Average Daily Cigarette Consumption Research Articles

Dose- and time-dependent association of smoking and its cessation with risk of peri-implant diseases.

A retrospective cohort study involved patients who received at least one implant-supported restoration at a university dental clinic between 2001 and 2013. Patients were randomly selected from an electronic database, and their recruitment via telephone contact spanned from February 2021 until July 2021. To investigate the association of smoking and its cessation with the risk of peri-implant mucositis and peri-implantitis in a cohort of implant-treated patients. The study adhered to the principles outlined in the Declaration of Helsinki and followed the STROBE guidelines for reporting observational research. Included were adult patients who were rehabilitated with dental implants, irrespective of the type of edentulism, superstructure, and prosthetic retention, provided that they had adequate access for peri-implant probing. Patients with incomplete records were excluded. Clinical measurements included plaque and bleeding indices, periodontal pocket depth, suppuration on probing, mucosal recession, and width of keratinized mucosa. Periapical radiographs were taken and marginal bone level (MBL) was measured using ImageJ software. The primary outcome variable was peri-implant status which was classified into: health (H), peri-implant mucositis (PM), and peri-implantitis (PI). Smoking status was categorized into: never-smokers, former smokers, and current smokers. Smoking information included: daily cigarette consumption, duration of smoking (in years), and age at initiation, and for former smokers, the duration of smoking cessation. The cohort included 117 patients (55 females and 62 males) with a mean age of 64.2 years at examination. They were rehabilitated by 450 implants, with an average of 4.6 implants per patient and a mean duration of 8 years in function. Out of the total, 39 patients were H, while 41 and 37 showed PM and PI, respectively. Periodontal and MBL measures were significantly higher in PM and PI groups compared to H group (p < 0.001). Considering tobacco use, 56 patients were never-smokers, 42 former smokers, and 19 current smokers. The average daily consumption of cigarettes was 15.7. Ever-smokers >23 pack-years had a significantly higher risk for PI (OR = 3.40; 95% CI 0.91-17.30; p = 0.002) compared to nonsmokers. Regression analysis showed that subjects with a span since smoking cessation of more than 21 years exhibited a significantly lower risk of peri-implant diseases (PIDs) than those who had ceased smoking within 21 years (p = 0.028). A smoking intensity exceeding 23 pack-years was significantly associated with PI risk, while the risk of PIDs was comparable between never-smokers and those who had quit smoking more than 21 years ago.

Impact of the minimum wage increase on smoking behaviour: A quasi-experimental study in South Korea

BackgroundWhile there's a growing body of research studying the health effects of minimum wage increases, evidence of its impact on smoking is inconsistent. Using nationally representative statistics, our quasi-experimental study examines the impacts of South Korea's 2018 minimum wage increase on smoking patterns, offering a distinctive context due to the significant wage growth and the country's permissive smoking culture. MethodsUsing the Korean Welfare Panel Study (KOWEPS), we conducted a difference-in-differences analysis using two-way fixed effect (TWFE) and Callaway and Sant'Anna Difference-in-differences (CSDID) methods. The study sample (n = 3494) included individuals aged 19–64 at baseline in 2016, and employed in the entire study period (2016–2019). ResultsThe model results suggest a roughly 2% increase in the probability of current smoking with an insignificant impact on average daily cigarette consumption following the 2018 minimum wage increase in Korea. These effects were most pronounced among men and age groups (45–64). We also found policy effects on those earning up to 150% of the minimum wage. ConclusionIn a culture with widespread acceptance of smoking, an exogenous increase in disposable income due to elevated minimum wage might enhance vulnerability to societal pressure to smoke. Although TWFE and CSDID both suggest the same overall trend, the latter approach allows a more detailed examination by acknowledging heterogeneous treatment effects. These results could guide policymakers to contemplate the potential for increased smoking resulting from minimum wage hikes in societies where tobacco use is common, and accordingly strategize anti-smoking public health initiatives.

Evaluation of a Pharmacist-Linked Smoking Cessation Intervention for Adults Experiencing Homelessness

Background: Interventions are needed to increase access to tobacco treatment for people experiencing homelessness. We developed a community pharmacist-linked cessation program for adults experiencing homelessness that included one-time, pharmacist-delivered counseling and furnishing nicotine replacement therapy (NRT) for 3 months. Methods: We conducted a single-arm, uncontrolled trial of the pharmacist-linked intervention among adults experiencing homelessness recruited from three homeless shelters in San Francisco, CA. We asked participants to complete questionnaires at baseline and during 12 weekly follow-up visits. We obtained information on cigarette consumption, use of NRT, and quit attempts at each visit, and reported cumulative proportions during the study interval. We used Poisson regression and logistic regression, respectively, to examine factors associated with weekly cigarette consumption and quit attempts. We conducted in-depth interviews with residents to understand barriers to and facilitators of engagement. Results: Among 51 participants, average daily cigarette consumption reduced 55% from 10 cigarettes per day at baseline to 4.5 cigarettes at 13 wk follow-up, and 56.3% had CO-verified abstinence. Use of medications in the past week was associated with a 29% reduction in weekly consumption (IRR 0.71, 95% CI 0.67–0.74), and increased the odds of a quit attempt (adjusted odds ratio (AOR), 2.37, 95% CI 1.13–4.99). While residents benefited from engaging in the pharmacist-linked program to increase quit attempts, they felt that to sustain abstinence, longitudinal tobacco treatment was needed. Conclusions: A pharmacist-linked smoking cessation program at transitional homeless shelters can reduce structural barriers to cessation care and reduce tobacco use among people experiencing homelessness.

Prevalence of smoking in adults aged 40 years and above in China, 2019-2020

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.

Assessing the association between smoking and hypertension: Smoking status, type of tobacco products, and interaction with alcohol consumption.

The association between tobacco use and hypertension risk has been extensively researched but remains controversial, and few existing studies have considered the role of tobacco type and dosage response in this association. In this context, this study aims to provide epidemiological evidence for the possible relationship between tobacco smoking and future hypertension risk, with the tobacco type and consumption dose into consideration. This study was based on 10-year follow-up data from the Guizhou Population Health Cohort conducted in southwest China. Multivariate Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals [95% confidence intervals (CIs)], and restricted cubic spline analyses were performed to visualize the dose-response association. A total of 5,625 participants (2,563 males and 3,062 females) were included in the final analysis. Heavy smokers of machine-rolled cigarettes had an elevated hypertension risk compared with non-smokers (HR: 1.50, 95% CI: 1.05-2.16). The interaction effects of heavy smoking-heavy drinking patterns increased the future hypertension risk, with an adjusted HR of 2.58 (95% CI: 1.06-6.33). This study did not find a significant association between overall tobacco use status and the risk of hypertension. However, heavy machine-rolled cigarette smokers had a statistically significant increased risk of hypertension compared with non-smokers, and a J-shape association has been found between the average daily consumption of machine-rolled cigarettes and the risk of hypertension. Besides, tobacco and alcohol consumption jointly increased the long-term hypertension risk.

Changes in tobacco and e-cigarette consumption in Spanish university students during the COVID-19 lockdown: Identification of vulnerable groups.

The objective of this study was to determine the changes in tobacco consumption in Spanish university students during the lockdown in 2020, and to identify vulnerable groups based on gender, age, and living situation. This was a cross-sectional descriptive study. From a sample of 1540 Spanish university students, 19.9% (n=306; 77.6% women; mean age=30.9 years; SD=8.3) reported having consumed tobacco. The frequency and average daily consumption of cigarettes and electronic nicotine delivery systems (ENDS) before the pandemic and during lockdown were analyzed. A total of 97.1% of students consumed only cigarettes, 2.9% only ENDS, and 3.3% were dual consumers. During lockdown, cigarette consumption was significantly reduced (5.3 before; 4.0 during; t(71)=3.6255; p<0.001) in the youngest group (aged 18-24 years). However, women daily users significantly increased their consumption (t(149)= -2.5461; p<0.05) and so did the 35-44 years age group (t(32)= -2.2285; p<0.05). Cigarette consumption significantly increased in those who were living alone (5.6 to 7.2; Z= -2.351; p<0.05) and with a partner (7.2 to 8.0; t(97)= -2.3771; p<0.05), but decreased in those who were living with their parents or other relatives (6.2 to 4.5; t(101)=3.4298; p<0.001). A total of 17.0% ceased consumption during lockdown, mainly women, younger students (aged 18-24 years), and those who lived with their parents. None of the people who used cigarettes daily during the pre-pandemic period stopped smoking during lockdown. Younger university students and those living with their parents decreased their tobacco use during the lockdown. Potentially vulnerable groups at risk of increasing their consumption were women who consumed tobacco daily before the pandemic and students aged 35-44 years who lived alone or with their partner.

Switching from cigarettes to IQOS: A pilot examination of IQOS-associated reward, reinforcement, and abstinence relief

BackgroundIt is unknown whether IQOS-associated decreases in cigarette craving, nicotine withdrawal, greater subjective reward, and relative reinforcing value predict subsequent switching from cigarettes to IQOS products. MethodsNontreatment-seeking adult daily smokers (n = 33; 18–65 years old) completed a within-subject pilot study consisting of a baseline ad-lib smoking period (days 1–5), two laboratory visits (days 6–7), and a two-week period where participants switch from using cigarettes to using IQOS (days 8–21). Mixed-effect modelling estimated the percentage of baseline cigarette consumption replaced by daily IQOS HeatSticks used. Predictors of use included IQOS-associated reinforcement, subjective reward, and craving and withdrawal relief. ResultsIQOS use alleviated cigarette abstinence-associated craving (change=−14.22, p < .001) but did not alleviate withdrawal symptoms. Smokers initially substituted IQOS for 59% of their average daily cigarette consumption, increasing to 87% by switch period end (B=0.02 [95%CI=0.01, 0.03], p = .002). Neither subjective reward of IQOS nor relief of cigarette craving and withdrawal symptoms were predictive of this change. By study end, IQOS consumption was 124% of regular cigarette consumption among participants with a low reinforcing value of cigarettes relative to IQOS (β = 0.03 [95%CI=0.00, 0.06], p = .049). In contrast, participants with a higher reinforcing value of smoking replaced 76% of their cigarettes with IQOS. ConclusionsIQOS shows potential as an alternative to combustible cigarettes. However, IQOS use may result in dual-use for most smokers and increase tobacco consumption among a subgroup of smokers. These preliminary findings highlight the need for a larger investigation of the relationship between IQOS use and cigarette smoking.

Was COVID-19 associated with increased cigarette purchasing, consumption, and smoking at home among US smokers in early 2020? Findings from the US arm of the International Tobacco Control (ITC) Four Country Smoking and Vaping Survey

Evidence of the impact of COVID-19 and mandatory stay-at-home orders on cigarette smoking is mixed. In the United States, household tobacco purchases increased in early 2020, but it is unclear whether this was associated with increased smoking. Using individual-level, longitudinal data from a representative cohort of US smokers (n = 3046), this study tested whether (1) carton purchases of cigarettes increased in early 2020 relative to the same calendar period in 2018, (2) more smokers permitted smoking inside their homes, and (3) smokers increased the number of cigarettes they smoked per day. Weighted multivariable logistic regression tested whether trends in carton purchasing and smoke-free homes differed in 2020 compared to 2018 while weighted multivariable linear regression tested whether trends in cigarette consumption differed in 2020 compared to 2018. Overall, 24.0% of US smokers last purchased cigarettes by the carton in early 2018; this increased to 28.8% in early 2020 (p = 0.007). Average daily cigarette consumption and the percentage of smokers reporting that smoking was not allowed inside their homes did not differ between 2018 and 2020 (p = 0.92 and p = 0.054, respectively). Overall, these findings suggest that COVID-19 mitigation measures implemented in the spring of 2020 had limited impact on the smoking behavior of US adult smokers.

Smoking Patterns and Anxiety Factors Among Women Expressing Perinatal Depression.

Background: Relationships among perinatal depression occurring a number of weeks before and after childbirth and smoking have been identified. Depression may lead to the inability to abstain from smoking during pregnancy.Objectives: This study aims to determine factors affecting smoking during pregnancy revealing potential relationships between depression and smoking patterns during and after pregnancy.Methods: A total of 206 mothers participated in the study. Data were collected through self-reporting as respondents were asked to answer questionnaires during the 12th week of pregnancy, during the 30th week of pregnancy, after childbirth, and during the period after pregnancy. Relationships between smoking behavior, sociodemographic variables, and feelings of perinatal depression were examined using chi-square test and binary logistic regression analysis. A follow-up investigation has been conducted after 2 years revealing the percentage of women returning to their smoking habits.Results: Smokers before (B = 0.568; p = 0.026) and during pregnancy (B = 1.238; p = 0.009) were more likely to express depression before childbirth. Average daily cigarette consumption before (B = 1.110; p = 0.001) and during pregnancy (B = 1.167; p = 0.002) was associated with depression during pregnancy. Women who smoked during pregnancy reported significantly more depressive symptoms after pregnancy (B = 1.757; p = 0.005) compared with nonsmokers and smokers who abstained during pregnancy. Average daily cigarette consumption during pregnancy (B = 1.402; p = 0.002) affects the expression of depression after pregnancy. Women who smoked before pregnancy (B = 0.568; p = 0.025) and their average daily cigarette consumption before pregnancy (B = 1.465; p = 0.025) were highly associated with the inability to abstain from smoking during pregnancy. However, the knowledge of risks of maternal smoking during pregnancy (B = −1.110; p = 0.001) and medical consult on abstaining (B = −1.238; p = 0.009) reinforced the maternal attempt to quit smoking. The follow-up investigation revealed an elevated amount of women returning to previous smoking patterns.Discussion: Perinatal depression is associated with smoking patterns during pregnancy. Assessment of depression and smoking is needed throughout perinatal period to support the health of women.

Tobacco price increase and consumption behaviour among male smokers in Saudi Arabia: a community-based study.

Saudi Arabia doubled its tobacco tax in June 2017. To examine the association between an increase in tobacco prices and consumption behaviour among current male smokers in Riyadh. We conducted a community-based study using a self-administered questionnaire distributed to current male smokers aged 15+ years in Riyadh in 2018. The survey included questions on sociodemographic characteristics, tobacco consumption and self-reported chronic health conditions. A total of 1481 participants were included in the final data analysis. After the tobacco tax was doubled, 25.6% of the participants reduced their cigarette consumption and 1.0% quit smoking. The average daily cigarette consumption after enforcing the tobacco tax [19.77, standard deviation (SD) 10.7], was statistically significantly lower than before taxation (21.19, SD 10.8) (P < 0.0001). The calculated price elasticity of demand was -0.20 (inelastic). Employment status (P = 0.002) and per capita gross domestic product purchasing power parity (P = 0.001) were the only statistically significant factors associated with the change in smoking habits. Increasing tobacco prices reduced tobacco consumption by 26.6% among Saudi Arabian male smokers.

A cross-category puffing topography, mouth level exposure and consumption study among Italian users of tobacco and nicotine products

Actual use studies play a key part in evaluating the reduced risk potential of tobacco and nicotine products. This study was undertaken to determine the puffing topography, mouth level exposure (MLE) and average daily consumption (ADC) relating to two commercially available tobacco heating products (THPs) and a prototype electronic cigarette (or e-cigarette) among Italian non-mentholated 7 mg ISO tar cigarette smokers. The study was conducted in Milan, Italy, with three groups of approximately 50 participants. Groups 1 and 3 included adult smokers of 7 mg ISO tar tobacco cigarettes, and Group 2 consisted of both solus vapers and dual users of vapour and tobacco products. Amongst smokers, e-cigarette mean puff volumes (41.6 mL vs 41.3 mL) and mean puff durations (1.4 s vs 1.5 s) were similar to that of the cigarette, although the average usage session was significantly longer (1064.8 s vs 289.5 s) with a higher total number of puffs (58.6 vs 17.3), however this may be attributable to differences in product operation. There were no significant differences across puffing topography measurements observed between smokers (Group 1) and regular vapers/dual users (Group 2) when using the e-cigarette. As consistent with previous research, users took, on average, larger mean puff volumes when using a THP compared to the reference cigarette (C651), although puff numbers and puff durations remained similar. The average interval between puffs was considerably shorter for THP1.0(T) compared to THS2.4(T) (11.0 s vs 17.1 s). MLE to nicotine-free dry particulate matter and nicotine was significantly reduced for THP1.0(T) and THS2.4(T) compared to the tobacco cigarette (C651). MLE to nicotine was also significantly reduced for the e-cigarette (IS1.0(T)) compared to C651. The average daily consumption (ADC) of cigarettes by groups 1 and 3 were higher than the respective ADCs of both THP consumables. There were no significant differences in ADC when comparing the same product between different groups. Differences seen between sensory scores for each of the product categories may be attributed to fundamental differences in design and mode of operation resulting in very different characteristics of the aerosol generated.

Do current smokers use more cigarettes and become more dependent on nicotine because of psychological distress after a natural disaster?

Natural disasters increase nicotine dependence and cigarette consumption, but the exact mechanisms and conditions responsible for this increase are relatively unclear. This study explored whether posttraumatic stress and depressive symptoms were pathways to increased nicotine dependence and cigarette consumption after disaster exposure using a representative sample of current smokers who were living in New Orleans at the time Hurricane Katrina struck (n = 175), and a comparison sample of smokers from Memphis (n = 222) who were not directly impacted by Hurricane Katrina. We assessed whether nicotine dependence and daily cigarette consumption differed by city and evaluated potential mediators and moderators of this association using conditional process analysis. Results showed that though nicotine dependence (B = 0.46, SE = 0.20, p = .02) and average daily cigarette consumption (B = 2.19, SE = 0.80, p = .01) were higher among New Orleans than Memphis smokers 27 months after Hurricane Katrina, hurricane exposure did not indirectly affect nicotine dependence and average daily cigarette consumption through increases in posttraumatic stress and depressive symptoms. Smokers who are exposed to disasters may not be increasing their cigarette use and their dependency on nicotine because of post-disaster psychological distress. Future studies should investigate other mechanisms and conditions to explain post-disaster changes in smoking behavior.

Can E-Cigarettes and Pharmaceutical Aids Increase Smoking Cessation and Reduce Cigarette Consumption? Findings From a Nationally Representative Cohort of American Smokers.

Many smokers believe that electronic nicotine delivery systems (ENDS) and pharmaceutical cessation aids can help them quit smoking or reduce cigarette consumption, but the evidence for e-cigarettes to aid quitting is limited. Examining 3,093 quit attempters in the nationally representative US Population Assessment of Tobacco and Health (PATH) Study, using data from 2013-2015, we evaluated the influence of ENDS and pharmaceutical cessation aids on persistent abstinence (≥30 days) from cigarettes and reduced cigarette consumption, using propensity score matching to balance comparison groups on potential confounders and multiple imputation to handle missing data. At PATH Wave 2, 25.2% of quit attempters reported using ENDS to quit during the previous year, making it the most popular cessation aid in 2014-2015. More quit attempters were persistently cigarette abstinent than were persistently tobacco abstinent (15.5% (standard error, 0.8) vs. 9.6% (standard error, 0.6)). Using ENDS to quit cigarettes increased the probability of persistent cigarette abstinence at Wave 2 (risk difference (RD) = 6%, 95% confidence interval (CI): 2, 10), but using approved pharmaceutical aids did not (for varenicline, RD = 2%, 95% CI: -6, 13; for bupropion, RD = 4%, 95% CI: -6, 17; for nicotine replacement therapy, RD = -3%, 95% CI: -8, 2). Among quit attempters who relapsed, ENDS did not reduce the average daily cigarette consumption (cigarettes per day, -0.18, 95% CI: -1.87, 1.51).

Changes in the smoking behavior of pregnant women andtheir family members during pregnancy: A cross-sectional study in China.

INTRODUCTIONStudies regarding the changes in smoking behavior of pregnant women have been mostly conducted in high income countries but rarely in China. This study thus focused on investigating the changes in smoking behavior among pregnant women and their family members in China, both before and during pregnancy.METHODSA cross-sectional study was carried out at nine Women and Children’s Hospitals in Shanghai, China, in 2014. A total of 2831 gestational households were recruited. The chi-squared test, paired sample t-test and logistical regression analysis were used during statistical analysis.RESULTSThe prevalence of smoking for all household members significantly declined during pregnancy: 76.2% of the pregnant women, 19.2% of their husbands and 14.0% of other family members quit smoking entirely. The average daily cigarette consumption rate decreased from 5.9 to 0.9 among pregnant women, 11.4 to 9.5 for husbands, and 11.4 to 9.5 for other family members (paired sample t-test, p<0.001). The likelihood that husbands continued smoking during pregnancy was significantly lower for those with a shorter history of smoking, had a lower daily cigarette consumption rate and a household registration in Shanghai.CONCLUSIONSThe prevalence of smoking among pregnant women, husbands and other family members significantly declines during pregnancy. Thus, pregnancy is most likely a key period in which to provide families with health education regarding the effects of smoking, both during the pregnancy period and in general. Intervention programs designed to reduce smoking among husbands during pregnancy should focus on those with a long history of smoking, a high rate of daily cigarette consumption, and those with household registration not in Shanghai.

Socioeconomic and gender inequalities in smoking. Findings from the Czech National Tobacco Surveys 2012-2015.

Smoking significantly affects morbidity and mortality of the population. The incidence of smoking is determined by gender and socioeconomic status (SES) of an individual. The aim of this study is to analyse the relationship between gender and SES indicators and smoking. The analysis is based on data from the Czech National Tobacco Surveys from 2012 to 2015 (N∼1,800 per year). The prevalence of smoking, average daily consumption of cigarettes, initiation ratio and quit ratio were monitored. Smoking habits of the respondents were surveyed using the Czech version of the standard Tobacco Questions for Surveys (TQS) questionnaire. SES was measured by a composite index comprising three variables (level of education, income and job prestige); it had four categories: low, lower-middle, upper-middle, and high. In comparison with women, men had a higher smoking prevalence (OR=1.41, 95% CI=1.09-1.84), higher consumption of cigarettes (B=4.11, 95% CI=1.97-6.26), and higher rate of smoking initiation (OR=1.38, 95% CI=1.10-1.74), but they did not differ in the quit rate (OR=0.85, 95% CI=0.60-1.21). Persons in the low SES category had higher prevalence of smoking and higher initiation ratio compared with those in the high SES category (OR=2.59, 95% CI=1.36-4.97; OR=2.23, 95% CI=1.26-3.95). Cigarette consumption and quit ratio did not differ according to SES. The prevalence of smoking in the years 2012-2014 did not differ; in 2015, it was lower compared to the previous three years. Inequalities in socioeconomic status affect smoking, which significantly contributes to morbidity and mortality. Measures aimed at reducing inequalities in health must take into account both smoking as a risk factor and socioeconomic status, which affects its occurrence. Programmes to reduce tobacco use should reflect the different needs of individuals with different SES levels. It is especially necessary to seek effective approaches for smokers with low socioeconomic status.

Cervical cancer screening visit as an occasion for counseling female smokers to quit.

In the last decades in Italy, a smaller decrease in smoking among women than in men has been observed and a younger age at start in young women. Nevertheless, gender-specific strategies for smoking cessation have rarely been developed, except those for pregnant women. A study was conducted to evaluate the feasibility of carrying out an intervention of primary prevention by counseling for smoking cessation the female smokers attending cervical cancer screening programs in Florence, Italy. All female smokers attending the services for cervical cancer prevention at the Cancer Prevention and Research Institute in Florence, Italy, between March 2004 and January 2005, who volunteered to participate in the study, received a brief motivational stage-matched counseling for smoking cessation and a face to face interview at enrollment and after 6 and 12 months. The counseling was evaluated by comparing quit rates, changes in smoking intensity, and motivation to quit at the first and second follow-up periods to the same data collected at enrollment. Multivariate logistic regression analysis was performed to estimate the influence on smoking cessation of demographic characteristics, smoking habit and attitude to quit. 177 women participated in the study. After 1 year, a quit rate of 12.4% (95% CI, 7.5-17.3) was observed. Among those who never quit, there was a 39.3% reduction in the average daily cigarette consumption and a 51.9% reduction in smoking the first cigarette of the day immediately on awaking or just after breakfast. The results and the opportunity to contact a large number of female smokers on the occasion of cervical cancer screening suggest the importance to evaluate the efficacy of the intervention of primary prevention in this health setting.

Smoking Status and Incidence of Cancer After Myocardial Infarction: A Follow-Up Study of over 20 Years

ObjectivesWe evaluated long-term incidence of cancer after myocardial infarction among current, former, and never smokers, and assessed whether reducing cigarette consumption is associated with decreased cancer risk. MethodsConsecutive patients aged ≤65 years discharged from 8 hospitals in central Israel after first myocardial infarction in 1992-1993 were followed for cancer and death. Extensive data including smoking habits were obtained at the index hospitalization and 4 time points during follow-up. Survival methods were applied to assess the hazard ratios (HRs) for cancer associated with smoking categories. ResultsIncluded in the study were 1486 cancer-free participants (mean age, 54 years; 81% men), among whom 787 were current smokers at baseline (average daily cigarette consumption = 29). Smokers were younger than nonsmokers and more likely to be male and of lower socioeconomic status. Over a median follow-up of 21.4 years, 273 (18.4%) patients developed cancer. Baseline smoking was associated with a ∼40% excess adjusted risk of cancer; ∼25% after accounting for death as a competing event. Considering changes in smoking during follow-up, the excess risk was confined to persistent smokers (adjusted HR 1.75; 95% confidence interval [CI], 1.22-2.50), whereas post- (HR 1.14; 95% CI, 0.80-1.62) and pre-myocardial infarction quitters (HR 1.02; 95% CI, 0.71-1.47) were comparable with never smokers. Among persistent smokers, each reduction of 10 cigarettes relative to pre-myocardial infarction consumption was associated with a ∼10% reduced adjusted risk. ConclusionAmong young survivors of first myocardial infarction followed-up longitudinally, smoking cessation is associated with lower risk of cancer. Reducing consumption among smokers may also be beneficial.

Serological evaluation of Bordetella pertussis infection in adults with prolonged cough

Pertussis is a vaccine-preventable disease that is transmitted from infected to susceptible individuals by respiratory route. Bordetella pertussis infection may occur at any age as neither vaccine nor natural infection induced immunity lasts life-long. This study was planned to demonstrate the serological evidence of infection among adults, to raise awareness among clinicians and to provide data for the development of strategies to protect vulnerable infants. A total of 538 patients (345 female, 193 male) ages between 18-87 years who had a complain of prolonged cough for more than two weeks were included in the study. Anti-pertussis toxin (PT) IgG and anti-filamentous hemagglutinin (FH) IgG levels from single serum samples were measured by an in-house ELISA test which was standardized and shown to be efficient previously. Anti-PT IgG antibody levels of ≥ 100 EU/ml were considered as acute/recent infection with B.pertussis. In our study, 9.7% (52/538) of the patients had high levels of anti-PT IgG (≥ 100 EU/ml) and among those patients 43 (43/52; 82.7%) also had high (≥ 100 EU/ml) anti-FHA IgG levels. There were no statistically significant differences in terms of age, gender, education level, DPT (diphtheria-pertussis-tetanus) vaccination history, smoking history or average daily cigarette consumption (p> 0.05) between the cases with high antibody levels (n= 52). When the symptoms and the presence of cases with high antibody levels were evaluated, it was detected that no one parameter was significantly different from others, except that 24.1% of the cases with inspiratory whooping had high anti-PT levels. There was also no statistically significant difference between high anti-PT levels ≥ 100 EU/ml and the patients with risk factors [smoking (21/200; 10.5%), presence of disease that cause chronic cough and/or drug usage (19/171; %11.1), and whole factors which cause chronic cough (32/306; %10.5)] and without risk factors (p= 0.581; p= 0.357; p= 0.249, respectively). The distribution of anti-PT IgG geometric mean titer (GMT) according to the age groups, was as follows; 32.41 in 18-30 years; 36.28 in 31-50 years; 36.82 in 51-70 years and 31.15 in ≥ 71 years. Our results indicated that B.pertussis infections are also present among adult population with a frequency not to be underestimated (9.7%) and the results also emphasized that since typical whooping cough symptoms may not be seen in adults, pertussis infection should be considered as a differential diagnosis in adults with prolonged cough, even if there are some other underlying factors of cough. The data obtained from this study was also considered to be helpful in the development of adult vaccination policies for the protection of infants who have not completed the vaccination schedule yet.

Factores asociados al éxito de los tratamientos del tabaquismo

Objectives: To assess the success of smoking cessation treatment, according to sex, comorbidities and treatments used. Method: Retrospective, descriptive study of the results obtained after analyzing the sample of all patients who attended the “Specialized Smoking Treatment” Unit in the University Hospital of Albacete from the 1st of January 2008 until the 31st of December 2009 and the subsequent posterior year follow-up. Results: 838 patients sent from Primary Care and Pneumology Service were included. 53.7% were men. The average age of the sample was 46.18 years. The average daily cigarette consumption was over a pack daily with 27.30 cigarettes per day. Most of the patients had comorbidities; among which was psychiatric comorbidity (37.7%), cardiovascular risk factors (CVRFs); among which the most common factor was dyslipidemia followed by hypertension and diabetes, and respiratory comorbidity (COPD, obstructive sleep apnea, asthma and chronic carriers of Domiciliary Oxygen Therapy). The global success in patients who attended the first consultation was (13.8%), while the success in patients who did not abandon the study without starting the treatment was 27.6%). With the variable “Respiratory Diseases / Cardiovascular Diseases” (RD/CVD) it was observed that having a respiratory or a cardiovascular disease does not influence the success of smoking cessation. There are hardly any differences in the success probability according to whether the patient is suffering or not hypertension, diabetes, dyslipidemia, psychiatric disorder, alcoholism or neoplasias. However statistical difference between success and the possibility of being diagnosed or not with SAHS was observed (p <0.028). Nor were found differences regarding the number of previous attempts to quit before starting the treatment and success. Moreover, the success was calculated according to the number of cigarettes smoked per day, but no statistically significant difference was found for a 95% confidence interval. Conclusions: In our study, cardiovascular or psychiatric comorbidities have no influence on quitting smoking success.

Maternal personality traits associated with patterns of prenatal smoking and exposure: Implications for etiologic and prevention research

BackgroundLittle is known about the characteristics of women who smoke during pregnancy beyond demographic factors. We examined the relationship between novelty seeking, harm avoidance, and self-directedness and (a) abstinence from smoking during pregnancy and (b) average daily cigarette consumption during pregnancy. MethodsParticipants were 826 birth mothers who made adoption placements in the Early Growth and Development Study and completed the Temperament and Character Inventory — Short Form, and interview-based smoking assessments 3–6months postpartum. Never smokers (n=199), pregnancy abstainers (n=277), pregnancy light smokers (n=184), and pregnancy heavy smokers (n=166) were compared on personality dimensions and smoking-related processes. Using regression analyses we examined relationships between personality and (a) abstinence versus smoking during pregnancy; and (b) average daily cigarette consumption among lifetime smokers, controlling for nicotine dependence, birth father substance dependence, maternal antisocial behavior, and depressive symptoms during pregnancy. ResultsSmokers with higher self-directedness and lower harm avoidance were more likely to abstain during pregnancy [O.R. 1.380; 95% C.I. (1.065–1.787); B(SE)=.322(.132); p=.015] and [O.R. .713; 95% C.I. (.543–.935); B(SE)=−.339(.138); p=.014], respectively. Novelty seeking differentiated never smokers from lifetime smokers (t=−3.487; p=.001), but was not significant in multivariate models. Lifetime smokers who abstained during pregnancy reported fewer depressive symptoms relative to never smokers. ConclusionsPersonality dimensions associated with abstinence from smoking and cigarettes per day during pregnancy may be important to consider in etiologic and intervention research.