was the electronic cigarette with 64.55% and the hookah with 63.29%. Regarding the attempt to discontinue use, 36.71% reported having anxiety. Smokers reported having frequent respiratory infections, secretion, coughing and sneezing with statistical significance (p<0.05). Pneumonia showed an increasing trend with longer smoking time. Conclusion: It was observed that the rate of academic smokers is considerable, the time of use varies from 3 to 5 years and most started in teenage years under the influence of friends

Smoking and loneliness in older adults: a population-based study in Campinas, São Paulo State, Brazil / Tabagismo e solidão em idosos: um estudo de base populacional em Campinas, São Paulo, Brasil / Tabaquismo y soledad en adultos mayores: un estudio basado en población de Campinas, estado de São Paulo, Brasil

This study aims to analyze the relationship between social isolation and loneliness with smoking in older adults. This is a cross-sectional, population-based study performed with 986 individuals aged 60 years or older. Data were collected from the Health Survey of the Municipality of Campinas (ISACamp 2014/2015), state of São Paulo, Brazil. We estimated the prevalence of smoking and smoking cessation according to independent variables and tested the associations using the chi-square test, considering a 5% significance level. Adjusted prevalence ratios were calculated using simple and multiple Poisson regression. Smoking and smoking cessation were not associated with most variables that indicate objective social isolation. "Often or always" loneliness was related to a higher prevalence of smoking (PR = 2.25; 95%CI: 1.38-3.66) whereas loneliness accompanied of self-reported emotional problems or common mental disorders was strongly associated with smoking and with lower smoking cessation (PR = 6.24; 95%CI: 1.37-28.47 and PR = 0.46; 95%CI: 0.28-0.77, respectively). These findings indicate that loneliness is a psychosocial aspect related to tobacco use which hinders smoking cessation in older adults, emphasizing the importance of emotional problems in this association.

O estudo busca analisar a relação entre isolamento social, solidão e tabagismo entre idosos. Trata-se de um estudo transversal de base populacional que incluiu 986 indivíduos com 60 anos ou mais. Os dados foram obtidos do Inquérito de Saúde de Município de Campinas (ISACamp 2014/2015), São Paulo, Brasil. Foram estimadas as taxas de prevalência do tabagismo e da cessação do tabagismo de acordo com as variáveis independentes e testadas as associações através do teste de qui-quadrado, considerando nível de significância de 5%. Foram calculadas as razões de prevalência ajustadas com o uso de regressão de Poisson simples e múltipla. O tabagismo e a cessação do tabagismo não mostraram associação com a maioria das variáveis que indicam isolamento social objetivo, enquanto o relato da solidão muitas vezes ou sempre esteve relacionado a uma maior prevalência de tabagismo (RP = 2,25; IC95%: 1,38-3,66). A solidão, acompanhada pelo autorrelato de problemas emocionais ou a presença de transtornos mentais comuns, esteve fortemente associada com o tabagismo e com menor prevalência de cessação do tabagismo (RP = 6,24; IC95%: 1,37-28,47 e RP = 0,46; IC95%: 0,28-0,77, respectivamente). Os achados sustentam o papel da solidão enquanto aspecto psicossocial relacionado ao uso de tabaco e ao impedimento da cessação do tabagismo em idosos e destacam a importância de problemas emocionais nessa associação.

El objetivo de este estudio fue analizar la relación entre el aislamiento social y la soledad con el hábito de fumar en adultos mayores. Se trata de un estudio transversal basado en población, realizado con 986 individuos con 60 años o mayores. Los datos se recogieron de la Encuesta de Salud de la Ciudad de Campinas (ISACamp 2014/2015), estado de São Paulo, Brasil. Estimamos la prevalencia del hábito de fumar y dejar de fumar según variables independientes y probamos las asociaciones usando el test chi-cuadrado, considerando un nivel de significancia de un 5%. Se calcularon las ratios de prevalencia usando una regresión simple y múltiple de Poisson. Fumar y dejar de fumar no estuvieron asociadas con la mayor parte de variables que indican aislamiento social objetivo, mientras que informar soledad a menudo o siempre estuvo relacionado con una más alta prevalencia de tabaquismo (RP = 2,25; IC95%: 1,38-3,66). Soledad acompañada de problemas emocionales autoinformados o la presencia de desórdenes mentales comunes estuvo fuertemente asociado con el tabaquismo y con una menor prevalencia de dejar de fumar (RP = 6,24; IC95%: 1,37-28,47 y RP = 0,46; IC95%: 0,28-0,77, respectivamente). Estos resultados apoyan el papel de la soledad como un aspecto psicosocial relacionado con el consumo de tabaco y el impedimento de dejar de fumar en adultos mayores, además de subrayar la importancia de problemas emocionales en esta asociación.

Small cell lung cancer: an overview of the targets

Abstract Lung cancer is the leading cause of cancer deaths worldwide. Small cell lung cancer (SCLC) accounts for approximately 15% of all lung cancer cases. Despite a frequently good response to first-line treatment with chemotherapy and/or radiotherapy, early relapse occurs in the majority of patients and 5-year survival is only about 5%. This histological subtype of lung cancer is strongly associated with tobacco smoking. The behavior of SCLC is unique within solid tumors. Initially, it positively responds to chemotherapy or radiotherapy. However, at relapse, which occurs early in the majority of cases, the tumor is resistant to available therapy and eventually will cause the death of the patient. These results in an overall 5-year survival of approximately 5% for the entire population of patients diagnosed with SCLC. This dismal prognosis has not significantly changed in past years. There is an urgent need for discovery targets to select patients more prone to having a proper response to the treatment, avoiding to reduce their resistance and resulting the increase of overall and progression-free survivals.

Estrés oxidativo en saliva generado por el humo de tabaco: impacto en la periodontitis y perspectivas hacia el uso de farmacología redox / Oxidative stress in saliva induced by tobacco smoke: impact on periodontitis and perspectives with redox pharmacology / Estresse oxidativo na saliva gerado pela fumaça do tabaco: impacto na periodontite e perspectivas para o uso da farmacologia redox

Numerosos reportes demuestran la presencia de biomarcadores de estrés oxidativo en la saliva de fumadores y hay un creciente interés en correlacionar estos procesos moleculares con la etiología de algunas enfermedades orales, como la periodontitis, una enfermedad inmunoinflamatoria crónica relacionada con un desequilibrio de la homeostasis redox celular. Objetivo: realizar una revisión narrativa sobre la relación entre la disminución de la capacidad antioxidante salival inducida por humo de tabaco, la periodontitis y el potencial uso de farmacología redox para el tratamiento de esta patología. Métodos: se realizó una búsqueda bibliográfica en bases de datos como PUBMED (NLM, NIH, NCBI) y SciELO. Resultados: existe evidencia que relaciona la baja capacidad antioxidante salival con un retraso en el restablecimiento de las condiciones normales en la cavidad oral ante el desarrollo de periodontitis. A su vez, el estado inflamatorio asociado colabora sinérgicamente, provocando un mayor daño tisular con pérdida de tejidos de soporte dentario, fenómeno que podría ser modulado por la acción de farmacología redox. Conclusiones: la intervención con farmacología redox, podría atenuar los biomarcadores de progresión de la enfermedad periodontal, constituyendo una herramienta prometedora para utilizar en conjunto con las estrategias de tratamiento tradicionales.

Numerous reports demonstrate the presence of oxidative stress biomarkers in the saliva of smokers and there is a growing interest in correlating these molecular processes with the etiology of some oral diseases, such as periodontitis, a chronic immunoinlammatory disease related to an imbalance of cellular redox homeostasis. Aims: achieve a narrative review on the relationship between the decrease in salivary antioxidant capacity induced by tobacco smoke, periodontitis, and the potential use of redox pharmacology for the treatment of this pathology. Methods: a bibliographic search was carried out in databases such as PUBMED (NLM, NIH, NCBI) and SciELO. Results: there is evidence that relates the low salivary antioxidant capacity with a delay in the reestablishment of normal conditions in the oral cavity before the development of periodontitis. In turn, the associated inflammatory state collaborates synergistically, causing greater tissue damage with loss of dental support tissues, a phenomenon that could be modulated by the action of redox pharmacology. Conclusions: intervention with redox pharmacology could attenuate the biomarkers of periodontal disease progression, constituting a promising tool to be used in conjunction with traditional treatment strategies.

Muitos artigos demonstram a presença de biomarcadores de estresse oxidativo na saliva de fumantes e há um interesse crescente em correlacionar esses processos moleculares com a etiologia de algumas doenças bucais, como a periodontite, uma doença imunoinlamatória crônica relacionada a um desequilíbrio da redox celular homeostase. Objetivo: realizar uma revisão narrativa sobre a relaçã o entre a diminuiçã o da capacidade antioxidante salivar induzida pela fumaça do tabaco, periodontite e o uso potencial da farmacologia redox para o tratamento desta patologia. Métodos: uma pesquisa bibliográica foi realizada usando bases de dados como PUBMED (NLM, NIH, NCBI) e SciELO. Resultados: há evidências que relacionam a baixa capacidade antioxidante salivar com o retardo no restabelecimento das condições normais da cavidade oral antes do desenvolvimento da periodontite. Por sua vez, o estado inflamatório associado colabora sinergicamente, causando maior dano tecidual com perda de tecidos de suporte dentário, fenômeno que poderia ser modulado pela açã o da farmacologia redox. Conclusões: a intervençã o com a farmacologia redox poderia atenuar os biomarcadores de progressã o da doença periodontal, constituindo-se em uma ferramenta promissora para ser utilizada em conjunto com estratégias tradicionais de tratamento.

Factores asociados al síndrome de Wellens en pacientes con síndrome coronario agudo sin elevación del segmento ST / Factors associated to Wellens' syndrome in patients with acute coronary syndrome without ST-segment elevation

Introducción: El síndrome de Wellens constituye un equivalente del síndrome coronario agudo con elevación del segmento ST. Este incluye dos patrones electrocardiográficos que sugieren lesión crítica de la arteria descendente anterior. Objetivo: Evaluar probables factores asociados al síndrome de Wellens en pacientes con síndrome coronario agudo sin elevación del segmento ST y lesiones coronarias significativas en la arteria descendente anterior. Material y métodos: Se realizó un estudio observacional, analítico, transversal en pacientes con diagnóstico de síndrome coronario agudo sin elevación del ST y lesión significativa en la arteria descendente anterior, comprobada mediante coronariografía, ingresados en la unidad de cuidados coronarios intensivos del Hospital Clínico-Quirúrgico Manuel Fajardo entre el 2016 y 2019. Resultados: La edad media fue de 66 años, predominó el sexo masculino (53,9 por ciento) y el antecedente de hipertensión arterial (89,5 por ciento). Los pacientes con síndrome de Wellens tuvieron un significativo menor porcentaje de antecedente de cardiopatía isquémica (58,1 por ciento vs. 84,8 por ciento; p = 0,012). Además, el síndrome arrojó asociación estadísticamente muy significativa con la condición de fumador activo (51,2 por ciento vs. 15,2 por ciento; p < 0,01). No se encontró relación estadística significativa entre el síndrome de Wellens y el resultado angiográfico. Conclusiones: La presencia de los patrones electrocardiográficos del síndrome de Wellens se asocia con el hábito tabáquico en pacientes con síndrome coronario agudo sin elevación del segmento ST y lesiones coronarias en la arteria descendente anterior, y su ausencia se asocia con el antecedente de cardiopatía isquémica en el mismo subgrupo de individuos(AU)

Introduction: Wellens' syndrome is equivalent to acute coronary syndrome with ST-segment elevation. It includes two electrocardiographic patterns suggesting a critical lesion in the anterior descending artery. Objective: Evaluate probable factors associated to Wellens' syndrome in patients with acute coronary syndrome without ST-segment elevation and significant coronary lesions in the anterior descending artery. Methods: A cross-sectional observational analytical study was conducted of patients diagnosed with acute coronary syndrome without ST-segment elevation and significant lesion in the anterior descending artery verified by coronary arteriography, admitted to the intensive coronary care unit at Manuel Fajardo Clinical Surgical Hospital in the period 2016-2019. Results: Mean age was 66 years, with a predominance of the male sex (53.9 percent) and a history of hypertension (89.5 percent). Patients with Wellens' syndrome had a significantly lower percentage of ischemic heart disease antecedents (58.1 percent vs. 84.8 percent; p = 0.012). A very significant statistical association was observed between the syndrome and active smoking (51.2 percent vs. 15.2 percent; p < 0.01). A significant statistical relationship was not found between Wellens' syndrome and angiographic results. Conclusions: The presence of electrocardiographic patterns of Wellens' syndrome is associated to smoking in patients with acute coronary syndrome without ST-segment elevation and coronary lesions in the anterior descending artery, whereas their absence is associated to a history of ischemic heart disease in the same subgroup of individuals(AU)

Short- and mid- term impact of tobacco smoking on donor renal function following living kidney donation at a tertiary referral hospital

Background: The negative impact of tobacco smoking on renal function has been widely studied. However, there is limited knowledge about the effect of smoking on pre-operative and post-operative renal function in living kidney donors. Objective: The objective of the study was to evaluate the short- and mid-term impact of smoking on donor renal function. Methods: This is a retrospective study of 308 patients who underwent living donor nephrectomy (LDN) at a tertiary referral hospital. We compared baseline characteristics as well as functional outcomes following LDN according to history of tobacco smoking. Estimated glomerular filtration rate (eGFR) was calculated with the modification of diet in renal disease equation in 6 time periods: pre-operative, 1 week, 1 month, 6 months, 12 months, and 24 months after surgery. We performed a Kaplan-Meier analysis for chronic kidney disease (CKD) outcome and binary logistic regression analysis to identify risk factors associated with CKD at 24 months of follow-up. Results: Among donors, 106 (34.4%) reported a smoking history before nephrectomy. Smoking donors had worse pre-operative eGFR than non-smokers (90 ± 26.3 mL/min/1.73m2 vs. 96 ± 27 mL/min/1.73 m2, respectively; p = 0.02) and lower eGFR at 1 week (p = 0.01), 1 month (p ≤ 0.01), 6 months (p = 0.01), and 12 months (p = 0.01) after LDN. Tobacco smoking (OR 3.35, p ≤ 0.01) and age ≥ 40 years at donation (OR 6.59, p ≤ 0.01) were associated with post-operative development of CKD at 24 months after LDN. Conclusions: Living kidney donors with a tobacco smoking history had an increased risk of developing chronic kidney disease following nephrectomy. Smoking-cessation strategies should be implemented.

Tobacco smoking and body composition in persons living with HIV/AIDS / Tagabismo e composição corporal em pessoas vivendo com HIV/AIDS

Abstract This study aimed to assess the association between tobacco smoking and body composition in patients with HIV/AIDS in combination antiretroviral therapy (cART). This is a cross-sectional study with people of HIV followed in specialized care service for HIV patients located in the South of Brazil. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was used to assess smoking and other psychoactive substance use. Body mass index (BMI) was calculated as the ratio of body weight (in kilograms) to squared height (in meters). Patients also had their body composition evaluated with a multi-frequency bioelectrical impedance (Bodystat® Quadscan 4000, RU) to estimate skeletal muscle index (SMI). In total, 320 subjects were included in the study. The prevalence of smoking was 54.7%. Tobacco smoking was associated with malnutrition, lower body mass index scores, and lower skeletal muscle mass index. It is concluded that there is a high prevalence of smoking among patients with HIV/AIDS and that this behavior is associated with worse body composition. Thus, it is suggested to implement strategies to support smoking cessation among people with HIV/AIDS.

Resumo O objetivo deste estudo foi avaliar a relação entre tabagismo e composição corporal em pacientes com HIV/AIDS em terapia antirretroviral combinada (TARVc). Trata-se de um estudo transversal com portadores de HIV acompanhados em um serviço de atendimento especializado localizado no Sul do Brasil. O instrumento Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) foi utilizado para avaliar o uso de tabaco e outras substâncias psicoativas. O índice de massa corporal (IMC) foi calculado como a razão do peso corporal (em quilogramas) pela altura ao quadrado (em metros). Os pacientes também tiveram sua composição corporal avaliada com uma impedância bioelétrica de múltiplas frequências (Bodystat® Quadscan 4000, RU) a fim de estimar o índice de massa muscular esquelética. No total, 320 sujeitos foram incluídos no estudo. A prevalência de tabagismo foi de 54,7%. O tabagismo foi associado à desnutrição, menores escores do índice de massa corporal e menor índice de massa muscular esquelética. Conclui-se que há uma alta prevalência de tabagismo entre pacientes com HIV/AIDS e que esse comportamento está associado a pior composição corporal. Assim, sugere-se a implementação de estratégias de apoio à cessação do tabagismo entre pessoas com HIV/AIDS.

Time trends of socioeconomic inequalities in adolescent smoking in Okinawa, Japan, 2008-2016: a repeated cross-sectional study

BACKGROUND@#Smoking among Japanese adolescents has decreased noticeably. However, little is known whether the decreasing trend in adolescent smoking can be seen across all socioeconomic status (SES) groups. This study aimed to examine trends in socioeconomic inequalities in smoking among Japanese adolescents between 2008 and 2016.@*METHODS@#We conducted a repeated cross-sectional study using data from three surveys of high school students in Okinawa, Japan, in 2008, 2012, and 2016. The study participants consisted of 7902 students in grades 10 through 12 (15-18 years). Smoking was assessed as current cigarette use. SES indicators included familial SES (parental education and family structure) and student's own SES (school type). To evaluate absolute and relative inequalities, prevalence differences (PDs) and ratios (PRs) between low and high SES groups were estimated. The slope index of inequality (SII) and relative index of inequality (RII) were also calculated.@*RESULTS@#Smoking prevalence among boys and girls significantly declined from 11.5% and 6.2% in 2008 to 4.7% and 1.9% in 2016, respectively. Similar decreasing trends in smoking were found among most of the SES groups. The PDs and SII for parental education in boys and family structure in girls decreased over time while those for school type persisted among boys and girls. The PRs and RII for school type in boys increased while those for other SES indicators among both sexes remained stable over time.@*CONCLUSIONS@#Smoking among Japanese adolescents has been declining and time trends of socioeconomic inequalities in smoking varied by absolute and relative measures. Further policies and/or interventions to reduce smoking inequalities should focus on the context of schools, especially in vocational high schools.

Mortalidad atribuida al consumo de tabaco en Brasil, 2016 / Mortality attributed to tobacco consumption in Brazil, 2016

RESUMEN: Objetivo: Actualizar la estimación de la mortalidad atribuida al consumo de tabaco en Brasil en población de 35 y más años. Métodos: Se aplicó un método dependiente de prevalencia, basado en la fracción atribuida poblacional. Este método estima la mortalidad atribuida a partir de la mortalidad observada en Brasil (fuente: Sistema de Información de Mortalidad del Sistema Único de Salud de Brasil-2016); de las prevalencias de fumadores, exfumadores y nunca fumadores (Encuesta Nacional de Salud de Brasil-2013) y del exceso de riesgo de morir (riesgo relativo) que tienen los fumadores y exfumadores en comparación con los nunca fumadores (5 estudios de cohortes norteamericanos). Se presentan estimaciones de mortalidad atribuida globales, por sexo, grupo de edad (35-54; 55-64; 65-74 y 75 años en adelante) y 3 grupos de enfermedades: tumores malignos, enfermedades cardiometabólicas y respiratorias. Resultados: En 2016, el consumo de tabaco causó con 163.831 muertes en Brasil, el 67% (109.369) fue en hombres y cuatro de cada diez (62.791) sucedieron antes de los 65 años. El 42% de la mortalidad atribuida se asocia a enfermedades cardiometabólicas, seguidas de respiratorias (34%) y tumorales (24%), sin diferencias por sexo. Conclusión: El 14% de las muertes que sucedieron en Brasil durante 2016 en población de 35 y más años se atribuye al consumo de tabaco. Realizar de forma periódica estimaciones de MA es necesario para valorar y fortalecer las leyes de control de tabaquismo implantadas.

ABSTRACT: Objective: To update the estimation of tobacco attributable mortality (AM) in the Brazilian population aged 35 years old and older. Methods: A prevalence-dependent analysis was applied based on the population attributed fraction. This method estimates the tobacco AM taking into account the mortality observed in Brazil (source: Brazilian Mortality Information System - 2016); the prevalence of smokers, former smokers, and never smokers (National Health Survey Brazil - 2013) and the excess of risk of death (relative risk) of smokers and former smokers in comparison to never smokers (derived from 5 North American cohorts). Estimates of overall AM are shown by gender, age group (35-54; 55-64; 65-74; and 75 years old and older) and 3 groups: malignant tumors, cardiometabolic diseases, and respiratory diseases. Results: In 2016, tobacco consumption caused 163,831 deaths in Brazil, 67% (109,369) were in men and four out of ten (62,791) occurred before the age of 65. Without differences by gender, 42% of the AM is associated with cardiometabolic diseases, followed by respiratory diseases (34%) and malignant tumors (24%). Conclusion: During 2016, 14% of the deaths occurred in the Brazilian population aged 35 years old and older were attributed to tobacco consumption. Periodic tobacco AM estimations are mandatory to assess and strengthen smoking control strategies and policies.

Prevalence of active and passive smoking during pregnancy: a cross-sectional study / Prevalência de tabagismo ativo e passivo durante a gravidez: estudo transversal

Purpose: The aim of the present study was to evaluate the prevalence of active and passive smoking during pregnancy and its association with sociodemographic indicators, as well as perinatal and postnatal outcomes in newborns. Methods: This cross-sectional study was comprised of 431 pairs of mothers/ newborns. The study variables were: preterm birth, birth weight, oral mucosal lesions, sociodemographic indicators and smoking data. We collected data from medical records and through a self-administered questionnaire answered by mothers. A pediatric dentist examined the newborns for oral mucosal lesions. Bivariate and multivariate logistic regression models were used to evaluate the association between active and passive smoking and the other variables (α=5%). Results: The prevalence of active (9.5%) and passive smoking (4.2%) during pregnancy was low. Active smoking was statistically associated with low birth weight (OR: 2.4; 95%CI:1.1-5.3), lower schooling level (OR: 0.2; 95%CI:0.1-0.5) and mothers aged ≥36 years old (OR: 4.9; 95%CI:1.2-20.0). Passive smoking was not statistically associated with the other variables. There was no association between active or passive smoking during pregnancy and premature birth and oral lesions of the newborn. Conclusions: The prevalence of active and passive smoking were low. Active smoking was associated with low birth weight, maternal age and mother's schooling, suggesting a social influence of smoking behavior among a population with a lower educational level. There was no association between active and passive smoking and prematurity and oral lesions of the newborn. (AU)

Objetivo: O objetivo do estudo foi avaliar a prevalência de tabagismo ativo e passivo durante a gestação e a associação entre indicadores sociodemográficos, bem como desfechos pré e pós-parto em recém-nascidos. Metodologia: Este estudo transversal foi composto por 431 pares de mães/recém-nascidos. As variáveis estudadas foram: nascimento prematuro, peso ao nascer, lesões mucosas orais, indicadores sociodemográficos e dados sobre tabagismo. Coletamos dados por meio de prontuários e por questionário auto-aplicado respondido pelas mães. Um dentista pediátrico examinou os recém-nascidos para lesões mucosas orais. A regressão logística foi utilizada para a análise bivariada e multivariada dos dados (α=5%). Resultados: Prevalência de tabagismo ativo (9,5%) e tabagismo passivo (4,2%) durante a gravidez foi baixo. O tabagismo ativo foi estatisticamente associado ao baixo peso ao nascer (OR: 2,4; 95%CI:1,1-5,3), às mães com menor escolaridade (OR: 0,2; 95%CI:0,1-0,5), e mães com idade ≥36 anos (OR: 4,9; 95%CI:1,2-20,0); enquanto o tabagismo passivo não esteve estatisticamente associado a nenhuma variável. Não houve associação entre tabagismo durante a gestação com nascimento prematuro e lesões orais de recém-nascidos. Conclusões: As prevalências de tabagismos passivo e ativo foram baixas. O tabagismo ativo esteve associado ao baixo peso ao nascer, à idade materna e à escolaridade da mãe, sugerindo influência social do comportamento do tabagismo entre a população com menor escolaridade. Não houve associação entre tabagismo ativo e passivo com prematuridade e lesões de mucosa oral em recém-nascido. (AU)

The correlation between micronuclei count and smoking behavior: a hospital-based study / Correlación entre recuento de micronúcleos y hábito tabáquico: un estudio hospitalario

Background: Micronucleus is a microscopically visible cyto-plasmic chromatin mass in the extranuclear vicinity, originating from aberrant mitosis, which consists of eccentric chromosomes that have failed to reach spindle poles during mitosis. The present study was designed to evaluate and compare cytogenetic changes in the buccal mucosa of smokers and non-smokers based on the occurrence of micronuclei. The study aimed to determine the correlation between the micronuclei count and the frequency and duration of smoking habit. Materials and Methods: Two groups (smokers and non-smokers) of 34 individuals each were examined. Cytological buccal smears were taken from participants using a moistened wooden spatula and stained with standard Papanicolaou stain. Presence of micronuclei was assessed at 40X magnification using a light microscope and a count per 500 cells was determined. The results of the study were analyzed statistically using Mann-Whitney U test, Spearman's rank correlation coefficient and Student t-test. Result: Smears from smokers showed a significant increase in the total number of micronuclei per 500 cell count compared to non-smokers. There was a strong positive correlation between the occurrence of micronuclei and the frequency and duration of smoking. A age-related increase in older age groups was also observed. Conclusion: The study reveals a strong positive correlation between the occurrence of micronuclei and the frequency and duration of smoking. This observation is vital in the utilization of the micronuclei detection in smears as a prognostic, educational and interventional tool in the management of patients with smoking habits.

Antecedentes: El micronúcleo es una masa de cromatina citoplasmática microscópicamente visible en el área extranuclear, que se origina a partir de la mitosis aberrante, y que consiste en cromosomas excéntricos que no han podido alcanzar los polos del huso durante la mitosis. El presente estudio fue diseñado para evaluar y comparar los cambios citogenéticos en la mucosa bucal de fumadores y no fumadores en función de la aparición de micronúcleos. El estudio tuvo como objetivo determinar la correlación entre el recuento de micronúcleos y la frecuencia y duración del hábito de fumar. Materiales and Métodos: Se examinaron dos grupos (fumadores y no fumadores) de 34 individuos cada uno. Se tomaron frotis bucales citológicos de todos los participantes con una espátula de madera humedecida y se tiñeron con la tinción estándar de Papanicolaou. La presencia de micronúcleos se evaluó al microscopio óptico con un aumento de 40X y se determinó un recuento por 500 células. Los resultados del estudio se analizaron estadísticamente utilizando la prueba U de Mann-Whitney, el coeficiente de correlación de rango de Spearman y la prueba t de Student. Resultados: Los frotis de fumadores mostraron un aumento significativo en el número total de micronúcleos por 500 células en comparación con los no fumadores. Hubo una fuerte correlación positiva entre la aparición de micronúcleos y la frecuencia y duración del tabaquismo. También se observó un aumento relacionado con la edad en los grupos de mayor edad. Conclusión: el estudio revela una fuerte correlación positiva entre la aparición de micronúcleos y la frecuencia y duración del tabaquismo. Esta observación es vital en la utilización de la detección de micronúcleos en frotis como una herramienta pronostica, educativa e intervencionista en el manejo de pacientes con hábitos de fumar.

Efectos biológicos protectores del ejercicio en modelos experimentales de tabaquismo: más allá de la cesación y la abstinencia / Protectives biological effects of exercise in animals models of tobacco smoking: beyond tobacco cessation and withdrawal

El tabaquismo es considerado una de las principales causas de morbilidad y mortalidad en la población general. En Chile la prevalencia de tabaquismo alcanza el 36,7% en hombres y 28,5% en mujeres. En este contexto, diversas estrategias farmacológicas y no farmacológicas han sido propuestas para promover la cesación de su consumo, así como para contrarrestar las comorbilidades asociadas al tabaquismo prolongado. Entre ellas, el ejercicio físico ha sido tradicionalmente considerado, por su impacto en la promoción de la cesación del hábito tabáquico, así como también por sus efectos en la reducción de las manifestaciones clínicas del síndrome de abstinencia post cesación. No obstante, estudios realizados en modelos animales durante los últimos 10 años han proporcionado datos contundentes para sustentar la hipótesis de que la práctica regular de ejercicio físico sería también efectiva para prevenir o modular el estrés oxidativo y la respuesta inflamatoria inducida por el tabaco, previniendo el deterioro orgánico de los sistemas fisiológicos expuestos. Esta revisión tiene por objetivo discutir la evidencia publicada respecto a los efectos biológicos inducidos por ejercicio físico y su impacto en la reversión de los mecanismos fisiopatológicos que subyacen a las comorbilidades asociadas al hábito tabáquico, focalizando el análisis en los mecanismos de estrés oxidativo y respuesta inflamatoria del sistema respiratorio y cardiovascular.

Smoking is considered one of the main causes of morbidity and mortality in the general population. In Chile, the prevalence of smoking reaches 36.7% in men and 28.5% in women. In this context, several pharmacological and non-pharmacological strategies have been proposed to promote the cessation of their use, as well as to counteract the comorbidities associated with prolonged smoking. Among them, physical exercise has been traditionally considered, due to its impact on the promotion of cessation of smoking, as well as its effects in reducing the clinical manifestations of withdrawal syndrome. However, studies conducted in animal models during the last 10 years have provided strong data to support the hypothesis that regular practice of physical exercise would also be effective in preventing or modulating oxidative stress and the inflammatory response induced by tobacco, preventing the organic deterioration of exposed physiological systems. The objective of this review is to discuss the published evidence regarding the biological effects induced by physical exercise and its impact on the reversion of the pathophysiological mechanisms underlying the comorbidities associated with smoking, focusing the analysis on the mechanisms of oxidative stress and inflammatory response of the respiratory and cardiovascular system.

Analysis of multidimensional factors in attempts to quit using tobacco by Korean adolescents

BACKGROUND@#This study aims to understand the extent of adolescents' attempts to quit using tobacco and the factors influencing such attempts in Korea, using a descriptive, cross-sectional design and secondary data analysis with the 2019 Youth Health Behavior Survey.@*METHODS@#The participants were 4028 adolescent tobacco users who had used tobacco for 1 day or more in the past 30 days. The data analysis was performed using IBM SPSS/WIN 26.0 program, and multivariable logistic regression analysis was conducted using the complex sampling method module.@*RESULTS@#A total of 68.2% of the participants attempted to quit using tobacco. We analyzed the factors for adolescents' attempts to quit using tobacco by dividing them into psychological, physical, behavioral, and environmental dimensions. The factors influencing adolescents' attempts to quit using tobacco, identified through multivariable logistic regression analysis, are as follows: participation in sports activities (OR = 1.20, 95% CI 1.01-1.41), vigorous physical activity (OR = 1.24, 95% CI 1.06-1.46), and type of tobacco product used (OR = 1.65, 95% CI 1.24-2.21) in the behavioral dimension; pictorial cigarette pack warnings (perceived smoking as unhealthy) (OR = 1.91, 95% CI 1.56-2.36), and the presence of secondhand smoking at home (OR = 1.18, 95% CI 1.01-1.38) in the environmental dimension.@*CONCLUSIONS@#Schools and public healthcare providers must consider multidimensional factors when providing support for successful tobacco cessation in adolescents and focus particularly on elements relating to physical activity and environmental factors.

The effects of sexual violence experienced in childhood and adolescence on undergraduate students / Os impactos da violência sexual vivida na infância e adolescência em universitários

ABSTRACT OBJECTIVE: This study aims to investigate the prevalence of adolescents and young adults who were victims of sexual violence at some point in their lives and to compare the presence of depressive and anxious symptoms, quality of life, and use of alcohol, tobacco, and illegal drugs among this population and those who were not abused. METHODS: Validated questionnaires and instruments were applied in a group of university students to assess: sexual profile and behavior, socioeconomic status, presence or not of sexual violence (Questionnaire on Exposure to Traumatizing Events), depressive (Beck Depression Inventory) and anxious symptoms (Beck Anxiety Inventory), quality of life (World Health Organization's Quality of Life Assessment) and the use or abuse of tobacco, alcohol, and illegal drugs (Smoking, Alcohol, and Substance Involvement Screening Test). RESULTS: Out of the 858 students who participated, 71 (8.3%) were victims of sexual violence, 52 girls (73.2%). In the victims of violence group there were more students who already had the first sexual intercourse (p = 0.029), students who already had become pregnant (p = 0.001), students with higher scores for depressive (p < 0.001) and anxious symptoms (p = 0.001), students with worse quality of life (p < 0.001), and who used more tobacco (p = 0.008) and marijuana (p = 0.025) as well as abused hypnotics or sedatives (p = 0.048) than in the non-victim group. CONCLUSION: The abuses are presented in several forms and affect, even in long term, the survivors' life. The sexual violence theme should be addressed and widely discussed in all spheres of society in order to mobilize, to sensitize, and provide society with knowledge, demystifying this subject and drawing attention to this important social issue.

RESUMO OBJETIVO: Investigar a prevalência de adolescentes e adultos jovens que foram vítimas de violência sexual em algum momento da vida e comparar a presença de sintomas depressivos e ansiosos, qualidade de vida e uso de álcool, tabaco e drogas ilícitas entre esta população e a que não sofreu abuso. MÉTODOS: Aplicaram-se questionários e instrumentos validados, em uma população de estudantes universitários, para avaliar: perfil e comportamento sexual, nível socioeconômico, presença ou não de violência sexual (Questionário sobre a Exposição a Eventos Traumatizantes), sintomas depressivos (Inventário de Depressão de Beck) e ansiosos (Inventário de Ansiedade de Beck), qualidade de vida (World Health Organization's Quality of Life Assessment) e o uso ou abuso de tabaco, álcool e drogas ilícitas (Teste para Triagem do Envolvimento com Fumo, Álcool e Outras Drogas). RESULTADOS: Dos 858 alunos que responderam à pesquisa, 71 (8,3%) foram vítimas de violência sexual, sendo 52 meninas (73,2%). No grupo vítima de abuso havia mais alunos que já tinham tido a coitarca (p = 0,029), alunas que já engravidaram (p = 0,001), estudantes com maiores escores para sintomas depressivos (p < 0,001) e ansiosos (p = 0,001), alunos com pior qualidade de vida (p < 0,001) e que usavam mais tabaco (p = 0,008) e maconha (p = 0,025) bem como abusavam de hipnóticos ou sedativos (p = 0,048) que no grupo não vítima. CONCLUSÃO: Os impactos causados pelo abuso são diversos e afetam, mesmo no longo prazo, a vida dos sobreviventes. Abordar o tema e o discutir, amplamente, em todas as esferas da sociedade é uma forma de mobilizar, sensibilizar e instrumentalizar o coletivo, desmistificando o assunto e chamando atenção para essa importante questão social.