Effects Of Tobacco Use Research Articles

Physician Views and Attitudes Regarding Tobacco-Cessation Strategies for Patients with Rheumatoid Arthritis.

In this study, we explored physicians' level of experience with patients with rheumatoid arthritis (RA) who used tobacco; their views on the effects of tobacco use on the efficacy of RA treatments; and their experiences and attitudes with respect to tobacco cessation programs. We conducted qualitative, semi-structured interviews of 20 physicians (10 primary-care physicians [PCPs] and 10 rheumatologists). The physicians had been in clinical practice for a mean of 9.9 years. Research themes included 1) risk perception of smoking, 2) cessation aids used, 3) preferences to deliver cessation programs, and 4) barriers and facilitators for tobacco cessation. For the first theme, many PCPs did not perceive smoking as influencing RA disease activity. For the second theme, most physicians supported the use of nicotine-replacement therapy and agreed that cessation-drug therapy (e.g., varenicline, bupropion) worked better than nicotine-replacement therapy or other cessation strategies, especially in patients with failed cessation attempts. For the third theme, some physicians recommended that patients join the Quitline cessation program and enroll in peer-support communities; others found educational programs informing patients about benefits of quitting and tailored with messages according to patients' specific clinical characteristics to be useful. For the fourth theme, PCPs and rheumatologists reported similar barriers to offering smoking cessation programs (e.g., lack of time, training in tobacco cessation, and financial motivation). Physicians agreed with the need for tailored, multifaceted interventions to support tobacco cessation in patients with RA. However, many perceived major barriers to helping their patients quit, some of which could be overcome by training.

Tax policy and tobacco consumption in Botswana: an ARDL-EC approach

PurposeBotswana imposed a 30% ad valorem tobacco tax in 2014 to reduce tobacco use. The purpose of the paper is to assess the effectiveness of the tax in curtailing tobacco consumption.Design/methodology/approachAn autoregressive distributed lag and equilibrium correction (ARDL-EC) framework is applied on data for the period 1975–2020 to estimate a dynamic tobacco demand model. The estimated price elasticity is then used to quantify the effects of the tax on tobacco consumption.FindingsA 10% rise in the tobacco price results in a 6.6% decrease in tobacco consumption, suggesting an inelastic response. A 10% rise in income yields a 12% increase in tobacco consumption, reflecting that the rapid economic growth Botswana experienced post-independence yielded increased tobacco use. Tobacco consumption declined by 3.6% per year, possibly capturing the effects of increasing awareness of the adverse effects of tobacco use over time. The 30% tobacco tax yielded a 20% reduction in tobacco consumption, suggesting moderate effectiveness in curtailing consumption. The tax reduced annual tobacco consumption by 100 grams per capita or 151 metric tons nationally.Research limitations/implicationsFuture research could explore the effects of non-price anti-tobacco measures and socioeconomic and demographic factors on tobacco use to provide further insights for guiding the development of targeted anti-smoking interventions.Originality/valueTobacco demand elasticities vary across countries and analytical methods. Therefore, country-specific empirical evidence is essential for policymaking. An existing study in Botswana employed cross-sectional analysis, which does not capture the addictive effects of tobacco. The ARDL-EC framework is employed to close this gap. Simulated effects of the tax are useful for policy reform in Botswana.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-01-2024-0097

The effect of tobacco use on clinical outcomes in total knee arthroplasty patients

Introduction Previous research has established that smoking significantly increases the complication rate of total knee arthroplasty (TKA). Risk of infection, prosthetic loosening, fractures, wound healing issues, and revisions are increased in smokers, but research is limited on the long-term clinical outcomes of pain, range of motion, stability, and functionality between smokers, nonsmokers, and former smokers, specifically utilizing Knee Society Scores (KSS). Methods This was a retrospective chart review of primary TKA patients (n = 203) at a single university hospital. The patients were divided by smoking status: nonsmoker, current smoker, or former smoker. One-way analysis of variance with associated f ratios was performed to assess variance in KSS by smoking status over time. Relative risk ratio analyses were employed to assess patients’ predictive risk of acquiring postoperative infection and requiring additional surgery following TKA based on smoking status. Results Postoperative KSS were significantly lower in the smoker group compared to nonsmokers and former smokers at 6 weeks and 1 year. For every 20 months a former smoker used tobacco, an approximate 1-point decrease in KSS was expected. The relative risk ratios for postoperative infection rates and patients requiring additional surgery were 2.13 and 1.44, respectively, when current smokers were compared to nonsmokers. Conclusions This analysis found that current smokers had lower KSS and higher infection rates following TKA when compared to nonsmoking controls. In addition, increased duration of smoking was correlated with poorer outcomes within the former smoker group.

A Research Study on Tobacco Associated Oral Potentially Malignant Disorders (OPMDs) Prevalent in Oral Mucosa of Lumbini Province/District Rupandehi Population of Nepal

Background: Tobacco associated Oral mucosal lesions (OML) oral potentially malignant disorders (OPMDs) that comprise of oral sub-mucous fibrosis, oral leukoplakia, tobacco pouch keratosis, chewer’s mucositis, pan encrustation are the most prevalent diseases in Rupandehi District, Lumbini province (Province Five) of Nepal. These OPMDs are usually caused by the consumption of both smokeless and smoked forms of tobacco. Smoking, chewing of the tobacco products including alcohol consumption are the common prevalent habits in Nepal and have been positively associated with such lesions. Aim of the Research Study: With this background, a research study has been conducted to assess the prevalence of OPMDs and their association among the patients visiting the outpatient department in Rupandehi district of Nepal. Research Methods and Material: This descriptive, cross-sectional prevalence study included five hundred participants who visited the Outpatient Department and fulfilled the inclusion criteria. The study data was carried out from August 2003 till April 2024. Institutional Review Committee (IRC) provided the ethical clearance to the study, which was duly obtained along with patient consent that were part of the study. Standardised proforma was used for recording demographic details, and WHO Assessment form for oral mucosal lesions were used to record the tobacco use status and findings of the clinical and laboratory investigations. Statistical analysis was performed using IBM SPSS version 23, and the results were calculated along with the level of significance. Research Study Results: The final sample was comprised of 500 cases of which 392 were males and 108 were females. The mean age of the study population was 58.19 ± 12.33 years (p<0.001). Leukoplakia in its varied forms (OPMD) accounted for almost 82% of the sample cases. The lesions from patients aged from 41 to 80 years presented moderate and severe dysplasia more often than lesions from patients in other age groups. The prevalence of tobacco use among study participants was 41.25% and that of the OML (oral mucosal lesions) positively attributed with use of tobacco was 39.28%. Tobacco chewing (areca nut) were significant predictors of oral sub mucous fibrosis in this population. Conclusion: The prevalence study emphasizes the deleterious effects of tobacco use on oral mucosa and also serves as a path for future tobacco cessation programs that would be helpful to prevent OPMDs in the Nepalese population especially in Province V (Rupandehi District) of Nepal. Keywords: OPMDs, oral diagnosis, oral leukoplakia, oral sub mucous fibrosis, chewer’s mucositis, tobacco cessation

Self-Reported Comfort and Use of Tobacco Cessation Interventions by Healthcare Providers.

Background The effects of tobacco use create a significant burden on the American healthcare system.The U.S. Preventive Services Task Force (USPSTF) recommends a tobacco cessation framework consisting of asking all patients about any tobacco use, advising they quit, assessing their willingness to start a quit attempt, assisting in any attempts, and arranging follow-up. This is known as the "5A's" and is considered a standard of care for tobacco cessation. Physician-provided cessation interventions have been shown to be effective in helping patients stop their tobacco use; however, studies have shown that physicians and other healthcare providers do not consistently offer tobacco cessation interventions. This study aimed to evaluate healthcare providers' comfort with and self-reported use of tobacco cessation interventions. Methods An online survey was made available to all Penn State HealthMilton S. Hershey Medical Center physicians, physician assistants (PAs), nurse practitioners (NPs), registered nurses (RNs), and respiratory therapists (RTs). The survey assessed respondents' use of the USPSTF"5A's" cessation framework, comfort in counseling patients, use of cessation interventions, and desire for further education. Descriptive statistics were generated, and chi-square tests were used to compare differences in responses across provider groups. Results A total of 430 healthcare professionals (mean age of 40.1 years,76.1% female) responded to the survey, including 55 (12.1%) physicians, 76 (17.7%) resident/fellows, 44 (10.2%) PAs, 57 (13.5%) NPs, 146 (33.9%)RNs, and 54 (12.5%)RTs. The majority (n = 407, 95.5%) of respondents reported a belief that it is "extremely" or "very" important for their patients to stop smoking cigarettes. Although more than 160 (70%) providers reported feeling "very comfortable" or "somewhat comfortable" counseling patients who were "ready to quit" smoking, only half reported the same for patients who were "not ready to quit." There was significant variation in the use of the recommended "5A's," with NPs and attending physicians reporting the most regular use. Self-reported use of the "Ask" and "Advise" components of the "5A's" was higher than the "Assess", "Assist", and "Arrange" components, with low rates of use of pharmacologic cessation methods. Only 13 (3.2%)providers reported regularly billing for cessation counseling. Conclusions While healthcare professionals recognize the importance of tobacco cessation for their patients, gaps persist in the consistent application of the "5A's" modeland provider comfort in counseling patients to quit, particularly those perceived as "not ready to quit." This discomfort with counseling, along with hesitancy to offer cessation interventions, results in missed opportunities to help patients with tobacco use disorder. Differences in cessation practices across healthcare roles suggest opportunities for targeted improvement. Enhancing both provider training and health system interventions is essential for expanding patient access to effective cessation interventions.

Correlates of nicotine patch adherence in daily life

BackgroundAfrican Americans who smoke are disproportionately affected by the health consequences of smoking. Nicotine replacement therapy (NRT) is effective for helping people successfully quit, yet there are well-documented issues with nicotine patch adherence. This study aimed to examine the real-time associations of risk factors for patch non-adherence [lapse, motivation, self-efficacy, urge, cigarette availability] with patch adherence in a sample of African Americans who smoke and are attempting to quit. MethodsParticipants were 239 African American adults, 50 % female, and ages 18–74. Ecological momentary assessment was used to assess patch use and risk factors. Multilevel modeling for binary outcomes was used to test concurrent and lagged associations between risk factors and patch use. ResultsLapse at a previous assessment (OR=0.61, 95 % CI: 0.42, 0.88), and urge (OR=0.77, 95 % CI: 0.66, 0.89) and cigarette availability (OR=0.84, 95 % CI: 0.71, 0.99) at concurrent assessments were associated with lower likelihood of patch use. Concurrent motivation (OR=1.28, 95 % CI: 1.05, 1.55) and self-efficacy (OR=1.31, 95 % CI: 1.06, 1.62) were associated with greater likelihood of patch use. There were no significant lagged associations between motivation, self-efficacy, urge, or cigarette availability with patch use. DiscussionIt is critical to examine correlates of non-adherence among African Americans who smoke because they are less likely to quit and are disproportionately impacted by the health consequences of tobacco use. The results suggest that interventions might focus on promoting patch adherence at certain times (e.g., when cigarettes are available) and/or leveraging the benefits of protective factors (e.g., motivation and self-efficacy).

Religiosity vs tobacco use: Religion's impact on tobacco use among adult Indian population - A cross sectional study.

Tobacco use is major serious threats to health and well-being killing approximately 1 million people each year. One of the better ways for tobacco cessation is by promoting the cultural-religious belief that may influence a person's tobacco-related habits. A Descriptive cross-sectional study was conducted among 174 adult subjects of smoking and smokeless tobacco users. The questionnaire consisted of demographic information and the Duke University Religion Index was used to assess the influence of religious belief and the use of tobacco products. The appropriate statistical tests were done using the Chi square test and ANOVA. The study involved 174 participants of smoking and smokeless tobacco users. The participants were predominantly males (96%) with a mean age of 36 years, and more than half were Hindus (71.85). Among the study participants, 37.4% were graduates and 17.8% were illiterates. With regard to Occupation, the majority of the respondents were Professionals (24.7%). Majority of tobacco users had religious beliefs and strongly accepted that using tobacco during the fasting period was against their religious beliefs. The study concluded that there is a strong influence of religious belief on tobacco usage. Hence, there is a need to conduct community awareness programs for the adult population about the consequences of tobacco use.

A Pre Experimental Study to Assess the Effectiveness of Video Assisting Teaching Programme On Awareness Regarding Hazardous Health Effect of Tobacco Use Among Factory Workers in Selected Urban Area of Kota, Rajasthan

A Pre Experimental Study to Assess the Effectiveness of Video Assisting Teaching Programme On Awareness Regarding Hazardous Health Effect of Tobacco Use Among Factory Workers in Selected Urban Area of Kota, Rajasthan

Opportunities for plain packaging of tobacco products in the Philippines: results of a nationwide online survey.

This study aimed to contribute to local research evidence to promote the implementation of plain packaging of tobacco products in the Philippines. The study aimed to assess Filipinos' perception of the effectiveness of plain packaging and their readiness by assessing the potential impact of plain packaging. We conducted a nationwide geographically representative online panel survey with a sample size of 2,000 Filipinos. The survey recruited respondents 18-65 years old and residing in the Philippines, with 500 respondents each from the National Capital Region, Luzon, Visayas, and Mindanao. We showed respondents six different mock-ups of cigarette packs in plain packaging, with two sizes of graphic health warnings (50 and 75%) and three plain packaging colors (black, white, and Pantone 448C). Using five-point Likert scales, participants rated their agreement with 18 items assessing readiness and rationales for plain packaging and 54 items related to pack design (9 items for 6 pack designs). The study showed that Filipinos recognize the value of adopting plain packaging with larger graphic health warning labels on tobacco products in the Philippines. Both non-smokers and smokers agreed that plain packaging has the potential to reduce the attractiveness and appeal of packs, prevent advertisement and promotion of tobacco products, reduce the ability of tobacco products to mislead consumers, increase the noticeability and effectiveness of the pictorial health warnings, increase recall of the pictorial health warnings, affect consumer perceptions of the attractiveness of the tobacco products and their relative safety, reduce youth experimentation with the use of tobacco products, prevent the use of tobacco brand variants as a promotional tool, prevent branding targeted toward youth, promote quitting among current users, and to more clearly inform consumers about the harmful effects of tobacco use. We recommend that policymakers pursue plain packaging as legislation or as part of a reform of the Philippines' graphic health warnings law. The law should target tobacco products sold in the Philippines.

Exposure to nicotine pouch marketing and nicotine pouch experimentation among U.S. adults who use commercial tobacco

ObjectiveU.S. nicotine pouch (NP) sales have grown since 2016. Among U.S. adults who currently and formerly used commercial tobacco, we examined demographic associations with learning about NPs through varying marketing channels, and their associations with NP experimentation overall and stratified by race/ethnicity. MethodsA nationally representative sample of U.S. adults who currently and formerly used commercial tobacco (n = 1,700) were surveyed online in January-February 2021. Participants reported their demographics and whether they learned about NPs through nine marketing channels. We used weighted multivariable logistic regressions to examine demographic associations of each channel, and each channel’s association with NP ever-use. ResultsOverall, 45.2 % were aware of NPs, and 17.4 % ever used NPs. Highest reported NP awareness was through stores (16.6 %), internet/social media ads (9.2 %), friends/family’s social media (8.2 %), direct mail/email (7.6 %), and print media ads (6.9 %). Younger, female, Black and Hispanic (vs. White) adults had lower odds of NP awareness through various marketing channels than their counterparts. Black adults (vs. White) had higher odds of NP awareness through news stories on TV/radio/online. Awareness through each channel was associated with higher odds of ever-using NPs, especially brand sponsored events, brand website/social media accounts, and direct mail/email (p’s < 0.05). Results were generally consistent when stratified by race/ethnicity, but notable differences were also observed (race/ethnicity interaction p < 0.05). ConclusionsNP marketing may promote NP experimentation among U.S. adults who use commercial tobacco. Future research should examine whether exposure to NP marketing leads to poly-tobacco use, which could increase the detrimental health effects of tobacco use.

Effects of Smoking on the Human Organism

Background: Smoking is widely recognized for its adverse impacts on health, contributing to chronic and acute conditions affecting nearly every organ system. This review synthesizes the extensive body of research highlighting the physiological and pathological effects of tobacco use. Methods and Materials: A comprehensive review was conducted using PubMed and additional databases, selecting studies published in the last 25 years. Studies were evaluated for relevance and reliability, focusing on those that provided clear outcomes and substantive evidence on the effects of smoking. Results: The analysis confirms that smoking is responsible for a significant burden of disease, including major risks for cancers, cardiovascular diseases, respiratory conditions, and reproductive health issues. Smoking increases the risk of lung cancer by 80-90% and is a primary factor in cardiovascular and respiratory diseases. Passive smoking further extends the risk to non-smokers, significantly impacting public health. Conclusion: Smoking cessation presents substantial benefits, potentially reversing many adverse effects. Public health policies should continue to focus on reducing smoking rates through education, cessation programs, and legislative measures to mitigate the extensive harm caused by tobacco consumption.

Effect of tobacco use on response to immunotherapy in patients with cancer.

e14537 Background: Evidence from existing literature suggests that it remains unclear if tobacco usage affects the efficacy of immune checkpoint inhibitors (ICI). This research aims to evaluate the connection between smoking and the effectiveness of immune checkpoint inhibitor (ICI) therapy in specific cancer types treated at our institution. Methods: This is a retrospective cohort study where cancer patients &gt;18 years old who received immunotherapy from 2017 to 2023 were identified through our center’s Cancer Registry. This study focuses on three major cancer types: lung, head and neck, and melanoma. 458 patients with their demographics, staging, duration of treatment and last contact have been assessed. SAS 9.4 was used for analysis with Chi-square/Fisher’s Exact testing, Student’s T-test, life tests and the Cox proportional hazards model to discern the effects of tobacco use and overall survival. Results: Among 458 patients, 48 (10.48%) are never-smokers, and 410 (89.52%) are smokers (current or former). Overall, 211 (46.06%) have stage 0-IIIA, while 247 (53.93%) have IIIB-IVB tumors. The mean age is 66.08 years. Additionally, 330 patients (72.05%) received chemotherapy as part of their treatment regimen in addition to immunotherapy. Non-tobacco users exhibit a higher survival probability compared to tobacco users. At five years, non-tobacco users showed a survival rate of 41%, whereas tobacco users had a survival rate of 28% (p=0.01) and hazard ratio [HR] of 1.55 (95% confidence interval, 1.00–2.39). The median survival for all patients is 40 months among non-tobacco users and 19 months among tobacco users. Moreover, there is no difference in the survival rates between current and former smokers. Conclusions: The study demonstrates that immunotherapy has better outcomes and increases survival probability in non-tobacco users. Also, there is no difference in survival between current or former tobacco users. However, these findings warrant future prospective studies.

Awareness and Attitude Towards Tobacco Products and Tobacco Industry and Perception about Government's Role in Tobacco Control among the Adult Rural Population: A Cross-sectional Study in the Indian State of Bihar.

Attitudes and impressions toward the tobacco industry and tobacco products among the general public are important determinants for curbing the menace of the tobacco epidemic. Accordingly, this study aimed to assess the knowledge and perceptions about the tobacco industry and tobacco products and analyze attitudes towards social denormalization (SD) of tobacco use and tobacco industry denormalization (TID) among the rural population of Bihar, India. This community-based cross-sectional survey was conducted on 421 adults aged 18 to 65 years who were selected using multistage systematic random sampling in a rural area of Bihar State in India from January to March 2022. Results were presented as proportions and the factors associated with support for TID and SD were identified using the chi-square test and binary logistic regression. Out of 421 participants, 342 (81.2%) did not consider smokeless tobacco to be very dangerous. Nearly half (192, 45.6%) of the individuals believed that tobacco companies never tell the truth about the ill effects of tobacco use on health. Maximum, 345 (89.5%) also believed that the tobacco industry is responsible for adverse health effects of tobacco use and that the government should sue them. The prevalence of favorable attitudes toward TID and SD was found to be 55.1% [95% CI: 50.3% - 59.8%] and 38.2% [95% CI: 33.7% - 42.9%], respectively. One out of every two and one out of every three individuals showed favorable attitudes toward TID and SD, respectively. There is a need to inform and educate the public on the ill effects of tobacco and the deceptive strategies used by the tobacco industry to help them choose health over tobacco.

The Impoverishing Effect of Tobacco Use in Indonesia.

Smoking households in Indonesia diverted a significant share of their budget to tobacco. Tobacco expenditure is deemed unproductive, as it crowds out resources from essential commodities and increases health care expenditure driven by tobacco-induced diseases. Therefore, despite having adequate resources, some smoking families in Indonesia may spend less on basic needs, which inadvertently puts their standard of living below the poverty line. Employing data from 2021 (March) Indonesia's Socioeconomic Survey (SUSENAS), this research aims to quantify the impoverishing effect of tobacco consumption in Indonesia, considering spending on tobacco and tobacco-attributable health care costs as unproductive expenditure. The de facto headcount poverty rate and poverty gap index are calculated by removing tobacco expenditures and tobacco-attributable health care expenditures from the household's total spending. Accounting for unproductive spending related to tobacco use, Indonesia's headcount poverty ratio in March 2021 would rise by 3.22 percentage points, equivalent to an additional 8.75 million people living below the poverty line. In addition, the poverty gap index would increase by 0.77 percentage points. The impoverishment effect of tobacco is larger among rural populations than their urban counterparts. Moreover, the impoverishment is mainly driven by direct tobacco spending rather than tobacco-attributable health care expenditure. Significant portions of Indonesia's population are exposed to secondary poverty due to tobacco use. A high level of cigarette spending among smoking households is the major source of the impoverishing effect of tobacco use. The study provides quantitative evidence of the true cost of smoking in Indonesia, where the de facto number of the poor population after accounting for tobacco-related spending is higher than what is published in the official statistics. The findings of this study support tobacco control policies in Indonesia, particularly to effectively reduce tobacco use and mitigate the impoverishing impact of tobacco use on low-income households.

Tobacco endgame measures and their adaptation in selected European countries: A narrative review synthesis.

Due to the continued detrimental effects of tobacco use, a growing number of countries are embracing the idea of tobacco endgame, meaning ending the tobacco epidemic instead of controlling it. This narrative review aims to synthesize and update the evidence from earlier scientific reviews on effective tobacco endgame measures, as well as to assess their integration to current national strategies among European countries with official tobacco endgame goals. The synthesis of the prior scientific literature found most evidence on product-focused and some evidence for supply-focused policies. Little evidence was detected for user- and institutional-focused measures. An update for the tobacco-free generation measure showed uncertainty in reducing smoking prevalence, especially for adolescents' reactions to age-restrictive laws. All the countries that established a tobacco endgame strategy have included product standards in their measures, predominantly based on European Union regulations on conventional tobacco products, yet standards above this level and considering other products were also common. Cessation measures were given strong emphasis in strategies, yet none of the countries linked these to specific endgame measures. Despite commonly mentioning vulnerable groups, such as youth and pregnant women, adoption of measures to reduce tobacco use among these groups was scarce. Lastly, the decline in tobacco use seems to be modest, implying challenges in meeting the endgame goals. To meet these goals, European countries should reinforce the implementation of known effective tobacco control measures such as tax increases. Furthermore, new innovative strategies and measures to meet the objective of an endgame should be explored.

Effect of tobacco use on Zenker's diverticulotomy outcomes

ObjectiveTo compare clinical outcomes in patients with and without history of tobacco use who underwent Zenker's diverticulotomy (ZD). Study designSingle institution retrospective review. SettingTertiary care academic hospital. MethodsA retrospective review of patients who underwent ZD via an open stapler, rigid endoscopic CO2 laser, stapler or harmonic scalpel, and flexible endoscopic technique from January 2006 to December 2020 was performed. Data were abstracted for patient demographics, diverticular features, and rates of adverse events and symptomatic recurrence. ResultsOut of 424 patients, 146 (34.4 %) had a history of tobacco use: 126 (29.7 %) were former smokers, and 20 (4.7 %) were active smokers. In univariable cross-sectional analyses, the likelihood of postoperative bleeding, perforation, emergency department visits, unplanned readmission, or recurrence did not demonstrate an association with tobacco use history even after adjustment for age, sex, and surgical approach. Similarly, in Cox Proportional Hazards regression, tobacco use was not associated with an increased risk of recurrence, even after correcting for age, sex, and type of surgery. The median time to recurrence observed in our cohort was 11.5 years amongst non-smokers, 8.7 years amongst former smokers, and 1.2 years amongst active smokers (p = 0.94). ConclusionsThere were no significant differences in post-operative adverse events or frequency of recurrence of ZD between active, former, and non-smokers. Although underpowered and not statistically significant, median time to recurrence appears to be shorter in smokers when compared with former and non-smokers following surgery.

Text Message-Based Cessation Intervention for People Who Smoked or Used Smokeless Tobacco in India: A Feasibility Randomized Controlled Trial.

Despite the high burden of tobacco use in India, users do not have access to adequate help. This pilot trial aimed to evaluate the feasibility and acceptability of a text messaging intervention for tobacco cessation, generate preliminary estimates of its impact, and fine-tune procedures for a definitive trial. Parallel two-arm single blind individually randomized controlled pilot trial with nested qualitative study. Participants included adult current tobacco users (smoked and smokeless). Eligible and consenting participants were randomized to receive either (1) text messaging intervention (ToQuit) which covered specific content areas such as psychoeducation about consequences of tobacco use and benefits of quitting and tobacco avoidance strategies or (2) information about tobacco cessation helplines such as the helpline number and the languages in which tobacco cessation support was available (control). Feasibility data included screening and consent rates, treatment dropouts, and outcome ascertainment. The primary abstinence outcome was self-reported abstinence from tobacco in the past seven days at 3 months post-randomization. In-depth interviews were conducted with a subsample of participants primarily to collect acceptability data. The primary abstinence analysis used a chi-squared test and logistic regression (complete case), and qualitative data was analyzed using thematic analysis. Ninety-eight participants were randomized into the two trial arms; 77 (79%) completed outcome evaluation. No between-arm differences in abstinence were found though findings favored the intervention (7-day abstinence: ToQuit 23%, control 19%; adjusted odds ratio 1.23, 95% confidence interval 0.38, 3.97). Participants appreciated the language, comprehensibility, and relevance of the messages; and reported overall satisfaction with and positive impact from the intervention on their lives. The findings indicate the acceptability and feasibility of ToQuit and if found effective, it could be a potentially scalable first-line response to tobacco use in low-resource settings. Our pilot randomized control trial provides sufficient findings supporting the acceptability and feasibility of an intervention for tobacco cessation which is suitable for a context which has a shortage of healthcare workers and for individuals who use smoked or smokeless tobacco. This is critical on a background of limited contextually relevant interventions for a problem with a high burden in low- and middle-income countries such as India.

Schizophrenia and Nicotine - A Bittersweet Psychiatric Story

Abstract Background: Schizophrenia is a chronic mental disorder affecting mood, perception, and most importantly cognition. This severely interferes with the functioning of such patients. On the other hand, nicotine use (both smoke and smokeless tobacco) is very much prevalent in schizophrenic patients, much more than normal population. This study aims to find the relation between nicotine use and cognition in schizophrenic patients. Methodology: Fifty-six new patients diagnosed with schizophrenia of both sexes between ages 18 and 60 years, giving valid and informed consent, were selected for the study. Fagerstrom test for nicotine dependence was done and the patients were divided into two groups: scores 4 or less (low-to-moderate dependence) and scores 5 or more (severe dependence). The Cognitive Assessment Interview was performed. Then, an independent sample t-test was used to compare the scores on various cognitive domains between the two groups. Results: The cognitive scores were better in the group with severe tobacco dependence, both globally and across individual domains. These associations were statistically significant (P = 0.001). The mean difference was highest in the social cognition group. Among all the domains, the t-value was highest for the speed of processing domain, indicating that this particular cognitive domain has the best discriminative value when compared between two groups of nicotine users. Conclusions: Hence, to conclude, whether nicotine has indeed a beneficial effect on cognition in schizophrenia has to be investigated longitudinally so that a possible treatment option to address cognitive impairment in schizophrenia is obtained. Extensive longitudinal studies needs to be conducted to better understand the long-term effect of tobacco use and cognition in schizophrenia patients.

Factors Influencing the Consumption of Tobacco amongst the Khasi Indigenous People in Northeast India.

Tobacco use in any form is a major public health concern. It accounts for nearly 1.35 million deaths every year. Many chronic illnesses occur due to the consumption of tobacco, either smoke or smokeless form. The study aims to explore how smoking and smokeless tobacco consumption are distributed across a range of demographic and socioeconomic markers among Khasi indigenous people in Northeast India. It is a case-control study conducted in adults over 31 years of age. The study was carried out between June 2020 and August 2021. An Independent t-test was performed to determine the significant difference in age between smoking/smokeless tobacco users and non-tobacco users. Univariate and Multivariate analyses were conducted to determine the significant predictors affecting the use of smoking/smokeless tobacco in the respondents. A total of 505 respondents were included in the present study. There was a high statistically significant difference in the income level of tobacco and non-tobacco users (P value- 0.002). In Univariate analysis, it was found that the odds of consuming both forms of tobacco were significantly lower in the respondents aged between 51-60 (OR = 0.61, P value = 0.0453). The participants who studied till graduation and above had lower odds of both using forms of tobacco as compared to respondents who were illiterate/primary educated only (OR = 0.85, P value = 0.046). In conclusion, smoking and smokeless tobacco consumption are still widely prevalent in this region and strongly associated with age, gender, level of education, and place of residence. There is a need for further detailed analysis to identify risk factors that are strongly associated with the use of smoke and smokeless tobacco so that the community will be conscious about the hazardous effects of tobacco use in any form.

Effect of tobacco use on cadmium accumulation in the oral keratinized mucosa

BackgroundThis cross-sectional study aimed to evaluate the effect of tobacco use on the accumulation of cadmium (Cd), a carcinogenic element, in the oral keratinized mucosa (OKM).MethodsOKM samples were obtained by standard punch biopsy from nonsmokers (n = 19) and smokers (n = 21). Cd analysis was performed using inductively coupled plasma optical emission spectroscopy (ICP-OES). The calibration curve R2 values for three wavelengths (214,439, 226,502, and 228,802 nm) were at the level of 0.9999. The frequency of consumption of foods that are Cd sources, such as seafood, rice, and vegetables, was assessed in all patients. The age, sex, and nutritional habits of all patients and the frequency of tobacco consumption by smokers were recorded. The independent t-test, Mann–Whitney U test, Fisher’s exact test, and Spearman correlation test were used for the statistical analyses, and p < 0.05 was considered significant.ResultsAlthough the Cd levels in nonsmokers were higher than those in smokers, no statistically significant difference was found (p > 0.05). In smokers, a positive correlation was found between age and Cd level (r = 0.574, p = 0.006). No significant relationship was found between the groups in terms of nutrition or between the frequency of tobacco consumption and Cd accumulation.ConclusionThe OKM may not have the characteristic cumulative accumulation in terms of toxic elements. Changes in the turnover rate, keratinization, and apoptotic mechanisms in the OKM with the thermal/chemical effects of tobacco may be responsible for the difference in Cd accumulation.Trial registration numberTCTR20230206001/06 Feb 2023 (TCTR: Thai Clinical Trials Registry).