Higher Risk Of Smoking Research Articles

Abstract A158: Community-based lung cancer screening navigation for populations at high risk

Abstract Rationale: Lung cancer screening (LCS) can reduce mortality in individuals with a high-risk smoking history, but uptake has been uneven and suboptimal. In our catchment area of Washington state, urban American Indian/Alaska Natives (AI/AN) and sexual and gender minorities (SGM) have high rates of commercial tobacco use and lower uptake of LCS. Mixed-methods community-engaged formative research with both populations revealed barriers to LCS related to social determinants of health, and interest in identity-tailored approaches to LCS care. We used this to develop tailored navigation approaches to LCS. Our study objective was to pilot and evaluate patient navigation programs to facilitate LCS uptake and care completion for these community members. Methods: We conducted parallel LCS navigation pilot studies, with participants who self-identified as AI/AN or as a member of SGM communities and who were LCS screen eligible. Participants were recruited through referrals to our multi-site university-based LCS program, community-based organization partnerships, outreach, and social media. Dedicated patient navigators were trained on LCS processes, navigation, and community-specific best practices. Navigation was guided by handbooks with barrier-specific resources, standardized scripting for contact points, and community-based resources specific to the populations. Participants completed pre- and post-navigation (1-3 months after enrollment) surveys and were followed for LCS uptake, outcomes, and navigation activities through chart review. Results: Between July 1, 2023 and February 1, 2024, 40 participants were enrolled in the navigation pilot studies, 21 in the AI/AN arm and 19 in the SGM arm. The median age of participants was 65 (interquartile range (IQR): 59-69), 80% reported current smoking, and 65% reported a household income below $30,000. Most (55%) reported at least one barrier that delayed access to healthcare in the past year. After enrollment, 35% completed LCS within one month and 55% completed LCS to date. Participants who completed post-surveys (n=22, 55%) indicated that the patient navigator was helpful. Common navigation activities included scheduling assistance, understanding screening results, addressing financial issues, and smoking cessation. Overall, participants approved of navigation approaches with a median Acceptability of Intervention Measure score of 5/5 (IQR: 4.8-5) and a median Patient Satisfaction with Interpersonal Relationship with Navigator score of 44.5/45 (IQR: 39.3-45). Conclusion: These single-arm pilot trials suggest tailored navigation for LCS for AI/AN and SGM communities is a useful approach to engage patients and address barriers and appears acceptable and welcomed. However, substantial variation in LCS completion may reflect complex barriers not addressed through navigation. Community-based and tailored navigation offers a promising approach to address LCS disparities, though further bi-directional refinement of patient navigation is necessary to optimize engagement and LCS completion. Citation Format: Ursula Tsosie, Katie DeCell, Nicolas Anderson, Madison Snidarich, Brandon Omernik, Nicholas Murphy, Matthew Triplette. Community-based lung cancer screening navigation for populations at high risk [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A158.

Maternal and foetal risks associated with teenage pregnancy - a comparative retrospective study in Turkey

Background Adolescent pregnancy is defined as pregnancy occurring in young women between the ages of 10 and 19 years. Adolescent pregnancies, which are among the social healthcare concerns in developed and developing countries, have negative effects on maternal and infant health. Pregnancy in adolescence puts the health of both the mother and child at risk, as adolescent pregnancies have higher rates of eclampsia, systemic infection, low birth weight, and preterm delivery compared to other pregnancies. In this study, the effects of education level, smoking, and marital status on maternal and foetal outcomes in adolescent pregnancies were evaluated. Methods The records of a total of 960 pregnant women (480 pregnant adolescents aged 15–19 years and 480 pregnant adult women aged 20–26 years) were examined retrospectively. The demographic data of the groups and maternal and foetal outcomes of the pregnancies were compared. A logistic regression model was established as a statistical method for reducing confounding effects. Results Unmarried women were statistically significantly more prevalent in the adolescent group (38.3% vs. 7.3%). Among the considered risk factors, preeclampsia (2.9% vs. 0.8%) and smoking (29.8% vs. 9.8%) were statistically significantly more common in the adolescent group. When the groups were compared in terms of risk factors in pregnancy, it was found that pregnancy in adolescence was associated with a 3.04-fold higher risk of smoking, 5.25-fold higher risk of being unmarried, 3.50-fold higher risk of preeclampsia, and 1.70-fold higher risk of intrauterine growth retardation (IUGR). Conclusions This study demonstrates an increased risk of preeclampsia, IUGR, and smoking during pregnancy in adolescent pregnant women. These findings can be used to identify adolescent pregnancies requiring specific assistance and to take measures to reduce the probability of adverse outcomes.

High-risk smoking in the United States: Nicotine staining predicts increased colonic adenomas and advanced adenomas on colonoscopy

BackgroundSmoking is linked with numerous adverse health effects. Nicotine staining on fingers or teeth is thought to suggest active or heavy smoking. The significance of nicotine staining within gastroenterology remains unclear. AimWe set out to establish the predictive value of nicotine staining for adenomas and advanced adenomas. MethodsThis was a cross-section study of patients who underwent colonoscopy at the Oklahoma City Veterans Affairs Medical Center from November 2019 to November 2020. Pre-procedure patient survey ascertained current smoking status. Endoscopist performed a nicotine staining survey upon completion of the respective colonoscopy. Chart review allowed determination of patient demographics, comorbidities, and colonoscopy findings. Patients without smoking history were assigned to a control cohort. We applied one-way analysis of variance when comparing the mean of continuous variables and the Chi-square test when comparing categorical variables. Lastly, we used stepwise logistic regression to estimate adjusted odds ratio. A p-value <0.05 was considered statistically significant. ResultsCompared to those without smoking history or evidence of nicotine staining, patients with positive nicotine staining were older (P = 0.03), leaner (P < 0.0001), and more likely to have chronic obstructive pulmonary disease (P < 0.0001) or history of alcohol abuse (P < 0.0001). Furthermore, presence of nicotine staining independently predicted increased likelihood of multiple adenomas (OR 1.5, 95% CI [1.2–1.9]) and advanced adenomas (OR 1.6, 95% CI [1.2–2.2]). ConclusionThis marks the first investigation of nicotine staining within gastroenterology. We have demonstrated that the presence of nicotine staining independently predicts numerous adenomas and advanced adenomas.

Abstract 1071: Circulation of rare events in the liquid biopsy for early detection of lung mass lesions

Abstract Lung cancer screening with low-dose CT scans (LDCT) has reduced mortality for patients with high-risk smoking histories. However, this method of screening remains imperfect. High rates of false positive scans expose patients to additional morbidity as they pursue subsequent diagnostic evaluation. Real-world application of screening LDCT remains low. Finally, current screening guidelines exclude those without smoking histories, a population which comprises up to a quarter of lung cancer patients. We sought to explore the utility of liquid biopsy (LBx) in lung cancer patients and its use in early cancer screening and diagnosis. Using the third generation High-Definition Single Cell Assay (HDSCA3.0) workflow, we analyzed 99 peripheral blood samples divided into three cohorts: Normal Donors (ND, n=50) who were healthy volunteers with no known pathology, Screening CT patients (CT, n=25) who underwent standard LDCT screening with resultant Lung-RADS 1-2, Biopsy patients (BX, n=24) who had abnormal CT scans requiring tissue biopsy. The ND group was used to characterize baseline epithelial, mesenchymal, endothelial, and immune cells, alongside acellular events (oncosomes). For the CT and BX patients, demographic information including age, gender, and average BMI was roughly equivalent, however average pack-years smoked differed owing to 10 (42%) patients in the BX group who had no prior smoking history. A total of 14 (58%) BX patients were diagnosed with primary lung cancer (BX+), of which 11(75%) were adenocarcinoma, 2 (19%) were squamous cell carcinoma and 1 (6%) was small cell. Across the cohorts we observed intra- and interpatient heterogeneity of rare events including multiple phenotypic rare cell populations and oncosomes. The comparison of the rare event enumerations between the ND, CT, BX+, and BX- cohorts revealed a greater incidence of total events, total rare cells and oncosomes, as well as specific cellular phenotypes in the CT and BX cohorts compared to the ND cohort. LBx analytes were detected at a significant elevation in the BX samples compared to the CT samples, but there was no significant difference between BX+ and BX- samples. The data supports the utility of the LBx in distinguishing patients with an alveolar mass lesion from those without, providing a mechanism for screening prior to LDCT to better inform clinical workup and avoid unnecessary radiation exposure and biopsy. Citation Format: Anya Shah, Karen Resnick, Jeremy Mason, Peter Kuhn, Jorge Nieva, Stephanie Shishido. Circulation of rare events in the liquid biopsy for early detection of lung mass lesions [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1071.

Is Asian Hate Just About Race? Religious Discrimination and Smoking Among Asian and Asian American Adults in the USA.

Prior research has shown that experiencing religious discrimination is tied to adverse physical and mental health outcomes. However, less known is whether or not religious discrimination may influence one's risk of smoking. In particular, there is a paucity of research examining the impacts of religious discrimination on smoking for Asians in the United States, whose experience of religious discrimination is heavily racialized. To fill in these gaps, in this study, 356 Asian and Asian American adults living in the US were surveyed. The key results suggest that perceived religious discrimination was associated with a higher risk of smoking among Asians and Asian Americans. Meanwhile, this deleterious effect of religious discrimination does not vary by important sociodemographic variables, such as ethnicity, religious identity, gender, and acculturation. Surprisingly, once controlling for religious discrimination, racial discrimination was no longer associated with smoking. Therefore, when it comes to smoking, it may be possible that religion is a more hazardous source of minority stress than race for Asians and Asian Americans.

A Plant-Centered Diet is Inversely Associated With Radiographic Emphysema: Findings from the CARDIA Lung Study.

Chronic obstructive pulmonary disease (COPD) is a significant public health concern and intercepting the development of emphysema is vital for COPD prevention. Smokers are a high-risk population for emphysema with limited prevention strategies. We aimed to determine if adherence to a nutritionally rich, plant-centered diet among young ever-smokers is associated with reduced risk of future radiographic emphysema. We studied participants from the Coronary Artery Risk Development in Young Adults (CARDIA) Lung Prospective Cohort Study who were 18-30 years old at enrollment and followed for 30 years. We analyzed 1706 adults who reported current or former smoking by year 20. Repeated measures of diet history were used to calculate A Priori Diet Quality Scores (APDQSs), and categorized into quintiles, with higher quintiles representing higher nutritionally rich plant-centered food intake. Emphysema was assessed at year 25 (n=1351) by computed tomography (CT). Critical covariates were selected, acknowledging potential residual confounding. Emphysema was observed in 13.0% of the cohort, with a mean age of 50.4 ± 3.5 years. The prevalence of emphysema was 4.5% in the highest APDQS quintile (nutritionally rich), compared with 25.4% in the lowest quintile. After adjustment for multiple covariates, including smoking, greater adherence to a plant-centered diet was inversely associated with emphysema (highest versus lowest quintile odds ratio: 0.44, 95% CI 0.19-0.99, ptrend=0.008). Longitudinal adherence to a nutritionally rich, plant-centered diet was associated with a decreased risk of emphysema development in middle adulthood, warranting further examination of diet as a strategy for emphysema prevention in a high-risk smoking population.

Lung cancer in nonsmokers- A risk factor analysis

Institutions:stony brook medical centerrationaleLung Cancer screening for the high-risk smoking population has been proven to save lives. However, in 2022, 20% of newly diagnosed lung cancers (47,300) were in nonsmokers. These patients were found to be diagnosed at later stages. This may be at least partly due to not meeting criteria for and participating in current lung cancer screening. This study aims to describe characteristics of a never smoker patient population to help identify common risk factors which might merit inclusion in lung cancer screening and thus improve patient outcomes. MethodsThis retrospective single center study included never-smoker patients diagnosed with lung nodules and never-smoker patients diagnosed with lung cancer from 2016 to 2022. Data was obtained from the Stony Brook Medical Center electronic medical record. 16,056 patients were identified as never-smokers who were asked by the medical assistant if they ever smoked in their lifetime. Patients were eliminated if they had any smoking history up to first diagnosis date. Demographics, radiology, histology, diagnosis dates, comorbidities, smoking status, and exposures collected through ICD10 codes and not self-reported, were investigated. ResultsOf 16,056 never-smoking patients, 9315 (58.02%) were females diagnosed with lung nodules and 6741 (41.98%) were males diagnosed with lung nodules.The univariate analysis showed significant differences between gender, age at nodule diagnosis, and patients with and without comorbidities including chronic obstructive pulmonary disease (COPD), hypertension (HTN), and family history (FHX) of lung cancer. The percentage of lung cancer patients among females was significantly higher than among males. Patients having lung cancer were older. The percentages of lung cancer patients with these comorbidities were significantly higher than those without. However, there was no significant difference found between patients with and without diabetes mellitus (DM).The multivariable logistic regression suggested that age at nodule diagnosis and comorbidities including COPD (which included asthma, emphysema and chronic bronchitis) and family history of lung cancer were significantly associated with lung cancer. Older patients and patients with those comorbidities had a higher risk of developing cancer than those who were younger or without those comorbidities. The study excluded HTN and included age at nodule diagnosis in the logistic regression model as HTN was found to be protective against lung cancer due to age at lung nodule diagnosis. Please refer to the appendix for further details. ConclusionNever-smoker patients who were older and with COPD and Family History of lung cancer had higher risk of developing lung cancer than younger patients without these comorbidities. In this study, gender had no impact on outcome.

Tobacco-control policy support among people from low socioeconomic positions in Massachusetts

People from low socioeconomic positions (SEP) are at a higher risk of smoking, face greater barriers to smoking cessation, and have lower access to health information. To improve tobacco-related health outcomes, policies requiring altering labeling on cigarette packs could be implemented. However, public support is needed to influence the policymaking process. We assessed factors associated with supporting tobacco-control communication policies. We analyzed data from Project CLEAR, a study conducted in Massachusetts. The analytic sample included participants who answered questions on their support for three policies: 1) graphic health warnings (GHWs), 2) Quitline number, and 3) smoking cessation information on cigarette packs (n = 357). Binomial logistic regression modeling was conducted by policy. Independent variables included demographic characteristics and smoking status. We found that younger vs. older individuals (aOR = 0.41, 95 %CI:0.23–0.72), males vs. females (aOR = 0.58, 95 %CI:0.35–0.96), and people who smoke vs. those who don’t smoke (aOR = 0.41, 95 %CI:0.24–0.70) were less likely to support a law requiring GHWs. Participants with a low vs. higher level of education (aOR = 0.55, 95 %CI:0.32–0.95) were less likely to support a law requiring a Quitline number. Younger (18–39) vs. older individuals (aOR = 0.53, 95 %CI:0.29–0.94), males vs. females (aOR = 0.57, 95 %CI:0.34–0.96), and participants with a low vs. higher level of education (aOR = 0.56, 95 %CI:0.32–0.98) were less likely to support a law requiring cessation information on cigarette packs. Findings suggest that targeted theory-based public health and communication strategies should be developed to increase awareness and support towards policies that would help reduce cigarette smoking among people from low SEP to eliminate tobacco-related health inequities in the US.

Biopsychosocial Factors of Adolescent Health Risk Behaviours during the COVID-19 Pandemic—Insights from an Empirical Study

The paper focuses on the association between Bulgarian adolescents’ health risk behaviours (cigarette smoking, vaping, alcohol use and drunkenness) and biopsychosocial factors at individual and interpersonal levels, using data from the pre-pandemic and the pandemic periods, i.e. Health Behaviour in School-aged Children (HBSC) study (2018) and the study of adolescent health and well-being in the context of the COVID-19 pandemic (2022/2023). Logistic regression models reveal a positive association with age in both periods, decreasing gender difference in smoking, presistant effect of family structure, strengthened effect of the material status of the family and a differenciating effect of ethnicity at the end of the pandemic. Family support is positively asociated with substance (mis)use in both periods. At the end of the pandemic generalized anxiety is positively associated with substance (mis)use, loneliness has a negative association with drunkenness, and limited social interaction and vaping are in a positive relationship. The experience of COVID-19 infection in the family is associated with higher risk of smoking, while treatment in hospital for COVID-19 of the adolescent or a family member is associated with a higher risk of vaping and drunkenness. Interactions with COVID-19 experience and psychosocial variables reveal a divergence in health risk behaviours, including also engagement in substance (mis)use. Effective interventions, targeting the identified risk factors and risk groups, are needed for promotion of healthy lifestyles among adolescents.

Using Smartphone Survey and GPS Data to Inform Smoking Cessation Intervention Delivery: Case Study.

Interest in quitting smoking is common among young adults who smoke, but it can prove challenging. Although evidence-based smoking cessation interventions exist and are effective, a lack of access to these interventions specifically designed for young adults remains a major barrier for this population to successfully quit smoking. Therefore, researchers have begun to develop modern, smartphone-based interventions to deliver smoking cessation messages at the appropriate place and time for an individual. A promising approach is the delivery of interventions using geofences-spatial buffers around high-risk locations for smoking that trigger intervention messages when an individual's phone enters the perimeter. Despite growth in personalized and ubiquitous smoking cessation interventions, few studies have incorporated spatial methods to optimize intervention delivery using place and time information. This study demonstrates an exploratory method of generating person-specific geofences around high-risk areas for smoking by presenting 4 case studies using a combination of self-reported smartphone-based surveys and passively tracked location data. The study also examines which geofence construction method could inform a subsequent study design that will automate the process of deploying coping messages when young adults enter geofence boundaries. Data came from an ecological momentary assessment study with young adult smokers conducted from 2016 to 2017 in the San Francisco Bay area. Participants reported smoking and nonsmoking events through a smartphone app for 30 days, and GPS data was recorded by the app. We sampled 4 cases along ecological momentary assessment compliance quartiles and constructed person-specific geofences around locations with self-reported smoking events for each 3-hour time interval using zones with normalized mean kernel density estimates exceeding 0.7. We assessed the percentage of smoking events captured within geofences constructed for 3 types of zones (census blocks, 500 ft2 fishnet grids, and 1000 ft2 fishnet grids). Descriptive comparisons were made across the 4 cases to better understand the strengths and limitations of each geofence construction method. The number of reported past 30-day smoking events ranged from 12 to 177 for the 4 cases. Each 3-hour geofence for 3 of the 4 cases captured over 50% of smoking events. The 1000 ft2 fishnet grid captured the highest percentage of smoking events compared to census blocks across the 4 cases. Across 3-hour periods except for 3:00 AM-5:59 AM for 1 case, geofences contained an average of 36.4%-100% of smoking events. Findings showed that fishnet grid geofences may capture more smoking events compared to census blocks. Our findings suggest that this geofence construction method can identify high-risk smoking situations by time and place and has potential for generating individually tailored geofences for smoking cessation intervention delivery. In a subsequent smartphone-based smoking cessation intervention study, we plan to use fishnet grid geofences to inform the delivery of intervention messages.

Newly diagnosed lung cancer in hospitalized patients during the COVID-19 pandemic: How well are LDCTs utilized?

10624 Background: Medicare covers the cost of lung cancer screening in individuals aged 50-77 years with a high-risk smoking history. The COVID-19 pandemic caused a decrease in outpatient visits and cancer screenings. The objective of this study was to provide a comparison between the multitude of lung cancer diagnoses upon presentation to the hospital predating and during the COVID-19 pandemic in patients with varying insurance types. Methods: We retrospectively reviewed fifteen hospitals in West Florida with newly diagnosed lung cancer during the pre-pandemic period from March 2019-August 2020 and the pandemic period from March 2020- August 2021. These patients were split into subcategories based on insurance type: private medical insurance; Medicare; Medicaid; no insurance; and other. The chi-square test was used for statistical analysis. Results: A total of 1409 inpatients, 676 during the pre-pandemic and 733 during the pandemic, were identified with a new diagnosis of lung cancer upon presentation to the hospital. 74% of the pandemic population and 77% of the pre-pandemic population were patients insured with Medicare. Hospitals without LDCT screening programs were found to have 317 lung cancer diagnoses during the pre-pandemic period and 292 during the pandemic period. Hospitals with LDCT screening programs were found to have 359 lung cancer diagnoses during the pre-pandemic period and 441 during the pandemic period. Chi-square tests comparing pre-pandemic to pandemic did not show a p-value of statistical significance. Conclusions: A substantial number of patients with Medicare were newly diagnosed with lung cancer during the pre-pandemic and pandemic periods compared to patients with other insurance types. Although Medicare provides LDCT screening for lung cancer in high-risk populations at no out-of-pocket cost, about 75% of West Florida’s patients were diagnosed with lung-cancer upon presentation to the hospital. Hospitals with LDCT screening programs had an increase in cancer diagnoses during the pandemic, consistent with prior research data. Instead, the pandemic did not seem to affect hospitals without LDCT screening programs. We need to address the barriers in implementation of LDCT hospital-based screening programs to increase early diagnoses and decrease hospitalization diagnoses, leading to improved lung cancer mortality. [Table: see text]

Effectiveness of the multi-component intervention ‘Focus’ on reducing smoking among students in the vocational education setting: a cluster randomized controlled trial

BackgroundSocial inequality in smoking remains an important public health issue. Upper secondary schools offering vocational education and training (VET) comprise more students from lower socioeconomic backgrounds and have higher smoking prevalence than general high schools. This study examined the effects of a school-based multi-component intervention on students’ smoking.MethodsA cluster randomized controlled trial. Eligible participants were schools offering VET basic courses or preparatory basic education in Denmark, and their students. Schools were stratified by subject area and eight schools were randomly allocated to intervention (1,160 invited students; 844 analyzed) and six schools to control (1,093 invited students; 815 analyzed). The intervention program comprised smoke-free school hours, class-based activities, and access to smoking cessation support. The control group was encouraged to continue with normal practice. Primary outcomes were daily cigarette consumption and daily smoking status at student level. Secondary outcomes were determinants expected to impact smoking behavior. Outcomes were assessed in students at five-month follow-up. Analyses were by intention-to-treat and per protocol (i.e., whether the intervention was delivered as intended), adjusted for covariates measured at baseline. Moreover, subgroup analyses defined by school type, gender, age, and smoking status at baseline were performed. Multilevel regression models were used to account for the cluster design. Missing data were imputed using multiple imputations. Participants and the research team were not blinded to allocation.ResultsIntention-to-treat analyses showed no intervention effect on daily cigarette consumption and daily smoking. Pre-planned subgroup analyses showed statistically significant reduction in daily smoking among girls compared with their counterparts in the control group (OR = 0.39, 95% CI: 0.16, 0.98). Per-protocol analysis suggested that schools with full intervention had higher benefits compared with the control group (daily smoking: OR = 0.44, 95% CI: 0.19, 1.02), while no marked differences were seen among schools with partial intervention.ConclusionThis study was among the first to test whether a complex, multicomponent intervention could reduce smoking in schools with high smoking risk. Results showed no overall effects. There is a great need to develop programs for this target group and it is important that they are fully implemented if an effect is to be achieved.Trial registrationhttps://www.isrctn.com/ISRCTN16455577, date of registration 14/06/2018.

Mental health and health behaviours among patients with eating disorders: a case–control study in France

BackgroundEating disorders (ED) are a public health concern due to their increasing prevalence and severe associated comorbidities. The aim of this study was to identify mental health and health behaviours associated with each form of EDs.MethodsA case–control study was performed: cases were patients with EDs managed for the first time in a specialized nutrition department and controls without EDs were matched on age and gender with cases. Participants of this study filled self-administered paper questionnaire (EDs group) or online questionnaire (non-ED group). Collected data explored socio-demographics, mental health including anxiety and depression, body image, life satisfaction, substances and internet use and presence of IBS (Irritable Bowel Syndrome).Results248 ED patients (broad categories: 66 Restrictive, 22 Bulimic and 160 Compulsive) and 208 non-ED subjects were included in this study. Mean age was 36.0 (SD 13.0) and 34.8 (SD 11.6) in ED and non-ED groups, respectively. Among patients and non-ED subjects, 86.7% and 83.6% were female, respectively. Body Shape Questionnaire mean score was between 103.8 (SD 46.1) and 125.0 (SD 36.2) for EDs and non-ED group, respectively (p < 0.0001). ED patients had a higher risk of unsatisfactory friendly life, anxiety, depression and IBS than non-ED s (all p < 0.0001) Higher risk of anxiety, depression and IBS was found for the three categories of EDs. Higher risk of smoking was associated only with restrictive ED, while or assault history and alcohol abuse problems were associated only with bulimic ED. The risk of binge drinking was lower in all EDs categories than in non-ED.ConclusionThis study highlights the common comorbidities shared by all EDs patients and also identifies some specific features related to ED categories. These results should contribute to the conception of future screening and prevention programs in at risk young population as well as holistic care pathways for ED patients.Plain English summaryThis case–control study evaluated mental health and health behaviours associated with the main categories of Eating Disorders (EDs). Cases were patients with EDs initiating care in a specialized nutrition department and controls without ED were matched on age and gender with cases. Self-administered paper questionnaires were filled by ED 248 patients (66 Restrictive, 22 Bulimic and 160 Compulsive) and online questionnaire by 241 non-ED controls. Body image satisfaction was significantly worse in ED patients than in controls. (p < 0.0001). Dissatisfactory life, anxiety, depression and irritable bowel syndrome were more found in patients with all EDs categories than in non-ED (p < 0.0001). Smoking risk was increased only in restrictive patients while and assault history and alcohol abuse was increased only in bulimic patients. These results highlight the global burden of ED and related comorbidities and provide useful information for future screening, prevention and care programs.

The circadian preferences in the context of sociodemographic indicators and lifestyle

ABSTRACT Circadian preferences are frequently used as a synonym for chronotype. Both terms are based on different principles and are measured by a variant questionnaire. We focused on circadian preferences, delimited as an individual preference for the timing of various activities, and their relationship to the selected sociodemographic factors. All participants (n = 2068) filled out online questionnaires including MEQ, MCTQ, and sociodemographic information (age, sex, place of residence, marital status, childcare, education, financial security, physical and mental health). Although the concept of chronotype and circadian preference differ, the mutual correlation was high. Our results of the observed variables are similar to other studies. We revealed evening preference is related to a higher probability of living in a big city, having a single life, a higher risk of smoking, worse health status, and worse financial security. We observed a higher social jet lag among them. Our research complies with previous studies, which found that in some areas, people with evening preferences evince worse results. Due to the evening preference, these people are at a disadvantage, and the society’s setting for morning operations can lead to a deepening of these differences. We recommend further research, which would focus on the practical application of results to the everyday life of participants to create preventive programs aimed at reducing the negative impact of evening preferences on life.

Sociodemographic predictors for smoking persistence among young males in Indonesia

The prevalence and burden of non-communicable diseases (NCDs) in Indonesia are increasing. One major risk factor for NCDs is smoking. Thus, this study assessed sociodemographic predictors of smoking persistence among young males in Indonesia, who are at high risk for smoking and NCDs. We analysed the Indonesian Demographic and Health Survey (IDHS) conducted in 2017, a nationally representative survey in 34 provinces of Indonesia. We included data from 9957 young males aged 15-24 who had tried smoking and were interviewed by the IDHS enumerators for their smoking patterns and sociodemographic characteristics. Logistic regression analyses were used to assess the predictors of smoking persistency. Our analyses uncovered that those who started smoking at high-school age, lived in rural areas, had an occupation, and had lower education levels, had higher odds of smoking persistence than other young males. The use of internet, also increased the odds of smoking persistence, while those reading newspapers had lower odds of smoking persistence. Regarding household characteristics, young males who came from poor households, whose household heads were smokers or not married, also had higher odds of smoking. In conclusion, this study also showed the significance of several individual variables and household sociodemographic factors related to smoking persistence. Based on our findings, we recommend the need for intervention that aims not only at large-scale policy to ban smoking and educational campaigns through the internet but also specific educational intervention targeting families, particularly poor families with active smokers. The educational campaign is also needed to target the younger population, who are at higher risk for smoking persistence if they start smoking earlier.

EP01.04-003 Effectiveness of Cloud-based Computer Aided Quality Control System in Korean National Lung Cancer Screening

Korean national lung cancer screening program (KNLCS) targeting high-risk smoking population using low-dose CT (LDCT) was implemented in 2019. A cloud-based quality control system (CQCS) using computer aided detection program (CAD) was used to assist radiologists in detection, measurement and categorization of lung nodules in LDCT. From 2021, Artificial Intelligence (AI)-based CAD has been launched as a developed version of CQCS. This study aimed to evaluate the effectiveness of CQCS on positive rate and inter-observer variability in KNLCS on national level.

Tobacco Consumption and Mental Health in the Canary Islands: A Quantitative Analysis.

Although the detrimental health effects of tobacco, there has been scant research into determining comprehensive profiles to characterize individuals with a higher risk of smoking. This paper identifies such profiles and probabilistically quantifies the effects of certain traits on the decision to smoke in the Canary Islands. This characterization is approached from a broad and novel point of view for the region studied, given that the analysis not only studies sociodemographic characteristics, lifestyle and health, but also incorporates mental health. The results show that suffering from some type of psychopathology leads to a higher probability of tobacco consumption. Moreover, just as the promotion of a healthy lifestyle has a direct impact on tobacco consumption, the implementation of public policies that reduce the risks of suffering from a mental illness could also reduce the prevalence of smoking in the region and contribute to the design of more effective prevention strategies.

Association between lung cancer screening and smoking cessation

IntroductionAdults with high-risk smoking histories benefit from annual lung cancer screening. It is unclear if there is an association between lung cancer screening and smoking cessation among U.S. adults who receive screening. MethodsWe performed this population-based cross-sectional study using data from the Behavioral Risk Factor Surveillance System (2017–2020). We defined individuals eligible for lung cancer screening as adults 55–80 years old with ≥ 30 pack-year smoking history who were currently smoking or quit within the last 15 years. We assessed the association between lung cancer screening and current smoking status. ResultsBetween 2017 and 2020, 12,382 participants met screening criteria. Current smoking was reported by 5685 (45.9 %) participants, of whom 40.4 % (2298) reported a cessation attempt in the prior year. Lung cancer screening was reported by only 2022 (16.3 %) eligible participants. Lung cancer screening was associated with lower likelihood of currently smoking (odds ratio [OR] 0.705, 95 % CI 0.626–0.793) compared to individuals who did not receive screening. Screening was also associated with higher likelihood of reporting a cessation attempt in the prior year (OR 1.562, 95 % CI 1.345–1.815) compared to individuals who did not receive screening. ConclusionsReceipt of lung cancer screening was associated with lower smoking rates and more frequent cessation attempts among U.S. adults. Better implementation of lung cancer screening programs is critical and may profoundly increase smoking cessation in this population at risk of developing lung cancer.

Audit on Smoking Cessation in a Community Secondary Mental Health Service

AimsSmoking is the single largest cause of preventable death. Smoking prevalence is higher in people with mental disorders and impacts on physical health, mental health and bioavailability of psychotropic medications. Evidence-based interventions exist to support smoking cessation (SC)/reduction in people with mental disorders, although evidence suggests less provision compared to the general population. We aim to determine the unmet SC needs and associated causes in a community secondary mental health service, in order to advise appropriate service response. This audit will inform relevant work of the RCPsych Public Mental Health Implementation Centre as a case example.MethodsFrom the caseload of 364 patients, a sample of 91 case records was randomly selected for recording of smoking and provision of treatment. A survey of 31 smokers and 12 ex-smokers identified patient attitude and barriers in SC. Information on availability and nature of other SC provision in the community was gathered from staff and relevant services.ResultsA sample of case records found 44% (n = 40) of patients were smokers compared to 13,5% in the general UK population. 31 patients were offered SC advice of whom 2 were recorded as wanting to quit. Nicotine Replacement Therapy (NRT) was offered to 13 patients and 5 were referred to SC services (SCS). Aside from smoking status, limited information on smoking was recorded.The survey revealed that 20/31 smokers wanted to reduce or quit smoking, of whom 10 used NRT. Six were referred to SCS which helped 3 reduce. Four ex-smokers used SCS, which helped 3 to quit. Most frequently reported barriers in SC were habit, social isolation, availability of tobacco, and stress. Frequently reported enhancers in SC were NRT, allocated support with follow-up, social interventions and family support.Regarding current service provision, we identified that local GP's did not prescribe NRT. Targeted SCS exist exclusively for inpatients and the only community SCS available offered 12 SC sessions without targeting needs of people with mental disorder.ConclusionDespite high smoking prevalence in our caseload, there is an implementation gap in providing and recording SC advice and treatment, both in our service as in local primary care and community services. Provision of evidence-based interventions and coordination with GP's and SCS could prove useful in narrowing this gap. Results from this local project could be explored on a larger scale to address the implementation gap in SC in this population at high risk of smoking associated harm.

Validity and cardio-metabolic risk profiles of DNA methylation clocks among adults in south-central C\xf4te d\u2019Ivoire

BackgroundAging populations in Africa face a growing burden of non-communicable diseases (NCDs), contextualized in broad external exposome and weak health systems. These could accelerate aging and shorten lifespan. DNA methylation (DNAm) epigenetic clocks allow investigation of biological aging, and perform well in high-income countries. However, their validity has rarely been tested in low- and middle-income countries. We investigated the performance of epigenetic clocks (as aging biomarkers), and their cardio-metabolic risk profiles among adults in south-central Côte d’Ivoire.ResultsWe derived four measures of epigenetic clocks (i.e., HorvathAge, HannumAge, PhenoAge and GrimAge) and their corresponding epigenetic age acceleration (EAA; Intrinsic, Extrinsic, PhenoAA and GrimAA) using genome-wide DNAm data from 393 participants of the Côte d’Ivoire dual burden of disease study, aged 18–79 years. Epigenetic age exhibited strong correlations (0.83 ≤ Pearson’s r ≤ 0.93) but weaker concordance (0.73 ≤ Lin’s rC ≤ 0.85) with chronological age. Epigenetic clocks optimally predicted chronological age at 32 (HannumAge), 62 (HorvathAge) and 78 (GrimAge) years. Multivariable linear EAA models identified male sex (IEAA, EEAA and GrimAA), lower household wealth (EEAA and PhenoAA), high-risk alcohol intake (PhenoAA and GrimAA), smoking (GrimAA), physical activity (IEAA and GrimAA) and body mass index [BMI] (GrimAA) as independent determinants. Physical activity and BMI exhibited quadratic associations with GrimAA. Illustratively, GrimAge was accelerated in underweight and obese participants. Risk associations of GrimAA were largely driven by age-adjusted DNAm surrogate plasminogen activator inhibitor-1 (DNAmPAI-1) and pack years. Multivariable logistic models of cardio-metabolic phenotypes identified EEAA, PhenoAA and DNAmPAI-1 as determinants of high blood pressure, fasting glucose, triglycerides and metabolic syndrome severity.ConclusionsWe provide evidence validating the applicability of epigenetic clocks as aging biomarkers and potential link between sociodemographic and lifestyle-related factors, and cardio-metabolic health in the underrepresented African population. Future longitudinal studies incorporating broad environmental aspects and age-related clinical outcomes should allow to pinpoint the clinical and public health utility of DNAm clocks as mediators in NCD trajectory, in low- and middle-income countries.