Current Daily Smokers Research Articles

The interplay between healthy lifestyle and body mass index in metabolic syndrome

Abstract The prevalence of metabolic syndrome (MS) tends to increase as body mass index (BMI) increases. However, the interplay between BMI and overall healthy lifestyle in MS remains unclear. We aimed to examine the association between healthy lifestyle and MS in BMI categories. Data comprised participants aged 30-64 years from the Healthy Finland Survey representing the Finnish adults (n = 2027). Information was collected through health examination measurements, blood sampling and questionnaires in 2023. Healthy Lifestyle Score (HLS) was defined as: 1) vegetables and fruits several times/day; 2) adherence to physical activity recommendations; 3) sufficient sleep duration; 4) no current daily smoking; 5) no risky alcohol drinking. Total score ranged 0-5; categorized as 0-2 (unhealthiest), 3, 4-5 (healthiest). MS was defined as exceeding risk limit in ≥ 3 of the following conditions: waist circumference, fasting glucose, triglycerides, blood pressure and HDL-cholesterol. BMI (kg/m2) was categorized as normal weight (<25), overweight, and obesity (≥ 30). Weighted prevalence and 95% confidence intervals (CIs) stratified by sex were calculated considering sampling design and non-response. In both sexes, the prevalence of MS was lowest in those with normal weight and healthiest lifestyle (men 7%; 95% CI 2-11; women 9%; 6-13) and highest in those with obesity and unhealthiest lifestyle (m 86%; 80-92; w 67%; 56-78). In men, the prevalence of MS decreased within each BMI class as HLS scores increased, but the difference between healthiest and unhealthiest lifestyle was greatest in those with normal weight (7% vs. 26%) and lowest in those with obesity (71% vs. 86%). In women, the differences were greatest among those with overweight. Obesity and unhealthy lifestyle together form a major risk factor for MS. Differences in the prevalence of MS according to lifestyle were evident especially in men with normal weight or overweight, but decreased when the obesity threshold was exceeded. Key messages • Obesity is strongly linked to the high prevalence of metabolic syndrome but maintaining a healthy lifestyle is important regardless of body mass index. • The results indicate the importance of multifaceted prevention influencing lifestyle factors and supporting weight management to enhance the cost-effective prevention of metabolic risk accumulation.

Patterns of Cigarette and Waterpipe Smoking in Erbil City, Iraq. A Household Survey

Background and objective: Globally, tobacco use is one of the most serious public health concerns and preventable causes of morbidity and mortality, expected to reach annually more than 8 million deaths by the year 2030. In light of this estimation and limited surveillance of smoking, this study aimed to identify the tobacco use trends and patterns in various forms in Erbil city. Methods: A community‐based cross‐sectional household survey was carried out from September 2021 through June 2022, on a sample of 2601 respondents selected through a multi‐stage cluster sampling method in Erbil city. A specially designed questionnaire through direct interviews was used to collect socio-demographic and smoking-related data. Results: The prevalence of current daily smoking was 44.3%, occasional smoking was 14.5%, Ex-smoking was 8.0%, and those who never smoked before 33.2%.The prevalence of cigarette, and waterpipe smoking was 37.2%, and 46.5%respectively. More than half (51.0%) had tried to quit smoking at least once in their life, while 11.9% succeeded to quit. The main reason behind quitting was anticipated health risks (97.3%). The prevalence of smoking was significantly higher among those aged 20-29 years, single, males, college education, those having skilled manual /non-manual occupations, those who have smoker friends, and from a middle socioeconomic level Conclusion: The prevalence of smoking (current daily and occasional) was more than half and about one-third never smoked before. More than half had tried to quit smoking at least once in their life but (11.9%) succeeded to quit due to anticipate health risks and family pressure.

Intention to Quit Tobacco due to Media Advertisements in India: Findings from Global Adult Tobacco Survey 2016-17.

Tobacco has been among the most important causes of morbidity and mortality worldwide. In reducing tobacco consumption, media campaigns are crucial in raising awareness and encouraging individuals to quit. The present study aimed to profile participants of GATS-2, including tobacco usage patterns and media exposure, and explore the factors associated with quitting in the presence of media exposure. Secondary data analysis of Global Adult Tobacco Survey-India (2016-17) data was done among current daily cigarette smokers and smokeless tobacco users. The primary independent variable was an intention to quit, while media exposure was the primary independent variable. Respondents were profiled as per various socio-demographic variables, and exposure to media advertisements and intention to quit were assessed using weighted bivariate analysis and multivariate log regression analysis. Males, and respondents aged 15 to 45, had more exposure to media and advertisements than female respondents. Cigarette smokers with moderate consumption, better awareness, those who had made any quit attempts in the last 12 months, and moderate to high media exposure depicted better intention to quit. In SLT users, intention to quit depicted significant odds per education level quit attempts and exposure to media and advertisements. We report a high intention to quit among those exposed to advertisements. Media campaigns play an important role in promoting tobacco control. There is a need to assess the impact of such advertisements on behavioral aspects. At the same time, comprehensive tobacco control policies should go hand in hand in reducing smoking rates.

Cigarette smoking behaviors and nicotine dependence at the intersection of sexual identity and sex in the United States: Findings from the National Survey on Drug Use and Health

Introduction: Cigarette smoking is disproportionately high among lesbian, gay, and bisexual (LGB) adults. Yet, collapsing these identities into a monolith can disguise important within group disparities (e.g., lesbian/gay versus bisexual female). The purpose of this study is to report recent national prevalence estimates and trends of cigarette smoking behaviors and nicotine dependence by sexual identity and sex. Methods: Data were from the 2015–2019 National Survey on Drug Use and Health (n = 210,392; adults 18+), a nationally representative, repeated cross-sectional study of substance use and mental health in the U.S. We examined bivariate and multivariable associations between sexual identity and cigarette smoking measures (i.e., former smoking, lifetime smoking, current smoking, current daily smoking, nicotine dependence) by sex. We also examined linear time trends in current and former smoking. Covariates included age, race/ethnicity, education, annual household income, and survey year. Results: Bisexual women had the highest unadjusted prevalence of current smoking (31 %) and lowest of former smoking (25 %). LGB females and males had higher adjusted prevalence of current smoking, daily smoking, and nicotine dependence than heterosexual adults. Bisexual females and gay and bisexual males had lower adjusted prevalence of former smoking (adjusted prevalence ratio range: 0.78–0.85) than heterosexual counterparts. Discussion: This is the first study to identify disproportionately low prevalence of former smoking among bisexual females. Paired with findings of high prevalence of current cigarette smoking and nicotine dependence, these data suggest that tobacco control interventions targeted toward bisexual females are urgently needed to reduce the burden of cigarette smoking among these individuals.

Associations of childhood and current secondhand smoke exposure at home with current secondhand smoke exposure at work: A cross-sectional analysis of the Singapore multi-ethnic cohort.

Relationships between secondhand smoke exposure (SHSE) in various temporal and physical settings are not fully studied despite its adverse impacts on human health, especially in multi-ethnic Asian populations. We investigated associations of childhood and current SHSE at home (SHSEhome) with current SHSE at work (SHSEwork) in Singapore and its relation to sources of daily smokers at home. This cross-sectional study identified 925 healthy, never smoker working adults from the Singapore Multi-Ethnic Cohort (2004-2010). Firstly, the multiple logistic regression model estimated the adjusted odds ratios (AORs) of SHSEhome. Subsequently, sources of daily smokers entered through an additional model building process using the former as a base. Current adults (AOR=2.05; 95% CI: 1.28-3.29) and childhood SHSEhome (AOR=1.43; 95% CI: 0.93-2.19) had a positive and no association with current SHSEwork, respectively. These findings persisted when smoker identity-related variables entered the model: child (AOR=3.56; 95% CI: 1.19-10.64) for current daily smokers; father (AOR=2.30; 95% CI: 0.94-5.64) and sibling (AOR=2.97; 95% CI: 1.55-5.68) for childhood. Compared to no childhood SHSEhome, only those living with their fathers and siblings who smoked daily at home had significantly higher odds of reporting current SHSEwork (AOR=3.70; 95% CI: 1.88-7.30). Current SHSEhome was a risk factor for current SHSEwork, with risks elevated among those who smoke daily at home and living with their children. Childhood SHSEhome becomes a risk factor when daily household smokers include fathers and siblings. Deformalizing smoking could consider interpersonal dynamics of daily smokers at home with family members in different temporal settings, to reduce SHSEwork.

Factors Influencing Tobacco Cessation in India: Findings from the Global Adult Tobacco Survey-2.

The study aimed to assess the socio-demographic and other correlates of cessation behavior across tobacco products among the adult population in India. We used data of adults (aged ≥15 years) who were current or former tobacco users (smoking and/or smokeless tobacco) from the Global Adult Tobacco Survey (GATS) India, conducted during 2016-17. The detailed analysis was done for current daily smokers (N=7,647), former daily smokers (N=1,353), and current daily smokeless tobacco users (N=1,2721). Multivariate logistic regression was separately performed to find the associated factors with attempts to quit, successful quitting, different cessation methods of smoking, and smokeless tobacco use. The findings of the study indicated that daily smokers, higher educated, urban residents and employed were more likely to quit smoking compared to their counterparts. Successful quitting of smoking was higher for employed, higher educated, current users of smokeless tobacco and older adults. For smokeless tobacco users, non-daily users, highly educated, urban residents, and employed were more likely to attempt to quit compared to their counterparts. Successful quitting of smokeless tobacco was higher for unemployed, highly educated, urban residents and current non-smokers, and higher age group adults. The findings of this study suggest a need for professionally channelized cessation interventions to reduce the prevalence and relapse of tobacco use and increase the quit rate. Well-designed, large-scale research into specific tobacco cessation methods is needed to establish the association between different tobacco cessation methods and increased quit rates.

Evaluating achieving tobacco control targets in Belgium using modelled projections

Abstract Background Tobacco use in Belgium remains a key public health concern with an estimated 15% of adults reporting daily tobacco use in 2018. In 2022, the Belgian government launched the “Interfederal Strategy 2022-2028 for a Smoke-free Generation.” The strategy outlines a number of targets for reducing daily tobacco use among adults 15+ years and young adults 15-24 years. We evaluate the feasibility of achieving these targets given current daily smoking trajectories at a national and regional level. Methods We modelled time trends of smoking in Belgium based on repeated cross-sectional data taken from the nationally representative Belgian Health Interview Survey. We applied a Bayesian inference model, the integrated nested Laplace approximation, to obtain a time series of daily tobacco use for adults by age, sex, and region of Belgium from 1997 to 2018. We then projected this model to 2070 using population projections from the Belgian Federal Planning bureau for population distributions. We compared trajectories with targets from the Interfederal Strategy to assess whether they are likely to be achieved. Results The national target of reducing daily smoking among adults 15+ years to 10% by 2028 and 5% by 2040 will not be achieved on current trajectories. Wallonia has the highest level of people smoking daily and is projected to miss the targets by the largest margin. Flanders is expected to reach the 10% threshold by 2032. The target for reduction of prevalence of daily smoking among youth 15-24 years to 6% by 2028 will not be achieved before 2040. Smoking among the youngest age group (15-24 years) is decreasing rapidly with prevalence of daily smoking in that age group projected to be < 2% in Flanders by 2059. Conclusions No region of Belgium is expected to achieve targets for reduction in daily smoking given current trajectories. Tobacco control policies in the country should be re-assessed, targeted and intensified. Key messages • The Belgian national target of 5% daily smoking prevalence in adults by 2040 will not be achieved. • Differences in smoking trajectories in Belgium exist by age and region; tobacco control policies should be targeted.

Attitude Towards Anti-smoking Measures and Its Associated Factors Among Adults in Sub-urban Area, in Kuala Terengganu, Terengganu, Malaysia

Introduction: General population across different countries have shown an overall support for anti-smoking measures that vary significantly by certain population parameters. However, characteristics of the public attitude in a community who has been exposed to prolonged awareness campaigns and smoke-free area legislation is unclear. Consequently, we investigate residents who reside next to Batu Buruk beach in Kuala Terengganu city which has been gazetted as a smoke-free area since 2017. Methods: The cross-sectional study involves self-administered validated questionnaires. Multiple linear regression with forward method was applied to identify significant factors associated with the attitude towards anti-smoking measures. Results: A total of 295 residents participated. Most of them were Malays (96.6%), married (64.4%), attained up to the secondary school level (45.4%) and employed (59.7%). The mean value of the total attitude scores was 181.86 (range: 70-200). Multivariate analyses revealed those having higher monthly income had a higher total attitude scores (adjusted b: 6.91, 95% CI: 2.15, 11.66), while current daily smokers had a lower total attitude scores towards anti-smoking measures than non-smokers (adjusted b: -23.30, 95% CI: -29.55, -17.05). These findings highlight comparatively stronger and more consistent support for anti-smoking measures that may vindicate high-stake investment and legislation against smoking. Conclusion: The novel evidence may also better-inform the strategy to expand the initiatives further through profiling the target population with heightened emphasis on the economic standing and prevalence of current daily smokers. Future research may adopt experimental design to establish causality relationship between predictors and outcomes revealed in this community.

Assessing the Effects of Standardized School-Based Educational Cessation Programs for Adolescent Smokers: A Research Protocol

Introduction: Cigarette smoking is a significant public health issue, and the primary cause of preventable health problems in the Greater Toronto Area (GTA). Nevertheless, the prevalence of adolescent smoking remains high. Our proposed study aims to investigate the effectiveness of school-based educational programs in reducing adolescent smoking rates in the GTA. It will compare the results of weekly integrated education sessions offered throughout a school term to more focused, discrete sessions offered at two different points in the term at 10 secondary schools in the GTA. The findings will help inform potential policy and curricular changes to promote smoking cessation among current and future youth. Methods: This study utilizes an experimental quantitative research design. Multi-stage cluster sampling will be used. 10 schools will be selected, with 20 students being recruited per school. The intervention group will receive a school-based education program for smoking cessation, lasting an academic semester. The control group will receive an educational session at the beginning and end of the semester. The inclusion criteria is as follows: participants must be (a) adolescents aged 12-17 and attending an accredited primary or secondary school, (b) living in the GTA, and (c) current daily smokers. The Fagerström Test for Nicotine Dependence (FTND) and biochemical tests will be used to collect pertinent data about smoking cessation rates. Abstinence will also be assessed using the Russell Standard. Results: The study will use statistical tests to compare the proportion of students in the intervention group who quit smoking to the control group. The primary outcome measures will be 4-week and 6-month abstinence counts and nicotine dependency as measured by the FTND. The analysis will be conducted using IBM SPSS ver. 29. Discussion: The results of this study will provide valuable insight into the effectiveness of educational programs in promoting smoking cessation among youth, which will inform the design of future school-based interventions. Additionally, the study will help to understand adolescent smoking patterns, which can be used to guide public health policies. Conclusion: The results will have the potential to inform future education and public health strategies for encouraging adolescent smoking cessation.

Occupational cold exposure is associated with upper extremity pain.

Occupational cold exposure is common in Sweden but potential impacts on musculoskeletal disorders have not been thoroughly investigated. The primary aim of this study was to determine the associations between occupational contact and ambient cooling in relation to pain in the upper extremity. In this cross-sectional study, a digital survey was conducted on a population-based sample of women and men between 24 and 76 years of age, living in northern Sweden. Occupational cold exposure, heavy manual handling, work with vibrating tools as well as the presence of upper extremity pain at different sites were subjectively reported. Associations between exposure and outcome were evaluated using multiple binary logistic regression. The final study sample included 2,089 (54.4%) women and 1,754 men, with a mean age of 56 years. Hand pain was reported by 196 (5.2%), lower arm pain by 144 (3.8%), and upper arm pain by 451 (11.9%). Severe ambient cooling for more than half of the working time was statistically significantly associated with hand pain (OR: 2.30; 95% CI: 1.23-4.29) and upper arm pain (OR: 1.57; 95% CI: 1.00-2.47) but not lower arm pain (OR: 1.87; 95% CI: 0.96-3.65) after adjusting for gender, age, body mass index, current daily smoking, heavy manual handling, and work with vibrating tools. Occupational cold exposure was statistically significantly associated with hand pain and upper arm pain. Therefore, occupational cold exposure should be recognized as a potential risk factor for musculoskeletal disorders in the upper extremity.

Ocular and Visual Activities-related Complaints among Healthy Smokers: a Cross-sectional Study

Smoking and the harmful compound in smoke has been associated with many deleterious effects on the eye. Yet, the ocular and visual-related complaints that may arise due to physiological changes are inadequately explored. This study aimed to investigate the effect of smoking behaviour on ocular symptoms. A self-administered questionnaire describing the ocular surface discomfort and visual-related activities was distributed to healthy smokers. Majority of smokers reported severe dry eye symptoms and often complained of glare disability. A comparison of reported symptoms between groups showed older-aged, dual smokers, longer duration of smoking, and current-daily smokers obtained significantly higher scores (p<0.005).

Recovery From Nicotine Addiction: A Diffusion Model Decomposition of Value-Based Decision-Making in Current Smokers and Ex-smokers.

A considerable number of people successfully give up tobacco smoking. In nicotine-dependent individuals, tobacco choice is determined by greater expected drug value; however, less is known about the underlying mechanisms through which people quit smoking. This study aimed to explore whether computational parameters of value-based decision-making (VBDM) characterize recovery from nicotine addiction. Using a preregistered, between-subject design, current daily smokers (n = 51) and ex-smokers who used to smoke daily (n = 51) were recruited from the local community. Participants completed a two-alternative forced choice task in which they chose between either two tobacco-related images (in one block) or tobacco-unrelated images (in a different block). During each trial, participants pressed a computer key to select the image they rated most positively during a previous task block. To estimate evidence accumulation (EA) processes and response thresholds during the different blocks, a drift-diffusion model was fitted to the reaction time and error data. Ex-smokers had significantly higher response thresholds when making tobacco-related decisions (p = .01, d = 0.45) compared to current smokers, although there were no significant group differences during tobacco-unrelated decisions. Furthermore, there were no significant group differences in EA rates when making tobacco or tobacco-unrelated decisions. Greater cautiousness when making value-based decisions about tobacco-related cues characterized recovery from nicotine addiction. The number of people dependent on nicotine has decreased steadily during the past decade; however, the mechanisms that underlie recovery are currently less well understood. The present study applied advances in the measurement of value-based choice. The aim was to explore whether the internal processes that underpin VBDM discriminate current daily tobacco smokers from ex-tobacco smokers who used to smoke daily. Findings revealed that recovery from nicotine addiction was characterized by higher response thresholds when making value-based decisions about tobacco-related cues; this may serve as a novel target for treatment interventions that focus on helping people to stop smoking.

Diurnal symptoms of sleepiness and dysfunction predict future suicidal ideation in a French cohort of outpatients (FACE-DR) with treatment resistant depression: A 1-year prospective study about sleep markers

BackgroundPatients suffering from treatment-resistant depression (TRD) are at risk of suicide. Sleep and circadian rhythm alterations are widely recognized as core symptoms of major depressive disorder and are associated with suicidal ideation. Thus, sleep and circadian rhythm alterations may be targeted to prevent suicide. MethodsPatients were recruited from a prospective cohort of the French network of TRD expert centers. Mood, sleep and circadian rhythms were assessed at baseline; suicidal risk was assessed both at baseline and during a one-year follow-up with standardized subjective questionnaires. ResultsExcessive daytime sleepiness (adjusted odds ratio aOR = 1.7(1–3.3), p = 0.04) and daytime dysfunction (aOR = 1.81(1.16–2.81), p = 0.0085) increased the risk of suicidal thoughts over the one-year follow-up period in patients with TRD after adjustment on age, gender, depression, trauma, anxiety, impulsivity, current daily tobacco smoking and body mass index. Hypnotics intake is associated with a reduced risk of suicidal ideation at one-year follow-up after the same adjustments (OR = 0.73(0.56–0.95), p = 0.019). Other associations between sleep quality or circadian rhythms and suicidal ideations at either baseline or one year did not remain significant in multivariate analyses after the same adjustments. LimitationsSleep assessments were based on self-reported questionnaires rather than objective measures. ConclusionsDaytime sleepiness and dysfunction are predictors of suicidal ideations, whereas hypnotics intake is associated with a reduced risk of suicidal ideations. Diurnal symptoms of sleep disturbances are therefore red flags to target for preventing suicide in depressed patients, and hypnotics seem efficient in preventing suicide for patients with TRD.

Prevalence and clinical features of heart failure in Greenland

ABSTRACT Heart Failure (HF) constitutes a significant burden for healthcare around the world. In Greenland, risk factors like smoking, diabetes, and obesity are prevalent. Yet, the prevalence of HF remains unexplored. This register-based cross-sectional study uses data from the national medical record in Greenland to estimate the age- and gender-specific prevalence of HF and to describe the characteristics of patients with HF in Greenland. A total of 507 patients (26% women) with a mean age of 65 years were included based on a diagnosis of HF. The overall prevalence was 1.1% and higher among men compared to women (1.6% vs. 0.6%, p < 0.05). The highest prevalence was among men above 84 years (11.1%). More than half (53%) had a body mass index above 30 kg/m2 and 43% were current daily smokers. The proportion diagnosed with ischaemic heart disease (IHD) was 33%. The overall prevalence of HF in Greenland is consistent with that in other high-income countries, yet high among men in some age groups, compared to Danish men. Almost half the patients were obese and/or smokers. A low prevalence of IHD was observed indicating that other factors may play a role in developing HF among Greenlanders.

Smoking, e-cigarettes and the effect on respiratory symptoms among a population sample of youth: Retrospective cohort study.

E-cigarettes have been steadily increasing in popularity, both as cessation methods for smoking and for recreational and social reasons. This increase in vaping may pose cardiovascular and respiratory risks. We aimed to assess respiratory symptoms in youth users of e-cigarettes and cigarettes. A retrospective survey design was utilized to assess Canadian youth aged 16-25 years. Participants were recruited from the Ontario Tobacco Research Unit Youth and Young Adult Research Registration Panel November 2020 to March 2021. A total of 3082 subjects completed the baseline survey. Of these, 2660 individuals who did not have asthma were included in the analysis. The exposure of interest was pack-equivalent years, a novel measure of vaping exposure equivalent conceptually to cigarette pack years incorporating number of puffs per day, number of days vaped per month, and number of years vaped. Respiratory symptoms were measured using the five-item Canadian Lung Health Test. Poisson regression analyses were performed while adjusting for demographic confounders, stratified by smoking status. A non-stratified model tested the interaction of status and vaping dose and the effect of vaping device used was assessed among ever vapers. Analyses controlled for demographic characteristics, use of cannabis and alcohol, and survey date. Each additional puff year increased the rate ratio (RR) of respiratory symptoms by a factor of 11.36 (95% CI: 4.61-28.00; p<0.001) for never smokers, but among current daily smokers higher pack-equivalent years were not associated with more respiratory symptoms (RR=0.83; 95% CI: 0.23-3.11). Among current vapers, those using pod-style devices were more likely to have more respiratory symptoms (RR=1.25; 95% CI: 1.08-1.45) after adjusting for dose. Vaping is associated with an increased risk of reporting respiratory symptoms among never smoking youth and non-daily ever cigarette smokers. Use of e-cigarettes among non-smokers should be discouraged.

Biochemical Verification of Tobacco-Use as an Inclusion Criterion in Smoking Cessation Trials- Lessons From the Cessation of Smoking Trial in the Emergency Department.

Biochemical verification of smoking status prior to recruitment into smoking cessation trials is widely used to confirm smoking status, most commonly using exhaled carbon monoxide (CO). There is variation in the level of CO used as a biochemical inclusion criterion, and thus the possibility for people reporting to be current smokers to be incorrectly excluded from trials. As part of the Cessation of Smoking Trial in the Emergency Department, people attending the Emergency Department (ED) who reported being current daily smokers underwent CO testing to confirm eligibility. Elective semi-structured interviews were undertaken with the researchers who recruited participants. As part of the interviews, researchers were asked their views and experiences with CO testing. Of the 1320 participants who reported being current daily smokers and underwent CO testing, 300 (22.7%) blew a CO reading of 7ppm or less and were excluded from taking part. Possible explanations offered by researchers for participants blowing low CO readings were (1) long wait times in the ED, therefore a long period having elapsed since people had last smoked and (2) patients having reduced smoking for the period before the ED attendance due to ill health. Biochemical verification has the potential to improve internal validity of smoking cessation for inclusion in trials, but at the cost of reduced generalisability through exclusion of participants who would receive the intervention if it were implemented in practice. We would recommend researchers carefully consider whether it is appropriate and necessary to include biochemical verification as an inclusion criterion.

Tobacco use and risk of COVID-19 infection in the Finnish general population

Empirical evidence, primarily based on hospital-based or voluntary samples, suggests that current smokers have a lower risk of COVID-19 infection than never smokers. In this study, we used nationally representative data to examine the association between tobacco use and the risk of having a confirmed COVID-19 case. We explored several forms of tobacco use, contributing to separate the role of nicotine from smoking. We used data from 44,199 participants from three pooled national health surveys in Finland (FinSote 2018–2020). The primary outcome was a confirmed COVID-19 case. We examined current smoking, moist smokeless tobacco (snus), e-cigarettes with and without nicotine and nicotine replacement therapy products. Current daily smokers had a relative risk of 1.12 of a confirmed COVID-19 case (95% CI 0.65; 1.94) in fully adjusted models compared with never smokers. Current snus use was associated with a 68% higher risk of a confirmed COVID-19 case (RR 1.68, 95% CI 1.02; 2.75) than never users. We did not find conclusive evidence of associations between e-cigarettes with and without nicotine and nicotine replacement therapy products and the risk of confirmed COVID-19 cases. Our findings suggest that nicotine might not have a protective role in the risk of COVID-19 as previously hypothesized.

Patterns of tobacco use in low and middle income countries by tobacco product and sociodemographic characteristics: nationally representative survey data from 82 countries

ObjectivesTo determine the prevalence and frequency of using any tobacco product and each of a detailed set of tobacco products, how tobacco use and use frequency vary across countries, world...

Prevalence of mortality among covid-19 patients in Kurdistan Region and various parts of the world and the role of ecological and environmental factors in shaping SARS-CoV-2 virulence

Evolutionary theories predict that virulence (host death due to a pathogen) positively associates with the pathogen transmission rates to new susceptible hosts. Severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2), the causative agent of coronavirus disease 2019 (covid-19) pandemic, like other RNA viruses, has quite variable genetic content due to its unique nucleus enzymes thus mutations can continuously occur during viral replications. Phenotype variations among new viral progeny can include individuals with different replication rates, infectivity, stability in the abiotic environment, and transmission rate. Here, the rate of transmission to new susceptible hosts may be affected by the pathogen’s vitality in the physical environments, and host-related factors such as control measures and vaccination. In this study, we analyzed the mortality rates of covid-19 positive patients among various parts of the world and explain the role of several factors in determining SARS-CoV-2 virulence. We found a weak negative correlation (R2 = 0.3) between the mortality rate of covid-19 patients and each of death rates due to cancer diseases (F = 9.135, P = 0.006) and the number of medical doctors per 10,000 populations (F = 8.104, P = 0.009). Other factors such as the prevalence of current daily tobacco smoking in males/females, life expectancy in males/females, general death rates, cardiovascular diseases, prevalence of COPD, prevalence of asthma and average yearly temperature did not associate with death rates among covid-19 patients. Inclusion, adequacy of healthcare services and proper infection prevention measures are the key factors to reduce the covid-19 mortality rate. More studies are required to better understand the management of SARS-CoV-2 virulence management.

Occupational cold exposure and symptoms of carpal tunnel syndrome – a population-based study

BackgroundCold exposure is an underrecognized occupational hazard that may increase the risk of peripheral nerve entrapment. The aim of this study was to determine if self-reported occupational exposure to contact and ambient cooling was associated with symptoms of carpal tunnel syndrome (CTS).MethodsIn this mainly cross-sectional study, surveys were conducted on a population-based sample of men and women between 18 and 70 years of age, living in northern Sweden. Cold exposure and presence of symptoms suggestive of CTS were subjectively reported. Associations between exposure and outcome were evaluated using logistic regression.ResultsThe study included 2,703 women and 2,314 men, with a median age of 60 years (interquartile range 19). Symptoms of CTS were reported by 453 (9.2%). Being highly occupationally exposed (almost always) to contact cooling of the hands was associated with reporting CTS (OR 3.20; 95% CI 1.62–6.33), as was ambient cooling (OR 2.00; 95% CI 1.03–3.88) and severe ambient cooling (OR 4.02 95% CI 2.09–7.71), after adjusting for age, gender, body mass index, current daily smoking, diabetes mellitus, joint disease, and hand-arm vibration exposure. The point estimates increased with longer daily exposure duration. For workers exposed to severe ambient cooling for more than half of their working hours, in addition to performing heavy manual handling every day, the OR for reporting CTS was 7.25 (95% CI 3.88–13.53), with a positive additive interaction effect (expressed as relative excess risk due to interaction) of 4.67.ConclusionsSelf-reported occupational exposure to contact and ambient cooling was associated with symptoms suggestive of CTS. There were statistically significant positive exposure–response patterns for time spent exposed to contact and ambient cooling at work in relation to reporting symptoms of CTS. Positive additive interaction effects between cold exposure and heavy manual handling were also found. Since there was important potential uncontrolled confounding regarding repetitive wrist movements and forceful gripping, the results need to be confirmed by other studies, preferably with longitudinal design and more detailed exposure assessment.