Exhaled Carbon Monoxide Levels Research Articles

Smoking and Real Life Results of Children and Adolescents

Aim: Smoking is a chronic disease and children are the most affected group. In this study, we aimed to question the smoking habits of children and their parents and examine the level of exhaled carbon monoxide (eCO) to evaluate the usefulness of the method in an outpatient allergy clinic. Methods: A questionnare was applied to 29 children who were smoker or exposed to second-hand smoke (SHS) and their parents separately. eCO levels of the participants were measured with CO Smokerlyzer. Results: The median eCO level of children who smoked was 10 (7-14) ppm and was significantly higher than children exposed to SHS (P <0.001). The children who smoked were significantly older, the more they had friends who smoked. Children who were not exposed to tobacco products had lower rates of hospitalization due to recurrent lower respiratory tract infections, and family history of asthma was lower than children exposed to SHS (p <0.05). All the children were aware of the harmful effects of smoking. 34.5% of the parents were never questioned by their physicians about tobacco and its products and were not informed about smoking. Conclusions: Using eCO in the clinic is a useful method to predict smoking status in daily practice. Children's attitudes towards smoking and peer relationships and parents' ignorance of smoking and SHS are still an unresolved issue.

Economic Evaluation of Enhanced vs Standard Varenicline Treatment for Tobacco Cessation

Smoking is the leading preventable cause of death and illness in the US. Identifying cost-effective smoking cessation treatment may increase the likelihood that health systems deliver such treatment to their patients who smoke. To evaluate the cost-effectiveness of standard vs enhanced varenicline use (extended varenicline treatment or varenicline in combination with nicotine replacement therapy) among individuals trying to quit smoking. This economic evaluation assesses the Quitting Using Intensive Treatments Study (QUITS), which randomized 1251 study participants who smoked into 4 conditions: (1) 12-week varenicline monotherapy (n = 315); (2) 24-week varenicline monotherapy (n = 311); (3) 12-week varenicline combination treatment with nicotine replacement therapy patch (n = 314); or (4) 24-week varenicline combination treatment with nicotine replacement therapy patch (n = 311). Study enrollment occurred in Madison and Milwaukee, Wisconsin, between November 11, 2017, and July 2, 2020. Statistical analysis took place from May to October 2023. The primary outcome was 7-day point prevalence abstinence (biochemically confirmed with exhaled carbon monoxide level ≤5 ppm) at 52 weeks. The incremental cost-effectiveness ratio (ICER), or cost per additional person who quit smoking, was calculated using decision tree analysis based on abstinence and cost for each arm of the trial. Of the 1251 participants, mean (SD) age was 49.1 (11.9) years, 675 (54.0%) were women, and 881 (70.4%) completed the 52-week follow-up. Tobacco cessation at 52 weeks was 25.1% (79 of 315) for 12-week monotherapy, 24.4% (76 of 311) for 24-week monotherapy, 23.6% (74 of 314) for 12-week combination therapy, and 25.1% (78 of 311) for 24-week combination therapy, respectively. The total mean (SD) cost was $1175 ($365) for 12-week monotherapy, $1374 ($412) for 12-week combination therapy, $2022 ($813) for 24-week monotherapy, and $2118 ($1058) for 24-week combination therapy. The ICER for 12-week varenicline monotherapy was $4681 per individual who quit smoking and $4579 per quality-adjusted life-year (QALY) added. The ICER for 24-week varenicline combination therapy relative to 12-week monotherapy was $92 000 000 per additional individual who quit smoking and $90 000 000 (95% CI, $15 703 to dominated or more costly and less efficacious) per additional QALY. This economic evaluation of standard vs enhanced varenicline treatment for smoking cessation suggests that 12-week varenicline monotherapy was the most cost-effective treatment option at the commonly cited threshold of $100 000/QALY. This study provides patients, health care professionals, and other stakeholders with increased understanding of the health and economic impact of more intensive varenicline treatment options.

Comparison of exhaled carbon monoxide levels and its association with nicotine dependence between electronic and tobacco cigarettes: A cross-sectional study among teenage smokers.

Carbon monoxide (CO), resulting from incomplete combustion such as tobacco smoking, serves as an indicator of nicotine addiction. The aim of this study was to compare the levels of exhaled CO levels between electronic cigarette (e-cigarette) and tobacco smokers and to determine the association between nicotine dependence and exhaled CO levels in e-cigarette and tobacco smokers. A cross-sectional study was conducted using purposive sampling on active smokers, with 70 smokers in each group. The nicotine dependence was measured using the Penn State Nicotine Dependence Index (PSNDI) questionnaire for the e-cigarette group and the Fagerstrom questionnaire for the tobacco smoking group. The CO level was measured using the smokerlyzer piCO. To compare the mean exhaled CO levels between e-cigarettes and tobacco smoker groups, the Mann-Whitney test was used. The Mann-Whitney test and Kruskal-Wallis test were used to assess the associations between nicotine dependence and mean exhaled CO levels in the e-cigarette smoker group and in the tobacco smoker group, respectively. The majority of e-cigarette smokers were 17 years old (65.7%) and male (75.7%). Among tobacco smokers, the majority were also 17 years old (44.3%), and mostly male (91.4%). The mean exhaled CO levels in the tobacco smoker group were significantly higher than the e-cigarette smoker group, 6.86 ppm vs 1.61 ppm with p<0.001. There was a significant association between nicotine dependence and exhaled CO levels among tobacco smokers (p<0.001). Nicotine dependence was not associated with exhaled CO levels among e-cigarette smokers. This study highlights that the smokerlyzer piCO devise could be used to screen nicotine addiction in tobacco smokers.

Quitting smoking improves two-year survival after a diagnosis of non-small cell lung cancer

BackgroundSmoking at diagnosis is associated with worse survival in lung cancer but the effects of quitting smoking on survival remain unclear. MethodsIn a UK multi-centre study (NCT01192256) we followed all 2751 patients with newly diagnosed non-small cell lung cancer (NSCLC) for up to 2 years or until death as part of the observational trial. Patients were offered smoking cessation advice and treatments according to national guidelines and local services. Smoking status was verified by exhaled carbon monoxide levels. Kaplan-Meier survival analysis and Cox Proportional Hazards Modelling examined the effects of quitting smoking on survival at 2 years. Findings646 were current smokers at the time of diagnosis. The unadjusted two-year Kaplan-Meier survivor functions for quitters (0.45, 95 %CI 0.37 to 0.53) and continuers (0.32, 0.28 to 0.36) were significantly different (log-rank test p < 0.01). Median survival times were 659 days for quitters and 348 days for continuers. After adjusting for age, sex, stage, performance status, curative intent surgery, radical radiotherapy and comorbidity, the hazard ratio for quitting at diagnosis (0.75, 95 % CI 0.58 to 0.98) indicated a statistically significant reduction in the risk of death across the two-year study period. InterpretationQuitting smoking is independently and significantly associated with improved survival regardless of stage in NSCLC. We recommend that smoking cessation advice and treatments should be offered to smokers with lung cancer. Trial RegistrationClinicalTrials.gov, identifier NCT01192256. FundingThis work was supported by a 2010 Global Research Award for Nicotine Dependence (GRAND), Pfizer.

Evaluation of Exhaled Carbon Monoxide Levels in Individuals Exposed to Passive Tobacco Smoke in Indoor and Outdoor Environments: How Far Can We Getaway Under the Same Roof?

Besides direct exposure, indirect contact with tobacco smoke significantly contributes to numerous health issues. Unfortunately, people are unaware that the precautions taken in closed environments are inadequate to deal with this issue. We conducted this study to assess carbon monoxide (CO) levels of people exposed to tobacco smoke indoors and outdoors. Our study between May and June 2023 included individuals exposed to tobacco smoke indoors (n=100) and outdoors (n=100). Our control group included 100 people who had never been exposed to healthy tobacco smoke and agreed to participate in our research. The amount of CO exhaled was measured by observing how long people were in contact with tobacco smoke and how close they were to it.Questionnaires were asked of the study participants about the harms and awareness of tobacco smoke exposure. Exhaled CO levels were 1.46 ± 0.1 ppm in people exposed to tobacco smoke indoors, 1.1± 0.03 ppm in people exposed to smoke outside, and 1.1± 0.02 ppm in the control group. The statistical analysis revealed that individuals exposed to tobacco smoke in the indoor environment had significantly higher exhaled CO levels than those in the outdoor and the control groups (p=0.006). In the correlation analysis of time and distance in the indoor environment with the exhaled CO level, there was no statistically significant difference between time and space (r= -0.168, p=0.09, r=0.09, p=0.37, respectively). While less than half of both groups were aware of second-hand tobacco smoke, individuals exposed to tobacco smoke in the outdoor environment were more familiar (p<0.001). Despite the precautions, indoor tobacco smoke exposure is severe because of second- and third-hand smoke. Raising individual awareness and enhancing the steps should be our top concern to prevent future health problems.

SYSTEMATIC REVIEW OF THE RELATIONSHIP BETWEEN TOBACCO SMOKE AND CARBON MONOXIDE: IMPACT ON HEALTH AND DISEASE

Aim : The objective of this study is to evaluate the correlation between tobacco consumption and levels of exhaled carbon monoxide. Material and Methods : To conduct the literature review, multiple databases and sources were utilized. The search was conducted using MeSH Terms related to tobacco and exhaled carbon monoxide. Initially, 421 titles were identified from these sources, and after screening, 118 records were examined, resulting in 25 research-related articles. The review adhered to the PRISMA guidelines for systematic reviews to ensure a standardized and rigorous approach to the evaluation of the selected studies. Results: Six randomized controlled trials were incorporated in the analysis, aiming to compare the association between tobacco consumption and exhaled carbon monoxide levels. The findings from all six trials consistently demonstrated a significant correlation between these two variables. Conclusion: To sum up, the analysis of research publications focusing on tobacco consumption and exhaled carbon monoxide (CO) levels yields valuable insights regarding the correlation between smoking behavior, CO levels, and the associated health implications. This body of literature enhances our understanding of the relationship between smoke &amp; implications on well being, shedding light on the potential risks and consequences of tobacco use. Clinical Significance: Gaining a deeper understanding of these relationships can play a significant role in developing impactful strategies for smoking cessation. Furthermore, it can help raise awareness about the detrimental effects of tobacco smoke and emphasize the importance of reducing tobacco consumption. By leveraging this knowledge, we can work towards implementing effective interventions and public health campaigns aimed at promoting smoking cessation and improving overall population health. KEYWORDS : Smoking cessation, tobacco, carbon monoxide

Association of multiple air pollutants with oxygen saturation during sleep in COPD patients: Effect modification by smoking status and airway inflammatory phenotypes

Air pollution contributes substantially to the development of chronic obstructive pulmonary disease (COPD). To date, the effect of air pollution on oxygen saturation (SpO2) during sleep and potential susceptibility factors remain unknown. In this longitudinal panel study, real-time SpO2 was monitored in 132 COPD patients, with 270 nights (1615 h) of sleep SpO2 recorded. Exhaled nitric oxide (NO), hydrogen sulfide (H2S) and carbon monoxide (CO) were measured to assess airway inflammatory characteristics. Exposure levels of air pollutants were estimated by infiltration factor method. Generalized estimating equation was used to investigate the effect of air pollutants on sleep SpO2. Ozone, even at low levels (<60 μg/m3), was significantly associated with decreased SpO2 and extended time of oxygen desaturation (SpO2 < 90%), especially in the warm season. The associations of other pollutants with SpO2 were weak, but significant adverse effects of PM10 and SO2 were observed in the cold season. Notably, stronger effects of ozone were observed in current smokers. Consistently, smoking-related airway inflammation, characterized by higher levels of exhaled CO and H2S but lower NO, significantly augmented the effect of ozone on SpO2 during sleep. This study highlights the importance of ozone control in protecting sleep health in COPD patients.

Evaluation of the value of exhaled carbon monoxide in the differentiation of viral and bacterial pneumonia.

Aim: This study compared exhaled carbon monoxide (CO) levels in patients hospitalized for bacterial and COVID-19-related viral community-acquired pneumonia. Materials & methods: The study included a total of 150 patients: 50 patients hospitalized for COVID-19 between February 2021 and March 2022, 50 patients with bacterial community-acquired pneumonia and 50 healthy controls. Results: In comparisons of exhaled CO levels among the groups, there was no significant difference between patients with bacterial pneumonia and controls, whereas patients with COVID-19 pneumonia had significantly higher exhaled CO levels compared with both the bacterial pneumonia and control groups (p<0.001). Conclusion: Viral agents can directly affect the heme oxygenase system of the lower respiratory tract, leading to greater increases in ferritin and exhaled CO levels compared with bacterial pneumonia.

The Relationship between Smoking Status, Carbon Monoxide Levels and Quality of Life, Disease Characteristics in Inflammatory Bowel Diseases

Objective: The aim of the study was to analyze the relationship between smoking status and exhaled carbon monoxide (E-CO) levels, quality of life, and disease characteristics in patients with inflammatory bowel disease. Methods: The demographic and disease characteristics and smoking status of 121 patients with inflammatory bowel disease who presented our hospital between 01.12.2020 and 01.03.2021 were investigated. After the first follow-up, the E-CO levels of these participants were measured every four consecutive weeks. The mean of these E-CO readings was accepted as the main E-CO value. After one month after their first application SF-36 Quality of Life Scale was applied. The relationship between these variables was investigated. Results: The mean age of the participants was 42.06±14.9 years, and 36.3% were active smokers. While patients with Crohn’s disease (CD) exhibited a higher smoking rate, smokers with ulcerative colitis (UC) registered significantly higher mean CO ppm readings (p&amp;lt;0.05). The general health components of smoker UC patients were higher than those of non-smokers (p&amp;lt;0.05). A weak correlation was determined between mean number of cigarettes smoked per day, mean CO ppm, Fagerström Nicotine Dependency Test (FNDT), package year, and the physical and mental components of SF-36 in the UC group (p&amp;lt;0.05). There was a weak negative correlation between mental components and mean E-CO in the CD group (p=0.027). No difference was observed in the non-smoker group between participants exposed to second-hand smoke and those with no such exposure (p&amp;gt;0.05). Conclusion: Our results revealed that smoking has a weak positive effect on the quality of health in patients with UC, but no effect on patients with CD.

Exhaled Carbon Monoxide Level and Practices among Tobacco and Nicotine Adult Users in Klang Valley, Malaysia.

Tobacco and nicotine derivatives uses are multiple in nature. These include conventional cigarettes (CCs), heated tobacco products (HTPs), and electronic cigarettes (ECs). This study aims to determine the practices, nicotine dependency profile, association with exhaled carbon monoxide (eCO) level, and pulmonary function (PF) among adult product users and non-smokers. This cross-sectional study involved smokers, nicotine users, and non-smokers from two public health facilities in Kuala Lumpur from December 2021 to April 2022. Data on socio-demography, smoking profile, nicotine dependency level, anthropometry, eCO monitor, and spirometer measurements were recorded. Out of 657 respondents, 52.1% were non-smokers, 48.3% were CC only smokers, poly-users (PUs) (27.3%), EC-only users (20.9%), and HTP-only users (3.5%). EC use was prevalent among the younger aged, tertiary educated, and females; HTP use was prevalent among those of an older age and CC users was common among lower educated males. The highest median eCO (in ppm) seen were as follows: in CC users only (13.00), PUs (7.00), EC users (2.00), HTP users (2.00), and the least was observed among non-smokers (1.00), which is significantly different across the groups (p <0.001). Comparison of practice between the different product users showed significant differences in age of product initiation (p <0.001, youngest in CC users in PUs), duration of product use (p <0.001, longest in exclusive CC users), cost per month (p <0.001, highest in exclusive HTP users) and attempt to quit product (p <0.001, CC use in PUs had the highest attempt to quit), while there is no significant difference in Fagerström score across the groups. Among EC users, 68.2% successfully switched from smoking CCs to ECs. The findings suggest that EC and HTP users are exhaling less CO. The use of these products in a targeted approach may manage nicotine addiction. Switching practice was higher among current EC users (from using CCs), hence emphasizing the need of switching encouragement and total nicotine abstinence later on. Lower eCO levels in the PU group, (as compared to CC-only users) and high quit attempt rate among in CC use in PUs may indicate attempt of PUs in reducing CC use through alternative modalities such as ECs and HTPs.

Does combined training of biofeedback and neurofeedback affect smoking status, behavior, and longitudinal brain plasticity?

Introduction: Investigations of biofeedback (BF) and neurofeedback (NF) training for nicotine addiction have been long documented to lead to positive gains in smoking status, behavior and to changes in brain activity. We aimed to: (a) evaluate a multi-visit combined BF/NF intervention as an alternative smoking cessation approach, (b) validate training-induced feedback learning, and (c) document effects on resting-state functional connectivity networks (rsFCN); considering gender and degree of nicotine dependence in a longitudinal design. Methods: We analyzed clinical, behavioral, and electrophysiological data from 17 smokers who completed five BF and 20 NF sessions and three evaluation stages. Possible neuroplastic effects were explored comparing whole-brain rsFCN by phase-lag index (PLI) for different brain rhythms. PLI connections with significant change across time were investigated according to different resting-state networks (RSNs). Results: Improvements in smoking status were observed as exhaled carbon monoxide levels, Total Oxidative Stress, and Fageström scores decreased while Vitamin E levels increased across time. BF/NF promoted gains in anxiety, self-esteem, and several aspects of cognitive performance. BF learning in temperature enhancement was observed within sessions. NF learning in theta/alpha ratio increase was achieved across baselines and within sessions. PLI network connections significantly changed across time mainly between or within visual, default mode and frontoparietal networks in theta and alpha rhythms, while beta band RSNs mostly changed significantly after BF sessions. Discussion: Combined BF/NF training positively affects the clinical and behavioral status of smokers, displays benefit in smoking harm reduction, plays a neuroprotective role, leads to learning effects and to positive reorganization of RSNs across time. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT02991781.

Cigarettes, heated tobacco products and dual use: exhaled carbon monoxide, saliva cotinine and total tobacco consumed by Hong Kong tobacco users

BackgroundIndependent studies on exhaled carbon monoxide (CO) and saliva cotinine levels in regular heated tobacco product (HTP) users, and how they compare with conventional cigarette (CC) smokers, are lacking.MethodsA total...

Evaluation of Exhaled Carbon Monoxide Levels in Smokers and Non-Smokers-A Comparative Study

Background: Cigarette smoke causes both acute and chronic changes of the immune system. Carbon monoxide (CO) exhaled through breath of an individual is an easiest, immediate and non-invasive method to assess smoking status. Aim: The aim of the study is to compare the exhaled CO levels in smokers and non-smokers using portable CO monitor. Material &amp; Methods: The exhaled CO levels were measured in 100 subjects (50 smokers, 50 non-smokers) who were examined during the OPD. Exhaled CO concentration was measured using the Micro+ Smokerlyser. Results: The mean carbon monoxide in the smokers was 6.34 PPM and the mean carbon monoxide in non-smokers was 1.26 PPM. There was statistically very highly significant difference of mean CO among smokers and non-smokers (P&lt;0.001). Conclusion: The exhaled CO levels successfully distinguished smokers from nonsmokers and it provides an easy and non-invasive mode of assessing a subject's smoking status. This will be beneficial for healthcare providers to examine the effectiveness of tobacco cessation and prevention programs.

Prevalence of reduced lung diffusing capacity and CT scan findings in smokers without airflow limitation: a population-based study

BackgroundPopulation distribution of reduced diffusing capacity of the lungs for carbon monoxide (DLCO) in smokers and main consequences are not properly recognised. The objectives of this study were to describe...

Effects of smoking cessation using varenicline on the serum concentrations of oxidized high-density lipoprotein: Comparison with high-density lipoprotein cholesterol.

The oxidized high-density lipoprotein (oxHDL) is a possible marker for cardiovascular diseases. This study investigated the effects of smoking cessation with varenicline (a partial agonist of nicotinic acetylcholine receptors) on the levels of oxHDL in the serum of subjects compared with those of high-density lipoprotein cholesterol (HDL-C). Data of 99 nicotine-dependent adult subjects who visited the smoking cessation outpatient services at International University of Health and Welfare Shioya Hospital were reviewed. Each subject was treated with varenicline titrated up to 1.0 mg twice daily for 12 weeks. Serum levels of oxHDL and HDL-C were repeatedly measured by enzyme-linked immunosorbent assay and enzymatic method, respectively. The serum levels of oxHDL were significantly decreased from 163.2 ± 96.6 to 148.3 ± 80.7 U/mL (p = 0.034, n = 99). This effect was more prominent when the data of subjects in whom the treatment was objectively unsuccessful (exhaled carbon monoxide at 3 months ≥ 10 ppm) were omitted (from 166.6 ± 98.4 to 147.4 ± 80.6 U/mL; p = 0.0063, n = 93). In contrast, the serum levels of HDL-C were significantly increased (p = 0.0044, n = 99). There was a close relationship between the baseline levels of oxHDL and HDL-C (R = 0.45, p < 0.0001, n = 99). Changes in the levels of oxHDL were closely associated with changes in the levels of exhaled carbon monoxide in subjects in whom smoking cessation with varenicline was very effective (decrease in exhaled carbon monoxide by ≥ 15 ppm after treatment with varenicline; R = 0.42, p = 0.0052, n = 43). Although there was a close relationship between the baseline serum concentrations of oxHDL and HDL-C, smoking cessation decreased oxHDL and increased HDL-C. This effect on oxHDL may be associated with the effectiveness of smoking cessation.

EVALUATION OF SERUM SCUBE-1 LEVELS AND AFFECTING FACTORS IN SMOKERS

Aim: Serum signal peptide-CUB-EGF domain-containing protein-1 (SCUBE-1), an indicator of platelet activation, is a biochemical marker used to evaluate the risk for cardiovascular diseases. This study aimed to evaluate the alteration of plasma levels of SCUBE-1 in smokers compared to healthy controls and determine the affecting factors.&#x0D; Materials and Methods: This prospective study was designed as an experimental, single-centered study with a control group. The study included smokers aged 18-65 years who were admitted to the Smoking Cessation Clinic of a tertiary hospital and a control group consisting of healthy volunteers admitted to the Family Medicine Outpatient Clinic and had never smoked. Sociodemographic data of all participants and smoking histories and addiction levels of smokers were questioned. Exhaled carbon monoxide (CO) levels were measured. Plasma SCUBE-1 levels were studied and compared from samples obtained from venous blood. &#x0D; Results: A total of 82 individuals, consisting of the "smoker" patient group (n=44) and the "non-smoker" control group (n=38), were included in the study. While the mean SCUBE-1 value was 1.28±0.70 ng/ml in smokers, it was 1.54±1.09 ng/ml in non-smokers. There was no statistical difference between smokers and non-smokers in terms of SCUBE-1 (p=0.500). There was no statistically significant correlation between SCUBE-1 levels and exhaled CO level, smoking characteristics and addiction levels in smokers. &#x0D; Conclusion: Our study showed that the plasma SCUBE-1 value in smokers did not increase at statistically significant levels compared to the control group. Therefore, it was concluded that it would not be useful in evaluating the risk of cardiovascular diseases and the susceptibility to thrombosis.

Levels of exhaled carbon monoxide in steakhouse workers in a town in the Brazilian Legal Amazon region

Occupational exposure to smoke from commercial kitchens such as steakhouses may be associated with an increase in the prevalence of respiratory symptoms and an acute reversible decrease in pulmonary functional capacity, and exposure to coal smoke is a risk factor for the development of respiratory diseases. The objetive of study was evaluate the levels of exhaled carbon monoxide (COex) and carboxyhemoglobin (COHb) in steakhouse workers. This is an observational, longitudinal and prospective study in the city of Cuiabá, Mato Grosso, Brazil. The total of 29 professionals working in steakhouses participated in the study. Data on socio-demographic characteristics, work environment characteristics, life habits and respiratory symptoms were extracted from questionnaires. COex and COHb levels were measured before exposure and every hour up to a 4 hour exposure period. Twenty-nine workers participated, with a predominance of females (55.2%), with a mean age of 36.40±11.49 years. It was observed that 18 (62%) of the workers had respiratory symptoms. COex and COHb levels were elevated after 4 hour exposure (p&lt;0.05), but within acceptable parameters. COex and COHb levels are elevated in a short period of time to occupational exposure to steakhouse activities.

Acupuncture combined with auricular acupressure for smoking cessation and its effects on tobacco dependence and smoking behavior among Hong Kong smokers: a multicenter pilot clinical study

BackgroundAcupuncture combined with auricular acupressure has been used as a complementary and alternative treatment for smoking cessation in Hong Kong for over 10 years. This study aimed to investigate the success rates of smoking cessation posttreatment, and to evaluate treatment effects on tobacco dependence, smoking behavior, anxiety levels, and sleep disturbances between successful and unsuccessful quit smokers in Hong Kong.MethodsThis prospective, multicenter clinical study conducted between September 2020 and February 2022 in Hong Kong was part of the Guangdong-Hong Kong-Macau Greater Bay Area project on smoking cessation. Thirty eligible current smokers (mean age 47.10 years; 40% female) were recruited and received a combination of standardized acupuncture and auricular acupressure treatments twice weekly for 8 weeks. The primary outcome was the success rate of smoking cessation at week 24. The secondary outcomes were the success rates of smoking cessation at weeks 8 and 16, exhaled carbon monoxide (CO) levels, and changes in scores on the Fagerström Test for Nicotine Dependence (FTND), Autonomy Over Smoking Scale (AUTOS), Hamilton Anxiety Rating Scale (HAM-A), Self-rating Anxiety Scale (SAS), and Pittsburgh Sleep Quality Index (PSQI). Adverse events were also recorded.ResultsOf 30 eligible participants, 28 completed 6 or more treatment sessions; all completed follow-up assessments. At week 24, the success rate of smoking cessation was 46.67%. The successfully quit rates at weeks 8 and 16 were 36.67% and 43.33%, respectively. The overall change in mean FTND scores from baseline improved significantly from weeks 2 to 24 (P < 0.05), with the successful quit group showing significantly greater improvement between weeks 8 and 24 (P < 0.01). Compared with baseline values, there were significant reductions in mean AUTOS scores from weeks 6 to 24 (P < 0.001), with the successful quit group showing greater improvement at weeks 16 (P = 0.04) and 24 (P < 0.001). No significant changes were detected in exhaled CO levels or HAM-A, SAS, and PSQI scores. No study-related adverse events were observed.ConclusionsAcupuncture combined with auricular acupressure could be an effective alternative treatment for smoking cessation and reduction of tobacco dependence among Hong Kong smokers.Trial registration Chinese Clinical Trial Registry, No. ChiCTR2000033650. Registered on June 7, 2020. http://www.chictr.org.cn/showproj.aspx?proj=54866

Photoacoustic heterodyne breath sensor for real-time measurement of human exhaled carbon monoxide

A breath sensor for real-time measurement of human exhaled carbon monoxide is reported. This breath sensor is based on a novel photoacoustic heterodyne gas sensing technique, which combines the conventional photoacoustic spectroscopy with the beat-frequency detection algorithm, thus offering a fast response time and a convenient optical alignment, as well as eliminating the needs for frequency calibration and wavelength locking. The principle of photoacoustic heterodyne gas sensing was explained in detail. The performance of the photoacoustic heterodyne breath sensor was evaluated in terms of minimum detection limit, response time, and linearity. The exhaled carbon monoxide levels of eight volunteers were measured and the results demonstrate the reliability and feasibility of this breath sensor.

Evaluation of the relationship between the level of addiction and exhaled carbon monoxide levels with neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in smokers

INTRODUCTIONSmoking has been reported to increase systemic inflammation. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are used as markers for systemic inflammation. In this study, the primary aim was to determine the NLR and PLR ratios in smokers. Secondly, we aimed to evaluate the relationship between the level of addiction and carbon monoxide (CO) level in the expiratory air, with these ratios.METHODSThis study was designed as a single-center, cross-sectional study. It was conducted with chronic smokers aged 18–40 years, without known health problems, visiting the smoking cessation outpatient clinic of a tertiary hospital. Sociodemographic data and smoking characteristics were collected, and exhaled CO levels were measured. Complete blood count (CBC) results were recorded, including NLR and PLR.RESULTSThe mean age of 247 patients was 31.2±6.1 years, with the majority of patients (68.4%) being male. While the mean value of CO was 11.6±5.6 ppm, 42.1% of cases had a high level of addiction. A statistically significant relationship was found between NLR and addiction levels, the CO level, and the amount of smoking in cigarettes/day and packs/year (all p=0.000). A statistically significant relationship was also found between PLR and addiction levels, CO level, cigarettes/day and packs/year (p=0.000, p=0.03, p=0.000, p=0.003, respectively).CONCLUSIONSWe found that as the level of addiction, cigarette use, and exhaled CO levels increased in smokers, NLR and PLR increased. Our data revealed that NLR and PLR may be a simple and easily assessable proxy of systemic inflammation in smokers.