Smoking Behavior Research Articles

Adapting a Mobile Health App for Smoking Cessation in Black Adults With Anxiety Through an Analysis of the Mobile Anxiety Sensitivity Program Proof-of-Concept Trial: Qualitative Study.

At least half of smokers make a serious quit attempt each year, but Black adults who smoke are less likely than White adults who smoke to quit smoking successfully. Black adults who smoke and have high anxiety sensitivity (an individual difference factor implicated in smoking relapse and culturally relevant to Black adults) are even less successful. The Mobile Anxiety Sensitivity Program for Smoking (MASP) is a smoking cessation smartphone app culturally tailored to Black adults who smoke to increase smoking cessation rates by targeting anxiety sensitivity. This study examined the acceptability and feasibility of the MASP smartphone app following a 6-week pilot test through postintervention qualitative interviews. The MASP smoking cessation app was adapted from an evidence-based app by adding culturally tailored narration and images specific to the Black community, educational content on tobacco use in the Black community and the role of menthol, culturally tailored messages, and addressing tobacco use and racial discrimination. The MASP app was piloted with 24 adults with high anxiety sensitivity who identified as Black, smoked daily, and were not currently using medications or psychotherapy for smoking cessation. At the end of the 6-week pilot test, 21/24 participants (67% female; 95.2% non-Hispanic; mean age=47.3 years; 43% college educated; 86% single or separated) completed an audio-recorded semistructured interview assessing the acceptability and utility of the app, individual experiences, barriers to use, the cultural fit for Black adults who wanted to quit smoking, and identified areas for improvement. Transcribed interviews were coded using NVivo (Lumivero), and then analyzed for themes using an inductive, use-focused process. Most participants (17/21, 81%) had smoked for more than 20 years and 29% (6/21) of them smoked more than 20 cigarettes daily. Participants felt the MASP app was helpful in quitting smoking (20/21, 95%) and made them more aware of smoking thoughts, feelings, and behaviors (16/19, 84%). Half of the participants (11/21, 52%) thought the combination of medication and smartphone app gave them the best chance of quitting smoking. Themes related to participant experiences using the app included establishing trust and credibility through the recruitment experience, providing personally tailored content linked to evidence-based stress reduction techniques, and self-reflection through daily surveys. The culturally tailored material increased app relevance, engagement, and acceptability. Suggested improvements included opportunities to engage with other participants, more control over app functions, and additional self-monitoring functions. Adding culturally tailored material to an evidence-based mobile health (mHealth) intervention could increase the use of smoking cessation interventions among Black adults who want to quit smoking. Qualitative interviews provide mHealth app developers important insights into how apps can be improved before full study implementation and emphasize the importance of getting feedback from the target population throughout the development process of mHealth interventions. ClinicalTrials.gov NCT04838236; https://clinicaltrials.gov/ct2/show/NCT04838236.

The association between stress-induced hyperglycemia ratio and cardiovascular events as well as all-cause mortality in patients with chronic kidney disease and diabetic nephropathy

The stress hyperglycemia ratio (SHR) is an emerging biomarker used to assess blood glucose levels under acute stress conditions and has been linked to the incidence of adverse clinical outcomes. However, the precise role of SHR in patients with diabetic kidney disease (DKD) and chronic kidney disease (CKD), particularly in relation to mortality, remains poorly understood. This study seeks to investigate the clinical value of SHR as a predictive tool for all-cause and cardiovascular mortality in these patient groups. This study analyzed data from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2018, encompassing 3,507 individuals diagnosed with diabetic kidney disease (DKD) or chronic kidney disease (CKD). The primary endpoints included all-cause mortality and cardiovascular mortality, with mortality data obtained from the National Death Index (NDI) through December 31, 2019. Participants were categorized into quartiles based on the stress hyperglycemia ratio (SHR), and Cox proportional hazards regression models were employed to examine the association between SHR and mortality. Model 1 did not account for any covariates, Model 2 adjusted for age, sex, and race, while Model 3 additionally incorporated adjustments for educational attainment, marital status, body mass index, smoking behavior, hypertension, hyperlipidemia, and cardiovascular disease. The study comprised 3,507 patients with a mean age of 60.7 years, of whom 56% were female. The overall incidence of all-cause mortality was 38,000 per 100,000 person-years, while cardiovascular mortality was 11,405 per 100,000 person-years. Kaplan–Meier survival analysis revealed that the second quartile of the stress hyperglycemia ratio (SHR) (Q2) exhibited the lowest all-cause mortality (log-rank P = 0.003). Cox regression analysis indicated that the hazard ratio (HR) for all-cause mortality in Q2 was 0.76 (95% CI: 0.63, 0.92), whereas the HR for Q4 was 1.26 (95% CI: 1.04, 1.52). Restricted cubic spline (RCS) analysis revealed a J-shaped association between SHR and all-cause mortality, as well as a U-shaped association with cardiovascular mortality. The minimum risk values for SHR were 0.923 for all-cause mortality and 1.026 for cardiovascular mortality. In patients with diabetic kidney disease (DKD) and chronic kidney disease (CKD), SHR demonstrated a J-shaped relationship with all-cause mortality and a U-shaped relationship with cardiovascular mortality. Subgroup analyses indicated that the effect of spontaneous hypertension on mortality was consistent across all subgroups. This study highlights a significant association between the stress hyperglycemia ratio (SHR) and both all-cause and cardiovascular mortality in patients with diabetic kidney disease (DKD) or chronic kidney disease (CKD). SHR may serve as a critical biomarker for prognostic assessment in these populations, enabling clinicians to identify high-risk patients and tailor personalized treatment strategies that enhance patient quality of life and mitigate mortality risk.Graphical abstract

How do Chinese smokers respond to cigarette price? Evidence from a nationwide household survey.

Despite the Chinese government's implementation of tax increases in 2009 and 2015 to curb tobacco use, the anticipated decline in cigarette sales has not materialized. This suggests a need for deeper understanding of smokers' demand behavior. The present study aims to provide a more accurate estimation of the price and income elasticities of cigarettes in China. We utilized Deaton's model to analyze a comprehensive micro-level dataset comprising 10,892 households surveyed in the 2012 wave of China Family Panel Survey, with the aim of estimating the price and income elasticities of cigarette demand, as well as to investigate how these elasticities vary across different income brackets. These resulting elasticities were subsequently integrated into the World Health Organization Tax Simulation Model to simulate the potential impacts of various tax increase scenarios on cigarette consumption and tax revenue. The price elasticity in China hovers around -0.72, with an income elasticity of about 0.23. Heterogeneity analysis indicated that lower-income smokers exhibit greater sensitivity to price changes. Policy simulations suggested that tax increases would substantially reduce consumption while concurrently increasing tax revenue. Chinese smokers exhibited a considerable sensitivity to cigarette prices, underscoring the efficacy of taxation as policy instrument for shaping smoking behavior. As tax reforms continue and cigarette retail prices increase, there lies promising potential for achieving tobacco control goals, generating additional revenue, and improving social equality. A primary contribution of this study is the provision of more reliable estimation of cigarette price and income elasticities in China. These parameters are crucial for assessing the potential impact of tobacco tax increases on cigarette consumption and government revenue. By leveraging a nationally representative survey from 2012 and employing Deaton's identification strategy, we significantly enhanced the data quality and methodological rigor of our analysis, leading to more accurate estimation results compared to previous studies.

Cross-sectional and longitudinal associations of smoking behaviour with central arterial haemodynamic measures: the Framingham Heart Study.

To assess the cross-sectional and longitudinal associations of smoking behaviour with central arterial haemodynamic measures in samples of the Framingham Heart Study. In 6597 participants [3606 (55%) women, 51.5% never smoked, 34.8% formerly quit, 4.3% recently quit, and 9.3% currently smoking], we assessed relations of smoking behaviour with central arterial measures using multivariable linear regression models. In cross-sectional models, central arterial measures were different across smoking behaviour groups. Particularly, augmentation index (AI) was higher among participants who formerly quit smoking (least squares mean ± standard error = 14.1 ± 0.4%; P < 0.001) and were currently smoking (18.1 ± 0.5%; P < 0.001) compared with participants who never smoked (12.6 ± 0.3%). Among participants currently smoking, higher cigarettes per day [B = 1.41; 95% confidence interval (CI), 0.47-2.34] were associated with higher AI. Among participants who had quit smoking, higher pack-years were associated with higher AI (B = 0.85; 95% CI, 0.60-1.14) and central pulse pressure (B = 0.84; 95% CI, 0.46-1.21). Using restricted cubic splines, we observed a negative linear association for AI, but non-linear associations for characteristic impedance and central pulse pressure, with higher time since quit (all P < 0.001). Additionally, we observed non-linear patterns of central arterial measures with smoking cessation by smoking burden (<20 vs. ≥20 pack-years). In longitudinal models, we observed higher increases in AI among participants who persistently quit (4.62 ± 0.41%; P < 0.001) and persistently smoked (5.48 ± 0.70%; P = 0.002) compared with participants who never smoked (3.45 ± 0.37%). Central arterial measures are sensitive to differences and changes in smoking behaviour. Longer cessation may revert central arterial measures to levels observed with lower smoking exposure.

Test-Retest Reliability of a Timeline Follow-back Method to Assess Opioid Use and Treatment.

Calendar-based timeline follow-back (TLFB) instruments have been used to assess alcohol use, smoking, and other behaviors. We assessed test-retest reliability of an adapted TLFB addressing opioid-related outcomes over 120 days among opioid overdose survivors using nonprescribed opioids. The Repeated-dose Behavioral intervention to reduce Opioid Overdose Trial utilized a TLFB that collected data over the preceding 120 days. A subset of participants was administered a retest TLFB 3-21 days after their TLFB assessment. The test and retest assessed days of opioid and medication for opioid use disorder (MOUD) use, hospitalization, residential substance use disorder (SUD) treatment, incarceration, and overdose during overlapping time periods. For outcomes reported by ≥15% of the sample, intraclass correlation coefficients (ICC) were calculated between test and retest. ICC > 0.9 was considered "very high" reliability. For outcomes reported by <15%, frequencies were described; statistical tests were not conducted. Seventy-seven participants completed a retest. On the test/retest, most participants reported opioid (87%/83%) and MOUD (58%/60%) use. Median (IQR) number of days of opioid and MOUD use on the test/retest was 71 (25-117)/86 (23-108) and 4 (0-72)/5 (0-79) days. ICC between test and retest was >0.9 for both opioid and MOUD use. On test/retest, few participants reported hospitalization (8%/9%), residential SUD treatment (3%/3%), incarceration (5%/7%), or overdose (4%/3%). The adapted TLFB had very high reliability for self-reported opioid and MOUD use over 120 days. For less frequent outcomes, including overdose, a higher frequency or larger sample size is needed to assess reliability.

Relation of smoking behaviour with severity of COVID-19 infections in a sample of Iraqi patients

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Efficacy and safety of repetitive transcranial magnetic stimulation in the treatment of male smokers with tobacco use disorder: a randomized controlled trial

BackgroundTobacco use disorder (TUD) is a long-term condition marked by compulsive smoking, intense cravings, and withdrawal effects. Repetitive transcranial magnetic stimulation (r-TMS), which targets the left dorsolateral prefrontal cortex (DLPFC), has been identified as a promising therapeutic approach. However, research on the use of r-TMS for treating TUD in Egypt remains scarce. This study aimed to assess the effectiveness of active r-TMS in reducing smoking behavior, withdrawal symptoms, cravings, and nicotine dependence, in comparison to sham treatment, while also examining its tolerability as a treatment option for TUD.ResultsForty male smokers (aged 18–60 years) who smoked a minimum of 10 cigarettes per day for a minimum of 12 months were randomized into two groups: the active r-TMS group (n = 20) and the sham group (n = 20). Active r-TMS treatment, delivered over 15 sessions (5 sessions weekly for 3 consecutive weeks), significantly reduced the number of cigarettes smoked daily (p = 0.001), nicotine dependence (p = 0.023), withdrawal symptoms (both self-reported and observer-rated) (p = 0.001), and craving (p = 0.007) compared to the sham treatment. Urinary cotinine levels, a biomarker of nicotine intake, were also significantly lower in the active r-TMS group during the follow-up period (p = 0.011). The treatment was generally well-tolerated, with only minor side effects, such as headaches (22.5%).ConclusionsActive r-TMS targeting the left DLPFC effectively reduced nicotine dependence, withdrawal symptoms, and craving, demonstrating its potential as a promising treatment for TUD. These findings align with previous studies supporting the efficacy of r-TMS in addiction treatment. Further research is needed to optimize treatment protocols, explore combined therapies, and assess long-term outcomes to improve smoking cessation in diverse populations.

Depression as a Mechanism of Perceived Stress for Smoking Behavior Among Young Women: Cross-Sectional and Daily Diary Evidence

Depression as a Mechanism of Perceived Stress for Smoking Behavior Among Young Women: Cross-Sectional and Daily Diary Evidence

Profile and factors associated with low birth weight in Indonesia: a national data survey.

The third objective of the UN Sustainable Development Goals (SDGs), 'ensure healthy lives and promote well-being for all at all ages', is manifest in Indonesia's commitment to health. One of the SDG3 targets is to reduce under-five mortality and infant mortality. In rural areas of Indonesia, there is a lack of access to medical facilities (healthcare services, anthropometry tools) and health workers, so low birth weight (LBW, <2500 g) in rural areas remains high. This study aimed to determine the profile of and test the factors that cause LBW in Indonesia. This study used secondary data from the National Socio-Economic Survey/Survei Sosial Ekonomi Nasional (SUSENAS) 2021 with a national sample of 4 711 455 women (weighted), which is analyzed descriptively and inferentially. The analysis was conducted descriptively to determine the profile and distribution of LBW at the national and provincial levels, while inferential analysis was performed using logistic regression to determine the variables that most influence LBW. The prevalence of LBW in Indonesia was found to be 11.7%. North Maluku was the province with the highest LBW rate (20.1%), and West Java had the highest number of LBW infants in Indonesia, with 104 585 infants. This study found that smoking, rural areas, poor nutrition, age of childbirth, age and birth spacing significantly affected the incidence of LBW in Indonesia. In rural Indonesia, women tend to give birth to LBW babies (adjusted odds ratio: 1.249; 95%CI: 1.241-1.256). The incidence of LBW babies in rural areas was higher than in urban areas (12.9% v 10.8%) in Indonesia. This study concluded that smoking behavior is the main variable that influences the incidence of LBW in Indonesia. Therefore, there should be assistance to families by prioritizing significant factors for LBW (living in a village/rural area, low education, smoking behavior, not or rarely consuming nutritious food, maternal age at first birth 35 years and birth spacing <33 months). Especially for rural areas, governments need to improve access to healthcare facilities including availability of anthropometry tools, health workers, and healthcare services.

The effect of cigarette smoking and heated tobacco products on different denture materials; an in vitro study

PurposeThis study compares the effect of conventional cigarette smoke versus heated tobacco on the discoloration, surface roughness, and bacterial colonization of different oral prosthesis materials.Materials and methodsA total of one hundred and twenty disc-shaped samples made of four different denture base materials were prepared to represent different denture bases to assess the surface roughness and biofilm formation; group (CA): conventional heat-cured acrylic resin (Acrostone, Egypt), group (FA): flexible acrylic resin (Valplast International Corp, USA), group (TA): heat-cured acrylic resin reinforced with titanium nanoparticles (TA nanoparticles, Nanogate, Egypt), and group (PA): 3D printed acrylic resin (Nexdent, The Netherlands). Another sixty samples of artificial and 3D printed teeth were used to assess the color change: conventional ready-made acrylic resin teeth (Acrostone, Egypt) and 3D-printed acrylic resin teeth (Nexdent, The Netherlands). Each group was further divided according to the smoking method into three subgroups (n = 10): the no-smoking exposure group (C), the conventional smoking exposure group (CS), and the heated tobacco exposure group (HT). A custom-made smoking device was used to perform the experiment. Six hundred cigarettes/heets representing 30 days of medium smoking behavior (20 cigarettes/day) were used. The surface roughness of the disc-shaped samples was measured before and after the experiment using the JITAI8101 surface roughness tester (Beijing Jitai Tech Detection Device Co., Ltd, China), and the color parameters were assessed before and after the experiment using VITA Easyshade Advance 4.01 (VITA shade, VITA made, VITA).ResultsThe results showed that both conventional cigarette smoking and heated tobacco increased the surface roughness of the denture base disc samples. This change was statistically significant in all sample groups. Bacterial accumulation was also increased in all four denture base sample groups, with the heated tobacco causing greater bacterial accumulation than conventional cigarette smoke. Regarding the color change, conventional smoking caused a more significant color change than heated tobacco for both types of teeth used.ConclusionBoth conventional smoke and heated tobacco affect dental materials adversely. Conventional cigarette smoking caused greater surface roughness and discoloration of the samples, while heated tobacco resulted in greater bacterial accumulation of study materials.Clinical implicationsIncrease dentists’ and patients’ awareness of the effects of different types of smoke.

Efficacy and working mechanisms of a Go/No-Go task-based inhibition training in smoking: A randomized-controlled trial.

Deficits in inhibitory control contribute to smoking behavior. Inhibitory control training (ICT), which involves repeatedly inhibiting responses to general or substance-related stimuli, shows promise in reducing problematic substance use. This preregistered randomized-controlled trial is the first to investigate the efficacy of general and smoking-specific Go/No-Go task-based ICT on smoking behavior compared to control groups receiving no ICT. Three potential working mechanisms were examined: inhibitory enhancement, automatic stimulus-stop associations, and stimulus devaluation. Individuals who smoke (N=122) were randomly assigned to complete 28 sessions of smoking-specific Go/No-Go, general Go/No-Go, Sham training, or to a Waitlist control condition. Clinical outcomes included daily cigarettes (primary outcome), carbon monoxide levels, tobacco dependence severity, and craving, assessed at post-intervention and 3-month follow-up. Go/No-Go training resulted in a significantly greater reduction in tobacco dependence (β=-0.88, p=.004) and craving (β=-4.31, p=.012) post-intervention compared to both control groups. The greater reduction in craving remained significant when compared to the Sham training group only (β=-4.64, p=.026). No significant effects of group were observed on daily cigarette consumption (β=-1.97, p=.093) or carbon monoxide levels (β=2.16, p=.818) post-intervention. At the 3-month follow-up, no significant effects of group emerged (all ps>.794). Smoking-specific Go/No-Go training did not outperform general Go/No-Go training (all ps>.075). No working mechanism for clinical outcome improvements was identified. Preliminary evidence suggests that (smoking-specific) GNG training reduces tobacco dependence severity and craving post-intervention in individuals who smoke compared to non-ICT-based control conditions. Its efficacy as an add-on in smoking cessation needs to be investigated. DRKS00014652.

Predictors of Relapse in Women after Substance Use Treatment: A Cross-sectional Study in the West of Iran

Background: Many individuals undergo drug addiction treatment relapse after treatment. Additionally, a few studies have focused on the unique challenges faced by women in addiction recovery. Therefore, we aimed to identify predictors of relapse among women who have undergone drug addiction treatment to develop a more effective intervention program tailored to their needs. Methods: The present cross-sectional study evaluated 320 addicted women from Lorestan province, Iran, in 2020 who had used illegal substances. Convenience sampling was used to select participants from outpatient addiction treatment centers, triangular clinics, and rehabilitation centers. Demographic characteristics, drug use patterns, and risk factors for addiction were recorded. Predictors of relapse were evaluated using a negative binomial regression model. Results: The study included women with a mean age of 34.78±9.31 years who had a history of drug addiction relapse. Around 43.44% of the women were married and 36.88% lived with their husbands. Methamphetamine, opium, and heroin were the commonly used drugs. The study found that women with primary school education had a higher rate of relapse (IRR: 1.71, p = 0.01) and women with husbands being substance users (IRR: 1.34, p = 0.014), history of imprisonment (IRR: 1.51, p = 0.002), smoking (IRR: 1.91, p &lt; 0.001), and alcohol consumption (IRR: 1.49, p = 0.005) were also associated with a higher rate of relapse. Conclusion: In conclusion, this study found that women with primary school education, husbands being substance users, history of imprisonment, smoking, and alcohol consumption behavior had a higher rate of relapse. By addressing the identified predictors of relapse, such programs can improve the success rate of addiction treatment and promote long-term recovery among women. In addition, this study highlights that addiction relapse is not necessarily caused by a single factor, and several different personal and environmental factors can influence this issue.

Influence of lateral ambient wind speed on fire smoke behavior in tunnel with unpowered ventilation caps shaft

Influence of lateral ambient wind speed on fire smoke behavior in tunnel with unpowered ventilation caps shaft

Tobacco Withdrawal and Cigarette Reinforcement as Mechanisms Underlying the Effects of Reduced Nicotine Content Cigarettes on Adolescent Smoking Behavior

Tobacco Withdrawal and Cigarette Reinforcement as Mechanisms Underlying the Effects of Reduced Nicotine Content Cigarettes on Adolescent Smoking Behavior

Sex differences in dorsal striatal volume and interest in quitting smoking.

Over the recent decades, smoking among women has become an increasingly pressing public health challenge. Mounting evidence suggests that, compared to men, women's smoking is more strongly influenced by habitual responses to sensorimotor cues. To understand the brain mechanisms underlying the cessation challenges commonly reported by women who smoke, the present study used voxel-based morphometry (VBM) to investigate sex-related volumetric differences in the dorsal striatum, a region implicated in habitual substance use behavior, and their associations with self-reported quit interest among daily smoking adults. Structural magnetic resonance imaging (MRI) data were collected from 41 women and 52 men (30.1 ± 7.5 years) who reported smoking an average of 15-40 cigarettes per day for at least past 24 months. Multiple regression analyses were carried out with sex and average gray matter volumes (GMV) of predetermined brain regions of interest (ROIs; bilateral caudate, putamen) and control regions (bilateral nucleus accumbens, thalamus) as predictors of self-reported interest in quitting smoking. Women displayed greater striatal GMV and lower current quit interest than men. ROI-based analyses revealed an interaction between sex and putamen GMV, wherein putamen GMV was more strongly and negatively linked to quit interest in women than men. Greater GMV in the putamen could be linked to an attenuated desire to stop smoking among women. This may serve as a neuroanatomical mechanism underlying the higher prevalence of habit-driven smoking behavior observed in women as compared to men.

Long-term engagement in smoking cessation campaign: A mixed methods randomized trial.

A long-term engagement (LTE) intervention was embedded in a social marketing campaign aimed at motivating quit attempts among Canadian adult commercial tobacco users 35 to 64 years of age. The purpose of this study was to examine the effectiveness and appeal of LTE within a marketing campaign. 3,199 Canadians who smoked cigarettes aged 35-64 recruited using Facebook and Instagram advertisements were randomized into Intervention and Control groups. Over the course of two years, Intervention Group participants received monthly emails connecting them to campaign news and activities, Mini Surveys to inform campaign refinement, feedback opportunities via focus groups and interviews, financial incentives, and proactive knowledge exchange presenting study findings. Both groups responded to a baseline and follow-up surveys every six months. LTE Intervention Group participants engaged frequently with emails (unique opens, open rates, click rates, and total clicks). Compared with Control Group members, they had significantly higher rates of: unaided and aided campaign awareness; engagement with the social marketing campaign (website visits, social media visits, likes/shares); actions towards making quit attempts; quit attempts. Many participants expressed feelings of motivation, support, and a sense of belonging. When embedded in a social marketing campaign, meaningful long-term engagement of adults who smoke cigarettes shows promise as an intervention to promote quitting behaviors. Active long-term engagement can significantly amplify the effects of social marketing campaigns aimed at promoting quit smoking behaviours among adults. The active engagement approach applied indicates that frequent long-term engagement is more effective when done in a more holistic, empathetic manner. The intervention also allows for real-time learning to support campaign development. ISRCTN94797633.

Psychological, social and cultural influences on smoking among lesbian, bisexual and queer women

BackgroundSmoking rates have declined markedly in Australia over time; however, lesbian, bisexual and queer (LBQ) women continue to smoke at higher rates than heterosexual women. Understanding the factors influencing smoking...

Exposure to major coronary heart disease events reduces lung cancer risk: a mendelian randomization study based on a European population

ObjectiveThis study seeks to elucidate the causal relationship between major coronary heart disease events (MCHDE) and lung cancer incidence through mendelian randomization (MR), with the goal of providing evidence to inform more effective lung cancer screening and prevention strategies.MethodsUtilizing data from the IEU OpenGWAS project and FinnGen, this study employed a two-sample MR approach, with genetic variants serving as instrumental variables. Relevant single nucleotide polymorphisms (SNPs) associated with MCHDE and lung cancer were carefully selected, with particular attention given to mitigating potential confounders, such as smoking behaviors and statin use.ResultsThe MR analysis, utilizing FinnGen's MCHDE as the exposure factor, revealed a significant reduction in the incidence of non-small cell lung cancer (NSCLC) [odds ratio (OR) 0.893, 95% confidence interval (CI) 0.800–0.998] and small cell lung cancer (SCLC) [OR 0.684, 95% CI 0.500–0.936], highlighting the protective effect of MCHDE against these cancer subtypes. However, this protective effect was not observed for other types of lung cancer. Furthermore, substituting FinnGen's MCHDE with that from IEU OpenGWAS did not yield similar protective effects across various lung cancer subtypes.ConclusionsThis study suggests that MCHDE reduce the risk of NSCLC in the U.K. population and SCLC in the Finnish population. However, given that the underlying mechanism through which MCHDE reduces the risk of NSCLC and SCLC remains unclear, it is premature to conclude that individuals exposed to MCHDE do not require lung cancer screening.

Modeling the determinants of cigarette consumption in Iranian households with children under 5 years of age using the Income and Expenditure Survey 2021

BackgroundCigarette smoking remains a significant public health concern, with detrimental effects on both smokers and those exposed to secondhand smoke. This study investigates the factors influencing smoking behaviors in Iranian households, focusing on households with children under five years old.MethodsWe conducted a cross-sectional analysis of 8751 Iranian households using data from the Iranian Household Income and Expenditure Survey (HIES) collected by the Statistical Center of Iran (SCI) in 2021. A variety of count regression models were examined, including Poisson (P), Negative Binomial (NB), Generalized Poisson (GP) and their zero-inflated counterparts. The best fitting model was selected based on goodness-of-fit indices.ResultsApproximately 87% of households were non-smokers, with a mean daily cigarette consumption of 14.29 (SD = 8.64) among smokers. The three-level Zero-Inflated Generalized Poisson (TL-ZIGP) model was considered a suitable model for the interpretation of the data. Key predictors of smoking included older age, male gender, lower education, higher income, and larger homes. Homeownership was negatively associated with smoking. Considerable geographic variation in smoking prevalence was observed.ConclusionsSocioeconomic and demographic factors, including lifestyle and geographic regions, are associated with smoking behavior among Iranian households. A three-level ZIGP regression model is appropriate for analyzing these complex relationships. This study reveals different patterns of smoking prevalence in different population subgroups and emphasizes the need for targeted interventions to effectively reduce smoking rates.

Closing Tobacco Treatment Gaps for Rural Populations: The Role of Clinic-Based Pharmacists at a Federally Qualified Health Center

Pharmacists are often the first point of contact for healthcare advice in rural communities, where access to healthcare is limited. Tobacco cessation rates improve with counseling from a pharmacist, and in many states, pharmacists can now prescribe medications for quitting. This study aimed to explore smoking behavior and cessation motivations among patients at a Federally Qualified Health Center (FQHC) clinic in rural Wyoming, estimate the prevalence of tobacco-related interventions by clinic staff, and assess patients’ interest in engaging in pharmacist-led cessation programs. A cross-sectional survey was administered over three months to clinic patients who self-identified as current tobacco users. Survey items assessed sociodemographics, tobacco use and vaping behaviors, previous cessation advice from pharmacists, and interest in pharmacist-led support for quitting. Of 63 respondents, 57 (90.5%) reported current tobacco use. Most were ready to quit within the next month (43.9%) or the next six months (33.3%), and 26.3% had previously received advice about quitting from a pharmacist. Most (59.6%) expressed interest in establishing care with a pharmacist for cessation support, and 45.3% requested to be contacted by a pharmacist for assistance with quitting. Interest did not differ by gender or age. The results indicate that rural patients are interested in engaging with pharmacists for quitting. Further research is needed to determine how pharmacy-led programs can complement existing healthcare resources to improve access to cessation support in underserved areas.