Non-smoking Group Research Articles

Assessing the Effectiveness of A-PRF+ for Treating Periodontal Defects: A Prospective Interventional Pilot Study Involving Smokers.

Background and Objectives: This study aimed to evaluate the effects of advanced platelet-rich fibrin (A-PRF+) tissue regeneration therapy on clinical periodontal parameters in non-smokers and smoker patients. The anticipated biological mechanisms of A-PRF+ include stimulating angiogenesis, thereby promoting the formation of new blood vessels, which is essential for tissue healing. Additionally, A-PRF+ harnesses the regenerative properties of platelet-rich fibrin, contributing to the repair and regeneration of periodontal tissues. Materials and Methods: The study was conducted on 55 patients, divided into two groups: non-smoker patients (n = 29) and smoker patients (n = 26). A single operator conducted the surgical procedure. Following the administration of local anesthesia with articaine 4% with adrenaline 1:100,000 precise intracrevicular incisions were made, extending towards the adjacent teeth, until the interproximal spaces, with meticulous attention to conserving the interdental gingival tissue to the greatest extent possible. Extended, full-thickness vestibular and oral flaps were carefully lifted, and all granulation tissue was meticulously removed from the defect without altering the bone contour. After debridement of the defects, A-PRF+ was applied. BOP (bleeding on probing), PI (plaque index), CAL (clinical attachment loss), and probing depth (PD) were determined at baseline and six months post-surgery. Results: Significant reductions were observed in PD and CAL after six months. In the non-smokers group, PD decreased from 7.0 ± 1.0 mm to 3.1 ± 0.1 mm (p < 0.001), while in the smokers group, PD decreased from 6.9 ± 1.1 mm to 3.9 ± 0.3 mm (p < 0.001). CAL decreased in the non-smokers group from 5.8 ± 0.7 mm to 2.6 ± 0.2 mm and from 5.7 ± 0.9 mm to 3.2 ± 0.2 mm (p < 0.001) in smokers. Notably, the reductions in CAL and PD were statistically more significant in the non-smokers group. Conclusions: Even though the clinical periodontal improvements were considerable in smoker patients, they did not reach the level observed in non-smoker patients.

Influence of smoking on cardiometabolic profile and surgical outcomes in patients with primary aldosteronism. A cohort study.

To evaluate the influence of smoking on cardiometabolic profile and surgical outcomes in patients with primary aldosteronism (PA). Multicenter retrospective study of patients with PA in 36 Spanish tertiary hospitals with available information on smoking habits (smokers and non-smokers [never smokers and ex-smokers]). A total of 881 patients were included, of whom 180 (20.4%) were classified as smokers and 701 as non-smokers. At diagnosis, smokers and non-smokers did not differ in blood pressure or serum potassium levels between. However, smokers had a higher prevalence of left ventricular hypertrophy (LVH) than non-smokers (OR 2.0, 95% CI 1.23 to 3.25), and smokers were more likely to have severe LVH than non-smokers (12.5% vs. 6.6%, P=0.164). A larger mean tumor size of the adrenal nodule/s was observed in the smoking group (18.6±9.66 vs. 15.8±8.66 mm, P=0.002). In addition, the odds of mild autonomous cortisol secretion (MACS) was greater in smokers than in non-smokers (OR 2.1, 95% CI 1.14 to 4.06), but these differences disappeared when adjusted for the size of the adrenal nodule/s (adjusted OR 1.6, 95% CI 0.76 to 3.37). The rate of biochemical and hypertension cure was similar in both groups; however, hypertension cure tended to be more frequent in the non-smoker group (41.2% vs 29.9%, P=0.076). Patients with PA who smoke have a higher prevalence of LVH and MACS and larger adrenal nodule/s than non-smokers. Smoking has no significant effect on the probability of hypertension response after adrenalectomy in patients with PA.

Evaluation of spermatic DNA fragmentation in smoking normospermic infertile individuals

Aim: In approximately 20% of infertile couples, the male factor is the only main cause. In recent years, it has been hypothesized that sperm DNA integrity may be a better indicator than routine semen analysis. Although the effects of smoking on male infertility have not yet been proven, smoking is considered a reasonable risk factor for infertility. In our study, we aimed to evaluate DNA damage in normospermic infertile men who smoke and do not smoke using the acridine orange method. Material and Methods: This study was conducted on semen samples from 50 male cases, 25 of whom were smokers and non-smokers, who met the infertility criteria and applied to the urology clinic of Dicle University Medical Faculty Hospital. Microscopic examinations and morphological evaluations were performed in accordance with the WHO 2010 criteria. The acridine orange method was applied to evaluate DNA fragmentation and DNA fragmentations were calculated. Statistical analysis of the obtained data was performed using the Mann-Whitney U Test. Results: In our study, in the smoking group, age was significantly associated with the duration of infertility, concentration with total motile sperm count, total sperm count with total motile sperm count, and amorphous head anomaly (p&lt;0.01). In the non-smoking group, age and infertility were significantly associated with the duration, volume and total count, concentration and total count, total motile sperm count, and DNA fragmentation (p&lt;0.01). However, there was no statistical difference between the smoking and non-smoking groups in terms of semen parameters and DNA fragmentation (p&gt;0.05). Conclusion: In order to obtain more reliable results, it is thought that large-scale studies are needed in the same groups and in the general population. Keywords: sperm, infertility, DNA fragmentation, smoking

Hypoxic Responses in Periodontal Tissues: Influence of Smoking and Periodontitis.

This study aimed to investigate the hypoxic changes in periodontal tissues resulting from smoking and periodontitis by assessing levels of hypoxia-inducible factors (HIF-1α, HIF-2α, HIF-3α) and vascular endothelial growth factor (VEGF) in gingival crevicular fluid (GCF). The study comprised 22 periodontally healthy non-smokers (Group H), 22 periodontally healthy smokers (Group HS), 22 non-smokers with periodontitis (Group P) and 22 smokers with periodontitis (Group PS). Clinical periodontal parameters were documented, and GCF samples were collected and analysed using enzyme-linked immunosorbent assay (ELISA). Significantly elevated levels of HIF-1α, HIF-3α and VEGF were observed in Groups HS, P and PS compared to Group H (p < 0.05). Moreover, higher HIF-2α levels were detected in the Groups HS and P compared to Group H (p < 0.05). Significant correlations were detected between all evaluated hypoxia biomarkers in the Group P (p < 0.05) except HIF-2α and HIF-3α. However, in the PS group, significant correlation appeared only between HIF-1α and HIF-2α (p < 0.05). Our findings indicate that smoking and periodontitis induce comparable hypoxic effects in periodontal tissues, as evidenced by the evaluated biomarkers. Further research is warranted to gain a deeper understanding of the mechanisms underlying hypoxia in periodontal tissues.

The Association Between Solid Fuel Use and Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia in Sichuan, China: Cross-Sectional Study.

Benign prostatic hyperplasia (BPH) is a global age-related disease. It has been reported that over half of the Chinese male population aged 70 years or older are experiencing BPH. Solid fuel, which is the major source of household air pollution, has been reportedly associated with several adverse events, including sex hormone disorders. Due to the certain relationship between sex hormone levels and prostate disease, the relationship between solid fuel use and lower urinary tract symptoms (LUTSs) suggestive of BPH (LUTS/BPH) deserves further exploration. This study mainly aimed to investigate the association between solid fuel use and LUTS/BPH. The data used in this study were obtained from the West China Natural Population Cohort Study. Household energy sources were assessed using questionnaires. LUTS/BPH was evaluated based on participant self-reports. We performed propensity score matching (PSM) to reduce the influence of bias and unmeasured confounders. The odds ratio (OR) and 95% CI of LUTS/BPH for the solid fuel group compared with the clean fuel group were calculated. We also conducted stratified analyses based on BMI, metabolic syndrome, waist to hip ratio, drinking status, smoking status, and age. A total of 5463 participants were included in this study, including 399 solid fuel users and 5064 clean fuel users. After PSM, the solid fuel group included 354 participants, while the clean fuel group included 701 participants. Solid fuel use was positively correlated with LUTS/BPH before and after PSM (OR 1.68, 95% CI 1.31-2.15 and OR 1.81, 95% CI 1.35-2.44, respectively). In stratified analyses, the OR of the nonsmoking group was higher than that of the smoking group (OR 2.56, 95% CI 1.56-4.20 and OR 1.47, 95% CI 0.99-2.18, respectively). Similarly, the OR of the nondrinking group was higher than that of the drinking group (OR 2.70, 95% CI 1.46-4.99 and OR 1.48, 95% CI 1.01-2.17, respectively). A positive correlation between solid fuel use and LUTS/BPH was observed. The results suggest that improving fuel structure for household cooking and other household needs can possibly help reduce the risk of LUTS/BPH.

Relationship between perception of body image on obesity and smoking status by age group in women: Findings of a seven-year Korean National Survey.

This descriptive study examined the relationship between body image perception and smoking status among women aged 19-64 years in Korea, using data from the Korea National Health and Nutrition Examination Survey (KNHANES). This study is a secondary analysis of data gathered from the KNHANES between 2014 and 2020, encompassing 12515 women aged 19-64 years. The final study group consisted of 742 current smokers (CS), 132 hidden smokers (HS), and 11641 non-smokers (NS). Hidden smokers were defined as participants who reported being non-smokers but had urine cotinine levels >50 ng/mL. The participants were divided into three age categories: 19-29, 30-49, and 50-64 years. A multiple logistic regression analysis was used to assess the relationship between body image perception and smoking status, by age group. Baseline statistics indicated that smokers (both CS and HS) generally had a lower socioeconomic status across all age groups. The highest rate of obesity perception was observed in the CS group, followed by the HS group, in both groups of women aged 19-29 and 30-49 years. However, only women aged 19-29 years in the CS group were more likely to perceive themselves as obese than those in the NS group (AOR=2.60; 95% CI: 1.49-4.52; p=0.001). Furthermore, factors such as current smoking status (AOR=2.32; 95% CI: 1.28-4.23; p=0.006), higher body mass index (AOR=2.95; 95% CI: 2.59-3.37; p<0.001), and perceived health status as poor (AOR=3.82; 95% CI: 2.11-6.92; p<0.001), significantly influenced the perception of obesity in this age group. This study identified a notable relationship between obesity perception and smoking among women aged 19-29 years only. These findings suggest that interventions aimed at weight reduction or modifying the perception of obesity, could potentially aid smoking cessation efforts in young women.

Effect of Smoking on Red Blood Cell Parameters: A Cross-sectional Study in a Divisional City of Bangladesh

Background: Several metabolic and biochemical processes, hormone secretion, and the haematological system are all affected by smoking. Numerous studies have found that smoking is associated with higher levels of haemoglobin concentration (Hb%), total red blood cell count (RBC), and red cell distribution width (RDW). Objectives: To study the RBC parameters in healthy male smokers and non-smokers among adults. Methodology: This research was carried out in the Department of Physiology of Sylhet MAG Osmani Medical College, from July, 2021 to June, 2022. A total of 200 participants were included with healthy adult smokers and age-matched healthy adult non-smokers. History and physical examinations were used to evaluate each individual. We measured height and weight, and calculated body mass index of the subjects. Calculations were made on cigarette smoking intensity and duration. Blood was collected to determine RBC parameters, such as total RBC count, haemoglobin level, haematocrit, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC) and red cell distribution width (RDW) by using Sysmex 500i automatic haematology analyzer (Japan). Results: Among the 200 participants, 100 were adult smokers and another 100 age-matched healthy adult non-smokers. The RBC indices were significantly elevated in smokers compared to non-smokers group: mean haemoglobin concentration (g/dl)+ standard deviation (SD) were 14.17 ± 2.13 versus 13.27 ± 1.39 respectively with p&lt;0.001, mean haematocrit (HCT) (percent)+ SD were 41.60 ± 6.88 versus 39.13 ± 5.46 respectively with p=0.005, mean corpuscular volume (MCV) (fl) + SD 91.13 ± 8.86 versus 88.33 ± 5.58 respectively with p=0.033, mean corpuscular hemoglobin (MCH) (pg) + SD 31.16 ± 3.26 versus 30.05 ± 3.0 respectively with p=0.016 and mean red cell distribution width (RDW) (percent)+ SD 14.74 ± 1.63 versus 14.00 ± 1.57 respectively with p=0.001. However, RBC count (×106/μl) (4.60 ± 0.80 versus 4.46 ± 0.60; p=0.143) and mean corpuscular haemoglobin concentration (MCHC) (g/dl) (34.23 ± 2.11 versus 34.11 ± 2.32; p=0.707) did not differ significantly between smoker and non-smoker groups. There was no statistical difference between mild, moderate, and severe smokers, according to the study's variables. Conclusion: MCV, MCH, RDW, haematocrit, and haemoglobin concentration were all significantly higher in smokers. Journal of Monno Medical College December, 2023; 9 (2):41-46

The impact of smoking on patient-reported outcomes following lumbar decompression: an analysis of the Quality Outcomes Database.

Smoking has been shown to negatively impact spinal health, as well as the outcomes of spinal fusion. Published reports show conflicting data regarding whether smoking negatively impacts patient outcomes following lumbar decompression. The objective of this study was to investigate whether smoking affects the outcomes of patients undergoing lumbar decompression for spinal stenosis or herniated disc. The Quality Outcomes Database was queried for patients with spinal stenosis or lumbar disc herniation who underwent one- or two-level lumbar decompression without fusion. All patients had preoperative and 12-month outcome measures and were divided into groups of nonsmokers and current smokers. Outcomes were compared between the two groups, as well as the percentage of patients reaching the minimal clinically important difference (MCID) threshold for numeric rating scale (NRS) back and leg pain scores and the Oswestry Disability Index (ODI). Of 17,271 patients, 14,233 were nonsmokers and 3038 were current smokers. Smokers had worse baseline NRS back and leg pain, ODI, and EQ-5D scores and experienced slightly less improvement in all measures following lumbar decompression (p ≤ 0.009), although changes were largely similar, and a high percentage of patients achieved the MCID thresholds for NRS back pain (78% nonsmokers vs 75% smokers), NRS leg pain (79% nonsmokers vs 73% smokers), and ODI (74% nonsmokers vs 68% smokers). Comparison of propensity-matched cohorts did not identify any difference in outcomes in smokers versus nonsmokers. In patients undergoing lumbar decompression for spinal stenosis or herniated disc, smokers demonstrated slightly less improvement in outcomes compared with nonsmokers, and a high proportion of both groups achieved meaningful improvement with surgery. While smoking cessation should be strongly encouraged in all patients, lumbar decompression procedures for spinal stenosis and herniated disc should not be denied to smokers.

Efficacy of Hydroxyapatite Cementless Femoral Stem in Primary Hip Arthroplasty in Elderly Patients

Abstract Background Total Hip Arthroplasty (THA) significantly improves the lives of patients with hip issues, achieving a 78% survival rate after 35 years. Challenges such as distal stem migration impact longevity, but innovations like tapered femoral stems and hydroxyapatite (HA) coatings enhance stability and osteointegration, thus promoting implant durability and avoiding the need for bone cement. Continuous advancements in surgical methods and materials promise even better future outcomes for THA patients. Objective To assess the efficacy of different hydroxyapatite stem designs in different Dorr index and to decrease complications of bone cement implantation syndrome in elderly patients. To assess the subsidence of cementless femoral stem in 65 years old and above patients. To measure the functional outcomes, complications, morbidity, and mortality after cementless femoral stem in 65 years old and above patients. Patients and Methods This was a prospective, interventional study. 34 patients were included in the study between 2022-2024. All patients were 65 years old and above, and all of them were planned to undergo HA-coated cementless femoral surgery after preoperative assessment of the Dorr index. Subsidence and functional outcomes (HHS, HOOS) were assessed at three time points (6 months, 1year and 2 years). In addition, subgroup analysis was performed to assess anti-osteoporotic agents and smoking, and their correlation with subsidence and functional outcomes. Results This study included 34 patients with a female-to-male ratio of 20:14 who underwent different primary hip arthroplasties. Our study employed a per-protocol approach for postoperative functional analysis, necessitating the exclusion of two patients (5.88%) due to inadequate filling fixation of the cementless stem, and we had to use a cemented stem. One patient (2.9%) had a dislocation three weeks post-surgery, which required revision due to stem instability, and another patient was excluded due to a periprosthetic infection (2.9%), necessitating implant removal in the 2nd session of debridement four weeks after surgery. Thirty patients were subjected to the final analysis using a per-protocol approach, and the mean subsidence was quantified at three time points (6 months, 1 year, and 2 years). The data demonstrated a temporal increase in mean subsidence, which peaked at 1.92 ± 0.34 mm at the conclusion of the 2-year period. The mean of Subsidence 1.92 ± 0.34 mm were statistically non-significant to the functional outcomes which showing statistically significant of the HA coating cementless femoral stem by time P-value of 0.001. Subgroup analysis of the anti-osteoporotic agents had a statistically significant effect on lowering the subsidence (P &amp;lt; 0.001) but did not affect the functional outcomes. Smoking showed a statistically significant decrease in subsidence (P = 0.007) compared with the non-smoking group. Conclusion The employment of cementless hydroxyapatite femoral stems in geriatric patients aged 65 years and above, presenting with hip pathologies such as osteoarthritis or fractures, constitutes a viable surgical strategy. This approach mitigates the risk associated with cement usage, while ensuring favorable functional outcomes with early unrestricted weight bearing and a low rate of complications. Additionally, our results indicate a reduction in stem subsidence among patients receiving anti-osteoporotic treatments and those who do not smoke when a hydroxyapatite cementless femoral stem is used; however, these variations did not demonstrate a correlation with functional outcomes. Consequently, we advocate for additional research to elucidate the influence of anti-osteoporotic treatment on femoral stem osteointegration in such a high-risk cohort.

Investigating the Effects of COVID-19 on Sperm in Male Smokers: A Prospective Integrated Proteomic and Metabolomic Study

Notable variations in semen parameters among non-smoking males have been documented post-COVID-19 pandemic. The role of smoking as a significant contributing factor to male infertility has been substantiated. Does the combined effect of smoking and SARS-CoV-2 infection impact male reproductive function? A prospective descriptive cohort study was performed using data from 90 smoking and 90 non-smoking males before and after coronavirus infection in a single center over a period of 3 months. Semen samples were collected before and within 15 days after COVID-19 infection, ensuring no more than three months elapsed between the two collections. The semen parameters evaluated included volume, concentration, progressive motility, normal morphology, and DNA fragmentation rate. Proteomic and metabolomic studies were further used to explore the differences between groups. Both non-smokers and smokers exhibited a marked reduction in sperm concentration, progressive motility, and normal morphology rate. Additionally, an increase in sperm DNA fragmentation index was noted for non-smokers and smokers. In the non-smoking group, dysregulation proteins including SEMG1, SEMG2 and DNAH5, and metabolites including L-glutamine, cis-9-Palmitoleic acid and Linoleamide were observed. In smokers, dysregulation proteins including SMCP, ROPN1B and IZUMO4, alongside metabolites including carnitine, gamma-Glutamylglutamic acid, and hypoxanthine were found. Comparative analysis between smoking and non-smoking patients post-COVID-19 also revealed significant differences in semen concentration, morphology and sperm DNA fragmentation rate. Dysregulated proteins including HSPA5, HSPA2 and PGK2, and metabolites such as acetylcarnitine, oxaloacetate and nicotinate were associated with impaired sperm function. Our study demonstrates that the virus also significantly compromises sperm quality in smoking males, who experience more pronounced declines post-infection compared to their non-smoking counterparts. This research underscores the necessity for comprehensive fertility assessments for smoking males after recovering from COVID-19.

Heterogeneous Association Between E-Cigarette Use and Diabetes Prevalence Among U.S. Adults

IntroductionE-cigarette use has increased among US adults. While the association between traditional cigarette smoking and the diabetes/prediabetes prevalence is well established, the relationship between e-cigarette use and these conditions remains unclear. This study examines the association between different types of cigarette use (including e-cigarettes alone, combustible cigarettes alone, and dual use) and the prevalence of prediabetes and diabetes among US adults. MethodsWe analyzed 1,285,783 observations from the 2020-2022 Behavioral Risk Factor Surveillance System surveys. Self-reported prediabetes and diabetes diagnoses were outcomes of interest. Propensity score matching with one-to-one nearest-neighbor matching was used to create balanced groups of smokers and non-smokers. Multivariable logistic regressions examined associations between self-reported smoking status and outcomes. We also conducted subgroup analyses to assess potential variations in these associations. Analyses were performed in September-December 2023. ResultsAfter propensity score matching and adjusting for covariates, sole e-cigarette users (adjusted odds ratio [AOR], 1.07; 95% CI, 1.03-1.11) and dual users (AOR, 1.28; 95% CI, 1.23-1.33) had higher odds of prediabetes diagnosis compared with never users. Sole e-cigarette use was not associated with diabetes risk, but dual users showed higher odds for diabetes diagnosis (AOR, 1.09; 95% CI, 1.06-1.11) versus never users. E-cigarette use was associated with varying odds of prediabetes and diabetes across different demographic groups. ConclusionsThis cross-sectional analysis found that e-cigarette use is associated with higher odds of prediabetes, with dual use potentially linked to increased odds of both prediabetes and diabetes. However, due to study limitations, including its cross-sectional design, self-reported data, and unmeasured confounders, these findings should be interpreted cautiously. As causal relationships and temporal sequences cannot be established, large prospective studies are needed to explore the metabolic health implications of emerging tobacco product use.

The Relationship Between NLRP3 Inflammasome and Its Downstream Inflammatory Factors in Obstructive Sleep Apnea Patients with Carotid Atherosclerosis Under Cigarette Exposure

Aim: To study the relationship between NLRP3 (nucleotide oligomerization domain [NOD]-, leucine-rich repeats [LRR]-, and pyrin domain-containing protein 3) inflammasome and its downstream inflammatory factors in obstructive sleep apnea (OSA) patients with carotid atherosclerosis (CAS) under cigarette exposure, further exploring the risk factors of CAS in OSA patients. Methods: A total of 109 adult males who underwent polysomnography and carotid artery ultrasonography in our hospital from October 2019 to December 2021 were selected. According to the detection results, they were divided into the OSA group, the CAS group, and the OSA combined CAS group; additionally, 29 healthy subjects who underwent a physical examination were also included. According to whether they were smoking, the groups were further divided into smoking and non-smoking groups. The age, body mass index (BMI), blood pressure, apnea-hypopnea index (AHI), lowest blood oxygen saturation (LSaO2), carotid intima-media thickness (CIMT), levels of blood sugar, blood low-density lipoprotein cholesterol (LDLc), and serum NLRP3, interleukin-1β (IL-1β), and interleukin-18 (IL-18) of all subjects were recorded. Results: The OSA combined CAS group had higher LDLc levels and AHI and lower LSaO2 than the OSA group and CAS group. The levels of serum NLRP3, IL-1β, and IL-18 in the OSA group were higher than those in the normal control group (P &lt; 0.05); and those in the OSA combined CAS group were higher than the OSA group and CAS group (P &lt; 0.05), regardless of cigarette exposure. Considering cigarette exposure, serum NLRP3, IL-1β, and IL-18 levels were higher in the OSA, CAS, and OSA combined CAS smoking groups than those in the non-smoking group (P &lt; 0.05). Under cigarette exposure, AHI, LDLc, NLRP3, IL-1β, and IL-18 were significantly positively correlated (P &lt; 0.05), and LSaO2 was negatively correlated with CAS in OSA (P &lt; 0.05). AHI, LSaO2, LDLc, NLRP3, and IL-1β are the risk factors for OSA combined with CAS. Conclusion: LSaO2, AHI, LDLc, NLRP3, and IL-1β are the important risk factors for OSA combined with CAS under cigarette exposure, and their levels can be used to predict the occurrence of CAS in OSA.

Association between smoking status and the prognosis of brain metastasis in patients with non-small cell lung cancer.

This study aimed to explore the relationship between smoking status and the interval to brain metastasis in patients with non-small cell lung cancer (NSCLC) and its impact on survival time after brain metastasis. Data were collected from patients with NSCLC with brain metastases who were treated at our centre between January 2005 and December 2017. Clinical indices such as clinicopathological features and smoking status were recorded, and patients were followed up until 1 September 2022. Based on our inclusion and exclusion criteria, 461 patients were analysed and matched using 1:1 propensity score matching. Three balanced groups were formed: non-smoking (n = 113), smoking cessation (n = 113), and smoking (n = 113). The interval to brain metastasis and overall survival were compared between the groups. There was a statistically significant difference in the interval to brain metastasis between the non-smoking and smoking cessation groups (p = 0.001), as well as between the non-smoking and smoking groups (p < 0.001). However, the difference between the smoking cessation and smoking groups was not statistically significant (p = 0.106). Multivariate and univariate analyses identified smoking status, clinical stage, lung cancer surgery, chemotherapy, and chest radiotherapy as independent predictors of the interval to brain metastasis. Additionally, the multivariate analysis showed that smoking status, driver gene mutations, and chest radiotherapy independently influenced survival after brain metastasis. Smoking status in patients with NSCLC affects the interval to brain metastasis and survival after brain metastasis.

Smoking and Cognitive and Mental Disorders: Evaluation of This Relationship in Elderly People in the Municipality of Porto Alegre – RS/Brazil

Objective: The objective of this study is to compare elderly smokers with elderly nonsmokers and to assess the prevalence of disorders in groups of current smokers, nonsmokers, and patients who have quit smoking. Theoretical Framework: Smoking is one of the main risk factors for a series of chronic diseases and debilitating conditions, including cognitive and mental disorders. The elderly population is particularly vulnerable to these impacts due to the coexistence of multiple comorbidities and the natural aging of the central nervous system (CNS). Method: Descriptive, cross-sectional study with prospective data collection, conducted in the city of Porto Alegre, capital of the state of Rio Grande do Sul, Brazil, with the elderly population (60 years or older) registered in the Family Health Strategy (ESF). Results and Discussion: In terms of current smoking, men (25.2%) tend to smoke more than women (18.4%), which is confirmed throughout their lives, representing 73.3% and 45.7%, respectively. Research Implications: The research can help to identify elderly individuals who are at greater risk of developing cognitive and mental disorders due to smoking early. This enables early interventions, such as smoking cessation programs integrated with psychological and psychiatric support. Originality/Value: The research focuses on a specific population — elderly individuals from Porto Alegre —, which allows for detailed analysis of a demographic group that is often underrepresented in studies on smoking and mental health.

Tobacco smoking and its impact on pain intensity of temporomandibular disorders: A systematic review and metanalysis.

Temporomandibular disorders (TMDs) encompass a spectrum of orofacial conditions characterised by pain and dysfunction in the temporomandibular joint and surrounding structures. Tobacco smoking has been posited as a potential factor influencing the prevalence and intensity of TMD. However, the nature and extent of this relationship remain unclear due to variations in study outcomes. This systematic review aimed to consolidate existing research findings to elucidate the association between tobacco smoking and TMD pain intensity. A comprehensive search of electronic databases was conducted to identify relevant studies published up to June 2023. Studies investigating the relationship between tobacco smoking and TMD pain were included. Data extraction was conducted by two reviewers. Quality assessment was performed using the New Castle-Ottawa scale. Review Manager 5.4 was used to quantitatively analyse the results. The review included four studies employing similar TMD assessment techniques. All studies reported elevated TMD pain intensity among tobacco users, with non-smokers exhibiting lower pain intensity. The quality of the included studies was good. Meta-analytic results showed that TMD pain intensity was higher in the smokers group compared to the non-smokers group, with a weighted mean difference (WMD) of 0.65 (BPM) (95% CI: [0.10, 1.19], p = .02). This systematic review provides a comprehensive synthesis of the existing literature on tobacco smoking and TMD symptoms. The findings underscore the multifaceted nature of the relationship between smoking and TMD pain, highlighting its clinical relevance and the need for tailored interventions. Further research is warranted to elucidate underlying mechanisms and potential moderating factors, contributing to a more nuanced understanding of this complex association.

Relationship Between Smoking and Lipid Profile in Four Primary Health Care Units: A Research Study.

Introduction Smoking is the most preventable cause of cardiovascular disease (CVD).Dyslipidemia is also an important risk factor for CVD. Yet, research has provided contradicting findings regarding the association between smoking and blood lipids. This study aims to assess the relationship between smoking and dyslipidemia, as well as compliance with the previously established treatment target. Materials and methods This was a cross-sectional study. Apparently, healthy users aged 40 or over, were from four primary health care units (PHCU) in Portugal. The inclusion criteria were: age between 40 and 69 and active enrollment in one of the four PHCU. The exclusion criteria were: background of atherosclerotic disease, heart failure, chronic kidney disease, diabetes mellitus, and a history of acute myocardial infarction; no record of lipid profile or triglyceride value of more than 400 mg/dL.Cardiovascular risk levels were determined using the Systematic Coronary Risk Evaluation (SCORE) 2 risk. The low-density lipoprotein cholesterol (LDL-c) target was considered the recommendation by the European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) 2019. Results From an initial population of 16,939 patients, 12,076 apparently healthy patients were included.The difference between cholesterol values is statistically significant, with total cholesterol, LDL-c, and triglyceride values tending to be higher in the smoking group and the high-density lipoprotein cholesterol (HDL-c) value tending to be higher in the non-smoking group. Regarding the LDL target, there is also a statistically significant difference between smokers and non-smokers. Discussion Smoking and dyslipidemia are two isolated cardiovascular risk factors. Their association has been questioned. This study demonstrated that there is an association between smoking and the lipid profile, but also with the LDL target. However, there are some biases that must be considered, and which do not allow for generalization. Conclusions This study concludes that smoking negatively influences the lipid profile, with lipids being found less frequently on target. However, more studies are needed in this area, particularly studying other relevant factors such as body mass index.

Protecting effects of smoking against COVID-19: a community-based retrospective cohort study in middle- and older-aged adults

On December 7, 2022, China switched from dynamic zeroing strategy against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to reopening. A nationwide SARS-CoV-2 epidemic emerged rapidly. The effect of smoking on SARS-CoV-2 infection remains unclear. We aimed to retrospectively investigate the relationship between smoking and coronavirus disease 2019 (COVID-19) using a community-based cohort of smokers and non-smokers. We included participants from a pre-pandemic cohort with a prolonged follow-up period. Data on smoking status, body mass index, and history of other diseases were collected from health examination and consultation clinic records. Cox regression analysis was used to identify the relationship between groups and SARS-CoV-2 infection over time. We analysed 218 male patients with varied smoking statuses (46.3% current or ex-smokers; average age 68.63 ± 9.81 years). Two peaks in the epidemic were observed following the December 2022 outbreak. At the end of the second peak, non-smokers, current smokers, and ex-smokers had primary infection rates increase to 88.0%, 65.1%, and 81.0%, respectively, with a significant difference between the groups. Current smoking significantly protected against SARS-CoV-2 infection (HR 0.625, 95% CI 0.402–0.970, p = 0.036). Further analyses showed that the prevalence of pneumonia in the unvaccinated, older, diabetic, and non-smoking groups was significantly higher than that in the other groups (p < 0.05). Our study suggests a potential association between smoking and a reduced risk of SARS-CoV-2 infection and pneumonia. This indicates that nicotine and ACE2 play important roles in preventing COVID-19 and its progression. We suggest smokers use nicotine replacement therapy during hospitalization for COVID-19.

Self-medication for Cough: a Study of Smokers and Non-smokers in Surabaya Colleges

The number of smokers among students is increasing. Smoking can cause coughing, the body's defense mechanism for clearing the airways. Cough can be treated with self-medication, which can cause drug-related problems. The level of knowledge and perception can influence the choice of cough medicine used. The purpose of this study was to determine the knowledge and perceptions of cough medicine self-medication in smokers and non-smokers. This research method was a case-control study using a questionnaire of knowledge (definition, method of use, and indications) and perceptions (definition, side effects, and experience) regarding using self-medicated cough medicine. The research sample was adult students at a private university in Surabaya from January 2023 to April 2023, and it was collected using a purposive sampling method. The sample size was 124 respondents, 62 smoking and 62 non-smoking students. The level of knowledge in both groups was high, namely 51.62% in the smoker group and 58.84% in the non-smoker group. Meanwhile, the perception level in the smokers group was mostly bad (56.45%), in contrast to the non-smokers who had a good level of perception (64.52%). There was a significant difference in the level of knowledge (0.00) and perception (0.00) between smokers and non-smokers regarding cough medicine self-medication. Therefore, smokers have the same high level of expertise but lower levels of perception than non-smokers. Health promotion programs to increase knowledge are essential considerations in optimizing self-medication.

Effect of Buerger’s disease on ocular microvascular structure

ABSTRACT Clinical relevance Buerger’s disease, being a systemic inflammatory vasculopathy, may present with ocular findings. Background This study aims to understand the potential role of optical coherence tomography and angiography findings in evaluating the course of Buerger’s disease. Methods This was a prospective, cross-sectional study that included 25 patients with Buerger’s disease (Group 1) and 51 healthy control participants, of whom 27 were smokers (Group 2) and 24 were non-smokers (Group 3). Following a detailed ophthalmic examination, optical coherence tomography and angiography measurements were conducted on participants. The values of macular superficial and deep capillary plexus, peripapillary capillary plexus vessel density measurements were taken into account from optical coherence tomography angiography measurements. Furthermore, measurements were taken for the parameters of the foveal avascular zone, including its area, perimeter and acircularity index. Additionally, the choriocapillaris flow area was assessed between radii of 1 mm, 2 mm, and 3 mm. Results In patients with Buerger’s disease, the area and perimeter of the foveal avascular zone were higher than in both smoker and non-smoker healthy groups (p < 0.001 for all). The vessel densities in superficial capillary plexus were found to be lower in patients with Buerger’s disease compared to both smokers and non-smokers in all regions except the parafovea (p < 0.05 for all). The radial peripapillary capillary plexus vessel densities in the whole retina and peripapillary region were lower than those in the non-smoker group (p < 0.001 and p = 0.008). The choriocapillaris flow areas in all three radius were lower in the smoker group than in the non-smoker group (1 mm, p = 0.01; 2 mm, p = 0.005; 3 mm, p = 0.011) Conclusions Buerger’s disease extends beyond the extremities, affecting vascular density and tissue perfusion in the optic disc and macula, making it a systemic condition. This disease can have ocular involvement without causing serious ocular findings.

Smoking paradox in coronary function and structure of acute ST-segment elevation myocardial infarction patients treated with primary percutaneous coronary intervention

BackgroundThe Smoking paradox has generated inconsistent findings concerning the clinical prognosis of acute ST-segment elevation myocardial infarction (STEMI) patients, while providing limited insights into coronary anatomy and function which are crucial prognostic factors. Therefore, this study aimed to further investigate the existence of smoking paradox in coronary anatomy and function.MethodsThis study divided STEMI patients into smokers and non-smokers. Quantitative coronary angiography, angiography‑derived microcirculatory resistance (AMR) and quantitative flow ratio (QFR) were utilized to analyze coronary anatomy and function. These parameters were compared using multivariable analysis and propensity score matching. The clinical outcomes were evaluated using Kaplan-Meier curve and Cox regression.ResultsThe study included 1258 patients, with 730 in non-smoker group and 528 in smoker group. Smokers were significantly younger, predominantly male, and had fewer comorbidities. Without adjusting for confounders, smokers exhibited larger lumen diameter [2.03(1.45–2.57) vs. 1.90(1.37–2.49), P = 0.033] and lower AMR [244(212–288) vs. 260(218–301), P = 0.006]. After matching and multivariate adjustment, smokers exhibited inversely smaller lumen diameter [1.97(1.38–2.50) vs. 2.15(1.63–2.60), P = 0.002] and higher incidence of coronary microvascular dysfunction [233(53.9%) vs. 190(43.6%), P = 0.002], but showed similar AMR and clinical outcomes compared to non-smokers. There was no difference in QFR between two groups.ConclusionSmoking among STEMI patients undergoing pPCI was associated with smaller lumen diameter and higher occurrence of coronary microvascular dysfunction, although it had no further impact on clinical prognosis. The smoking paradox observed in coronary anatomy or function may be explained by younger age, gender, and lower prevalence of comorbidities.