Health Effects Of Smoking Research Articles

Less harmful ≠ safe: Effects of cigarette graphic health warnings on E-cigarette evaluations

ABSTRACTAs mandated by the FDA, color graphics depicting some of the lesser-known negative health consequences of smoking will soon be required on all cigarette packaging and advertising. Extensive prior research has demonstrated that Graphic Health Warnings (GHW) are a highly cost-effective way to demarket cigarettes. However, the results of this study suggest that GHW may have unintended negative health implications for consumers. While e-cigarette Addiction Warnings (AW) increased fears about the negative health effects of vaping, cigarette GHW decreased fears and beliefs about the negative health effects of vaping. GHW also had an indirect effect on consumers’ beliefs about the negative health risks of vaping. Consumers’ mindfulness (low vs. high) moderated these effects. The results provide initial insight into the inter-relationships between cigarette GHW, e-cigarette AW, and individual difference.

Effect of Maternal Smokeless Tobacco use during Pregnancy on Neonatal Outcome- A Hospital-Based Study

Introduction: Outcomes that are related to maternal smokeless tobacco (ST) were considerably assessed over the past 50 years with resultant health issues. About 28% of Bengali women have been seen using ST. Some significant health consequences of smoking during pregnancy as, continuous abortion, stillbirth, preterm delivery, preeclampsia, low birth weight babies, and intrauterine growth retardation. Aim of the study: To investigate the influence of use ST during pregnancy on aspects of neonatal outcome like LBW & preterm birth. Methods: A comparative cross sectional study, conducted in the Department of Paediatrics and Department of Gynecology & Obstetrics, Dhaka Medical College Hospital, Dhaka from January 2009 to December 2010. A total of 340 mother-neonate pairs were included in the study and among them,170 mothers using ST for years and heir recently delivered newborn infants ( mother-neonate pairs) were enrolled as ‘cases’ by purposive sampling, and another 170 mother-newborn pairs matched with histories of not using smokeless tobacco or smoke were enrolled as controls. Detailed history of each mother about the antenatal period was taken and through physical examination of the mother was done immediately. Each neoborn was assessed for birth weight and gestational age. Birth weight was weighted in gram using baby scale. Gestional age was determined by LRMP method and also by New Ballard Scoring System. Result: Most of the mothers in this study used shada, followed by jorda, shada+jorda and gul. Smokeless tobacco (ST) used by mothers during pregnancy had a significant association with the delivery of LBW baby (P <0.001) and carries a risk of having delivery of LBW baby 3.7 times higher compared to nonusers of smokeless tobacco. Preterm delivery((P <0.001 )was significantly associated with use of smokeless tobacco by mothers in the study group in comparison to the control group and carries a risk of having preterm delivery 3.1 times more than nonusers. ...........

Experienced Effects on Well-Being following Smoking Cessation: Findings from the 2020 ITC Four Country Smoking and Vaping Survey.

Background and Aims: There has been limited research addressing changes in subjective well-being as a result of quitting smoking. This paper examines recent ex-smokers’ well-being related experiences overall and as a function of (1) duration of cessation and (2) continued nicotine use from vaping. Methods: A sample of 1379 ever-daily smoking ex-smokers (quit for up to 5 years) from the 2020 ITC Four Country Smoking and Vaping Survey (Australia, Canada, the UK, and the US), of which 27.1% currently vaped daily. Well-being measures were perceived changes post-quitting in emotion coping (stress and negative emotions), enjoyment of life, and day-to-day functioning. We also assessed the level of persisting worry about past smoking leading to future health problems. Results: Overall, among those answering all four well-being measures, 51.8% of the ex-smokers reported positive effects and no negatives, but 27.3% reported at least one negative effect, with the remainder reporting no change in any measure. Positive effects were greater among those who had quit more than 1 year prior. The largest improvement (56.3%) was for daily functioning, which showed improvement over time since having quit. Current daily vapers reported similar well-being as those not vaping; however, fewer daily vapers reported worsening ability to cope with stress (10.2% vs. 20.7%). Overall, 84% reported being worried about future negative health effects of smoking, with no clear differences by quitting duration or vaping status. Conclusions: Most ex-smokers reported changes in their well-being since quitting, with more reporting improvements than declines. Well-being improved with duration of time since quitting, but did not appear to be influenced by daily vaping use, but stress coping may be better among vapers. Persisting worries about possible future health effects from smoking may be reducing the experienced benefits of quitting smoking for some.

Sustained decline in tobacco purchasing in Denmark during the COVID-19 pandemic

BackgroundAn estimated 8 million people die every year due to tobacco use. The COVID-19 pandemic has increased the health consequences of smoking, which is a leading risk factor for more severe COVID-19 symptoms, hospitalization, and death. The pandemic has also led to reductions in physical activity, increases in stress and declines in mental well-being, all factors commonly associated with triggering higher tobacco use.MethodsUsing a longitudinal data set of purchasing behavior from 2019–2020 among a national sample of the Danish population (n = 4042), we estimate changes in tobacco use during the COVID-19 pandemic. Our analysis compares tobacco purchases prior to the pandemic to purchases during the pandemic, at the individual level. We also examine effects within subgroups based on smoking behavior in 2019 prior to the pandemic. We estimate effects for smokers and non-smokers and, within smokers, for occasional smokers and regular smokers.ResultsWe find large, sustained decreases in tobacco purchases during COVID-19. We estimate that weekly tobacco purchase rates decline by 24% and average quantities decline by 12% during the period spanning the onset of the pandemic in March 2020 through the end of the year. The declines are driven by regular smokers with little change in behavior among nonsmokers and increases in purchases among occasional smokers. Among regular smokers, purchase rates decline by about 30%, tobacco purchases decline by about 20% and quitting rates increase by about 10 percentage points.ConclusionsOur results suggest that the COVID-19 pandemic could lead to sustained reductions in smoking.

The 1964 US Surgeon General's report on smoking and health.

The 1964 report of the US Surgeon General on smoking and health made an authoritative case that tobacco smoking was a cause of premature deaths from lung cancer and chronic bronchitis. It justified the practice of drawing causal inferences from epidemiological studies, specified influential criteria for doing so, and made use of an early form of meta-analysis.

Influence of smoking on the gastrointestinal tract : Range of findings

HintergrundNikotin ist ein hochwirksames Suchtgift, das bei regelmäßiger Einnahme chronische oder unheilbare Erkrankungen und somit eine eingeschränkte Lebensqualität zur Folge haben kann.FragestellungDas Ziel dieser Übersichtsarbeit besteht darin, mögliche gesundheitliche Folgen des Rauchens auf den Gastrointestinaltrakt aufzuzeigen und einen Überblick über raucherassoziierte neoplastische und nichtneoplastische gastrointestinale Erkrankungen zu geben.Material und MethodeAnhand einer ausführlichen Literaturrecherche wird der aktuelle Wissensstand zu raucherassoziierten Folgen auf den Gastrointestinaltrakt dargestellt.ErgebnisseRauchen ist ein wesentlicher Risikofaktor für die Entstehung neoplastischer und nichtneoplastischer Erkrankungen des gesamten Gastrointestinaltrakts. Diese weisen in der radiologischen Bildgebung allerdings keine spezifischen, raucherassoziierten Merkmale auf.SchlussfolgerungDie Kenntnis einer Raucheranamnese sowie möglicher Auswirkungen von Nikotin auf den Gastrointestinaltrakt können in der radiologischen Bildinterpretation hilfreich sein sowie die diagnostische Entscheidungsfähigkeit und Genauigkeit verbessern.

Long-Term Effects of Cigarette Smoking on All-Cause Mortality and Cardiovascular Outcomes in Thai Population: Results From a 30-Year Cohort Study.

Despite the overwhelming evidences on the health consequences of smoking, studies in Asian population in low-to-middle income countries are very limited. Baseline data of a prospective cohort study were collected in year 1985. Endpoints regarding all-cause mortality and major adverse cardiovascular events (MACE) were followed for 30 years. Cox proportional hazard models were used for analysis. Participants had an average age of 43 years, 23% were female, and 43% were current smokers. All-cause mortality was significantly higher in ex-smokers (hazard ratio [HR] 1.32) and current smokers (HR 1.70) when compared with never smokers. Participants with any history of smoking had significantly higher risk of developing MACE. Furthermore, all-cause death, cardiovascular death, and MACE increased with increasing pack years. Statistically significant dose-response relationships were established. Therefore, cigarette smoking increased the risk of all-cause mortality, cardiovascular mortality, and MACE in Thai population. Results emphasized the importance of tobacco control in Thailand.

The interference of the tobacco industry on the scientific debate

To reassure smokers about the health effects of smoking itself, the tobacco industry has always sought to play an active role in the scientific debate. Their objective was to counterbalance the growing empirical evidence from independent research that was strongly unfavourable for tobacco use [1,2]. Tobacco companies’ strategy was to subsidise doctors, researchers, and scientists who were willing to propagate pro-industry messages. (...)

An online survey on knowledge, attitude and practice among primary healthcare providers towards smoking cessation in Selangor, Malaysia

ObjectiveWe assessed knowledge about the health effects of smoking, attitude, and intention to practice smoking cessation advice. MethodsA cross-sectional online survey was done among 524 healthcare providers in 30 primary care clinics in Selangor State, Malaysia. Association of HCPs’ smoking cessation practices with demographics, service-related and smoking-related factors were tested by Poisson regression. ResultsOverall current smoking prevalence was 3.1 (95%CI 1.6, 4.5), significantly higher among males (14.4 vs 0.2, p < 0.001). Knowledge score was higher (mean 10.8, SD 1.5, maximum 13) than attitude (mean 43.5, SD 13.2, maximum 65) and practice (mean 33.0, SD 9.2, maximum 45) towards smoking cessation. Practice score was associated with female sex [Incidence Rate Ratio (IRR) 1.1, 95%CI 1.09, 1.2], being a nurse (IRR 1.08, 95%Cl 1.04, 1.12), knowledge (IRR 1.02, 95%CI 1.01,1.03), attitude (IRR 0.997, 95%Cl 0.99–1.00) and smoke-free homes (IRR 0.89, 95%CI 0.85,0.94). ConclusionInvolvement of female HCPs (nurses) could improve cessation practices in primary care.

Biologically Active Compounds Present in Tobacco Smoke: Potential Interactions Between Smoking and Mental Health.

Tobacco dependence remains one of the major preventable causes of premature morbidity and mortality worldwide. There are well over 8,000 compounds present in tobacco and tobacco smoke, but we do not know what effect, if any, many of them have on smokers. Major interest has been on nicotine, as well as on toxic and carcinogenic effects and several major and minor components of tobacco smoke responsible for the negative health effects of smoking have been elucidated. Smokers themselves report a variety of positive effects from smoking, including effects on depression, anxiety and mental acuity. Smoking has also been shown to have protective effects in Parkinson’s Disease. Are the subjective reports of a positive effect of smoking due to nicotine, of some other components of tobacco smoke, or are they a manifestation of the relief from nicotine withdrawal symptoms that smoking provides? This mini-review summarises what is currently known about the components of tobacco smoke with potential to have positive effects on smokers.

Characteristics of Aboriginal and Torres Strait Islander smokers exposed to anti-smoking marketing in South Australia

ABSTRACT Background Smoking is disproportionately prevalent among Aboriginal and Torres Strait Islander Australian peoples, with 39% of Indigenous Australians aged over 15 years smoking daily. Efforts to reduce the prevalence include culturally focused media campaigns, designed through community consultation, that highlight the need to determine how such health messaging is perceived by smokers. This study aimed to examine Indigenous Australian smokers’ reactions to a culturally focused anti-smoking mass media campaign. Methods Intercept surveying across health services and events recorded demographics, smoking status, quit attempts, smoking health effects, anti-smoking campaign recall, social support, and campaign reactions. Participants rated four different campaign images in five domains: (1) whether it made them stop and think; (2) personal relevance; (3) believability of design and message; (4) prompting concern about smoking; and (5) motivation towards quitting. Cluster analysis was used to identify smoker types. Results Smoking health effects knowledge was high, and did not differ by quit readiness, attempts, or social support. Cessation support access was higher among those with greater readiness to quit. Social smoking behaviour and confidence to support others quitting did not significantly differ between participants, however importance of others quitting did. Quit readiness, attempts, and social support were associated with reaction to campaign design, but not message recall. Four types of smokers were identified using smoking characteristics, who differed in campaign message reactions. Conclusions Culturally focused anti-smoking media can benefit from exploring how smoker types can be used to differentiate messaging by smokers’ profile characteristics, to support mass media smoking cessation efforts.

Low housing quality, unmet social needs, stress and depression among low-income smokers

Smokers are at greater risk of multiple health conditions that are exacerbated by environmental hazards associated with low housing quality. However, little is known about the prevalence of low housing quality among low-income smokers. Using correlations and logistic regression, we examined associations among eight housing quality indicators – pests, water leaks, mold, lead paint, and working smoke detectors, appliances, heating, and air conditioning – and between housing quality and social needs, depressive symptoms, perceived stress, sleep problems, and self-rated health in a community-based sample of 786 low-income smokers from 6 states. Most participants were female (68%), and White (45%) or African-American (43%). One in four (27%) completed less than high school education, and 41% reported annual pre-tax household income of less than $10,000. Housing quality problems were common. Most participants (64%) reported at least one problem in their home, and 41% reported two or more problems, most commonly pest infestations (40%), water leaks (22%), lack of air conditioning (22%) and mold (18%). Lack of heat and air conditioning were correlated, as were water leaks and mold. Using logistic regression analyses controlling for participant demographic characteristics, we found that reporting more housing quality problems was associated with greater odds of worse mental and physical health outcomes. Multiple health threats, including housing quality, depressive symptoms, stress, poor sleep, and financial strain may be mutually reinforcing and compound the health consequence of smoking. Future research should seek to replicate these findings in other samples, and examine associations longitudinally to better understand causality.

Support of smoking restriction in public areas among adolescents in Malaysia-The findings from Tobacco and E-Cigarette Survey among adolescents in Malaysia (TECMA)

Introduction: Adolescents are the future generation, and their support for smoke-free policies might create momentum for future stringent smoke-free initiatives. This study aimed to determine the levels and factors associated with support for smoking in public areas among Malaysian school-going adolescents aged 10-19 years. Methods: The data were derived from the Tobacco and E-cigarettes among adolescents in Malaysia (TECMA), which employed the cross-sectional study design and multistage sampling to select the representative samples of school-going adolescents. Data was obtained through self-administered of pre-validated questionnaire. Descriptive study, cross-tabulation and multivariable analysis were used for analysis Result: Majority of respondents supported smoking restriction in public areas (86.3%, 95 CI 85.4-87.1). The proportion and likelihood of support of smoke-free initiative were higher among respondents with better knowledge of the harmful effects of second-hand smoke (SHS), been taught in school about the health effects of smoking, older age group (16-19 years), female, those students schooling in urban areas, Malay and other Bumiputras from Sabah and Sarawak. However, current smokers and ECV users were less likely to support smoke-free initiatives in public areas. Conclusion: The level of support for smoke-free initiative in public areas was high among youths in Malaysia, and this might offer promising prospects to expand the non-smoking areas to more public areas in the future. . Keywords: smoke-free public area, level of support, school-going adolescent,smoking status, TECMA

The COVID-19 Pandemic and Smoking Cessation-A Real-Time Data Analysis from the Polish National Quitline.

Since the outbreak of the COVID-19 pandemic, tobacco research has delivered new evidence on the harmfulness of smoking in the context of SARS-CoV-2 infection and the course of the COVID-19 disease. More and more research proves that smoking is an important risk factor contributing to increased risk of mortality among COVID-19 patients. The aim of this study was to assess whether and how the COVID-19 pandemic impacted decisions about quitting smoking. A total of 4072 records of anonymized data were obtained from the Polish National Quitline. Between 15 April 2020 and 31 May 2021, the callers were asked about the COVID-19 pandemic and its influence on their decisions on smoking continuation or cessation. Our results indicate that smokers are very receptive to communication concerning COVID-19 and smoking risk. This phenomenon can possibly be connected to the immediate potential health consequences of smoking and COVID-19 virus infection. Results may indicate that putting emphasis on arguments combined with short-term health consequences of smoking may result in better outcomes in smoking cessation. There is a need for further and constant education on tobacco-related health harm. Our results showed that an irregular and mass communication on health consequences may result in high effectiveness in smoking cessation.

Public Support for Cigarette Pack Pictorial Health Warnings Among US Adults: A Cross-sectional Analysis of the 2020 Health Information National Trends Survey.

The US Food and Drug Administration issued a final rule requiring new warnings for cigarette packages and advertisements. This study examines population-level characteristics of support for-versus neutrality or opposition toward-cigarette pack warnings that use text and images to portray the negative health effects of smoking. We used nationally representative cross-sectional data of US adults age 18 and older from the 2020 Health Information National Trends Survey (n = 3865). Frequencies and weighted proportions were calculated for neutrality toward, opposition to, and support for pictorial warnings across sociodemographics and other predictors. Weighted, multivariable logistic regression examined predictors of being neutral or opposed versus supportive of pictorial warnings. In 2020, an estimated 69.9% of US adults supported pictorial warnings, 9.1% opposed, and 20.9% neither supported nor opposed them. In fully adjusted models, current smokers had almost twice the odds of being neutral or opposed to pictorial warnings as never smokers (odds ratio [OR] = 1.99, confidence interval [CI] 1.12, 3.52). Adults 75 years and older (vs. 18-34) (OR = 0.55, CI 0.33, 0.94) and those with children under 18 in their household (vs. no children) (OR = 0.67, CI 0.46, 0.98) were less likely to be neutral or opposed. In advance of the Food and Drug Administration's implementation of pictorial warnings on cigarette packages, nearly 70% of American adults support this policy. Disseminating information about the effectiveness of pictorial warnings may further strengthen support among current smokers who are less supportive than never smokers. Furthermore, framing messages around the benefits of pictorial warnings for protecting youth may increase public support. While public support for pictorial warnings on cigarette packages is high in the United States, it may increase further after policy implementation and be strengthened by utilizing information campaigns that convey the evidence that pictorial warnings are an effective public health strategy.

Strengthening tobacco control must remain a global health priority

In the almost 60 years since the publication of the landmark US Surgeon General's report on the health consequences of smoking in 1964,1 even stronger evidence on the health risks of smoking has accrued from a wealth of research.2 However, there is a dominance of studies from high-income countries and hence uncertainty on whether risk estimates are generalisable to countries at different economic levels. In The Lancet Global Health, Thirunavukkarasu Sathish and colleagues3 have, for the first time, to our knowledge, studied systematically whether risks associated with smoking differ across country income categories.

Association Between Tobacco Retailer Density and Smoking Among Adults With Diabetes and Serious Mental Illness in New York State.

IntroductionSmoking prevalence is high among adults with comorbid diabetes and serious mental illness. This population is at elevated risk of smoking-related health consequences and premature death. We focused on the community environment and investigated the association between tobacco retailer density and smoking in this population.MethodsWe obtained individual-level data from the 2017 Patient Characteristics Survey, a medical record–based survey of patients served by the public mental health system in New York State. We computed the density of state-authorized tobacco retailers at the 3-digit zip code level.ResultsThe data included 19,492 adults (aged ≥18) with comorbid diabetes and serious mental illness. Of these, 55.6% resided in New York City, 53.1% were female, 38.1% were non-Hispanic White, 30.7% were non-Hispanic Black, 25.2% were Hispanic, and 38.1% were smokers, including electronic cigarette users. The density of tobacco retailers (range, 6.1–16.4 per 10,000 population) was positively associated with smoking (odds ratio = 1.05; 95% CI, 1.03–1.07) after adjusting for sex, race or ethnicity, education, employment, health insurance coverage, obesity, and region (New York City vs outside New York City). We observed no interaction between region and tobacco retailer density.ConclusionFindings of this study suggest that allocating more smoking cessation resources to zip code areas with a high density of tobacco retailers, especially in rural areas, along with supporting policy change to reduce tobacco retailor density, may mitigate the negative health consequences of smoking among people with comorbid diabetes and serious mental illness.

Perception of Cigarette Graphic Health Warnings and Its Impact on Smoking Behavior: A Cross-Sectional Study among Current Smokers of Western Part of Nepal.

Globally, tobacco use (smoked, secondhand, and chewing) accounted for 8.71 million deaths, which is 15.4% of all deaths in 2019. Tobacco was ranked first among males and sixth among female in terms of level 2 risk factor for attributable deaths globally. The objective of this study was to identify the perception of cigarette graphic health warnings and their impact on smoking behavior in Nepal. A cross-sectional study using purposive sampling technique was done. Out of 169 respondents, 79.9% were male, 49.1% were illiterate, and 37.9% were above 60 years of age. Eighty-four percent had initiated smoking before the age of 20, and 39.6% had smoked cigarettes for more than 40 years. All the respondents had noticed the graphic health warning on cigarette packages. The majority (80.5%) of the respondents reported that the warning informs about specific health consequences of smoking, and the percentage of respondents believing that warning motivates smokers to quit smoking, encourages smokers to reduce the number of cigarettes smoked per day, and deters potential smokers from starting to smoke was 40.2%, 33.1%, and 30.8%, respectively. More than half of the respondents (50.9%) attempted to quit smoking because of the warning. The implementation of graphic health warnings had favorable perception from majority of smokers and positive impact on smoking behavior of the respondents. Further large-scale research on impact on smoking behavior through repeated cross-sectional studies can be future research priority.

Human Bronchial Epithelial Cell Culture Models for Cigarette Smoke and Vaping Studies.

Despite the continuing public health efforts to stop or reduce smoking, cigarette smoke use remains popular in the youth and adult population. A recent surge in the use of electronic cigarette and vaping products has created another major health challenge in public health. There is an urgent need to use physiologically relevant models to study the health effect of smoking or vaping in human subjects. Airway diseases such as bronchitis (Landman et al., CMAJ 191:E1321-E1331, 2019; Goniewicz, et al. Harm Reduct J 17:91, 2020; Xie et al., JAMA Netw Open 3:e2020816, 2020) have been described in people who smoke, vape, or both. Here, we will describe methods to collect, expand, and culture human airway epithelial cells from endobronchial brushings and expose these cells cultured at the air-liquid interface to cigarette smoke or electronic cigarette vapor.

Support of the Implementation of a Whistleblowing System for Smoke-Free Environments: A Mixed Methods Approach.

Enforcement of a smoke-free policy is of vital concern in support of the health of smokers and bystanders. Indonesia has issued a smoke-free law, but implementation and enforcement lie with the regional and municipal governments. In a survey of 225 respondents recruited via schools, knowledge about the health effects of smoking and the smoke-free regulation, as well as attitudes towards and commitment and support of the enforcement of the smoke-free regulation in the Kendari City through an electronic whistleblowing system was examined. Furthermore, the participants were asked about the smoking status and smoking behavior. About half of the respondents were students (teenagers), the other half—their parents. Male respondents were strongly overrepresented (85%). Only 18% of the respondents declared to be smokers, mostly adults and males. Both the smokers and the non-smokers supported the smoke-free law and its enforcement through a whistleblowing system. Representatives of the local government were interviewed and participated in focus group discussions. In general, they also exhibited strong support of an electronic enforcement tool. However, issues of efficiency, costs, and responsibility must still be resolved. Nevertheless, an electronic whistleblowing system has the potential to further the health and livelihoods in a community like the Kendari City.