Changes In Smoking Behavior Research Articles

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.

Behavior Changes for Smokers and Betel Quid Chewers Participating in the Organized Oral Mucosal Screening Between 2010 and 2021 in Taiwan

Objective: To investigate the likelihood of smoking and betel quid chewing behavior changes, as well as the associated factors, among subjects in a nationwide oral cancer screening program in Taiwan, where oral cancer is the fourth leading malignancy in men. Methods: The Taiwanese Oral Cancer Screening Program targets smokers and betel quid chewers over the age of 30. Between 2010 and 2021, 2,578,245 individuals participated in the program at least twice. During each visit, the central data monitoring center collected information on gender, age, education level, smoking and betel quid chewing habits, the quantities consumed, and diagnoses of oral potentially malignant disorders (OPMDs) and oral cancer. A three-state Markov chain exponential regression model was employed to assess the probabilities of behavior change—deterioration, maintenance, or improvement—and the factors influencing these changes. Results: The largest proportion of both smokers and betel quid chewers remained unchanged in the repeated attendees. The smoking cessation transition result was less than 10%, whereas the reduction in dosage exceeded 20%. However, the discontinuation of betel quid chewing was observed in more than 20% of individuals in the low-dose group, and there was also a reduction in dosage of more than 20%. The positive OPMDs caused the progression of the Net Force Progression (NFP) from an initial stage of none, as well as the NFP between low and high doses of both smoking and betel quid chewing. Higher levels of education, residing in urban areas, and receiving screenings in large hospitals help to avoid the progressive NFP between low and high doses of smoking. Additionally, these factors also help to prevent the development of the NFP from an initial stage of none, as well as the progressive NFP between low and high doses of betel quid chewing. Conclusion: Participation in an oral cancer screening program can effectively enhance hazardous oral behaviors, including smoking and betel quid chewing. Although it may not have a substantial effect on smoking cessation, it can decrease the daily consumption of cigarettes. This approach demonstrates encouraging outcomes in encouraging individuals to quit betel quid chewing and decrease their daily consumption. Higher levels of education, urban residency, and receiving screenings at large hospitals all have a good impact on reducing dangerous oral cancer behaviors.

A Study on Adolescent Smoking Prevention and Cessation Policies: Based on the Propensity Score Matching-Difference-in-Differences Method.

Introduction: Adolescent smoking can lead to various health problems including atherosclerosis and cardiovascular disease, making it more difficult to quit smoking during adulthood. This study aims to evaluate the effect of the ordinance by assessing adolescents' smoking cessation behaviors and environmental conditions, according to the "Ordinance for the Prevention of Child and Adolescent Smoking and Support for Smoking Cessation", which was enacted in 2019 in Gwangju City, South Korea, for the first time in the country. Methods: The data for the analysis were obtained from the 2018 and 2021 Korea Youth Risk Behavior Survey. Propensity score matching (PSM) ensured homogeneity between ordinance-adopted and non-adopted areas, followed by a difference-in-differences (DID) analysis to assess changes in adolescent smoking behavior, secondhand smoke exposure, and related advertisements. Results: The difference-in-differences analysis of the homogeneous treatment and control groups in 2018 and 2021 showed statistically significant reductions in the variables "experience of secondhand smoke indoors at school" in the secondhand smoke category, and "exposure to smoking advertisements in convenience stores" in the smoking advertising category. However, there were no statistically significant changes in the other eight variables, such as smoking behavior and smoking cessation advertising. Conclusions: The results of this study suggest that the ordinance enacted in Gwangju Metropolitan City in 2019 created a positive environment for smoking prevention in convenience stores and schools for adolescents. Furthermore, if the ordinance is supplemented with the management of smoking behaviors and smoking cessation advertisements, it is expected to achieve the main purpose of the policy, which is to protect adolescents from smoking.

Effects of smoking behavior change on diabetes incidence after cancer development: A nationwide cohort study.

Cigarette smoking and diabetes mellitus (DM) increase risks of cardiovascular diseases and all-cause mortality in cancer survivors. An increased risk of DM incidence in cancer survivors has been observed and smoking is an important modifiable risk factor for DM development in the general population. Thus, we investigated the association between smoking behavior change after cancer diagnosis and DM incidence in cancer survivors. This retrospective cohort study using the Korean National Health Insurance System database included patients with newly diagnosed cancers between 2010 and 2016. Smoking behavior changes after cancer diagnosis were categorized as never smoker, ex-smoker, quitter, smoking starter, and persistent smoker. The associations between smoking behavior changes and DM incidence in overall and specific cancers were investigated using Cox regression analyses. Of the 263,940 cancer survivors, 67.6 % were never smokers, 16.0 % were ex-smokers, 9.3 % were quitters, 1.0 % were smoking starters, and 6.2 % were persistent smokers. During a mean follow-up of 4.0 years, 12,175 patients were diagnosed with DM after cancer development. Compared to the never smokers, the adjusted hazard ratios (95 % confidential interval) of DM incidence were 1.06 (1.00-1.13) for ex-smokers, 1.45 (1.35-1.54) for quitters, 1.46 (1.25-1.71) for starters, and 1.57 (1.45-1.69) for persistent smokers. Compared with never smokers, cancer survivors who engaged smoking at any point before or after cancer diagnosis showed an increased risk of DM incidence after cancer diagnosis. Cancer survivors should be advised to quit smoking promptly and to maintain abstinence throughout cancer survivorship.

Cross-sectional study of partners’ tobacco consumption during their spouse’s pregnancy

Background A smoking partner is a major risk factor for passive smoking and continued maternal smoking. Objective To assess the smoking habits, knowledge, and information received to stop smoking of smoking partners during their spouse’s pregnancy. Method This was a cross-sectional study of partners who smoked at the start of pregnancy and whose spouses had just given birth. Recruitment was carried out in maternity hospitals in the Auvergne-Rhône-Alpes region from June 2021 to December 2021. Data were collected using a self-administered questionnaire. Results A total of 105 men using tobacco were recruited, average age 34 years (± 6.4). Of these, 46 (44%) had modified their consumption during pregnancy: 11 (10.5%) had stopped smoking until maternity hospital entry, 24 (23%) had cut down and 11 (10.5%) had relapsed after initial total cessation. A multivariate analysis revealed a statistically significant relationship between men’s change in smoking behaviour during pregnancy and a first pregnancy, an overweight participant, not living in a rural area, and information provided by the General Practitioner (GP). GPs are the first point of contact for participants looking for help to quit smoking. Among men who have not changed their smoking habits, 46% have not received any information from health professionals. Conclusions Intervention and medical information provided by GPs to smoking partners may be associated with changes in smoking habits during pregnancy. Additional prospective, comparative studies are needed to support a robust conclusion.

The effects of emotional distress on attentional bias toward cigarette warnings according to smokers' anxiety levels.

Anxiety is related with the substance use, including cigarette smoking. Avoidance is one of the strategies smokers with anxiety adopt to manage negative affect, which can be contradictory to a strategy of cigarette warnings that is used to induce negative affect to change smoking behaviors. Therefore, this study examined whether smokers' anxiety levels decrease their attentional biases toward cigarette warnings, especially in response to emotional distress. High-anxiety (n = 60) and low-anxiety (n = 60) smokers were randomly assigned to either a stress condition that utilized the PASAT-C task (Paced Auditory Serial Addition Task-Computer version) or a controlled condition. With the eye-tracking task that involved viewing 8 visual stimuli of cigarette packs composed of warnings and brandings, time to first fixation and fixation duration to warnings compared to brandings were measured both pre and post conditions. The results revealed that high-anxiety smokers detected warnings faster after stress conditions while low-anxiety smokers showed the consistent time to first fixation on warnings. In terms of fixation durations, high-anxiety smokers showed hypervigilance toward warnings that are considered to be a threat, but low-anxiety smokers showed avoidance under stress conditions, particularly toward social-focused warnings. These results indicate that high-anxiety smokers are more vulnerable to emotional distress and have an attentional bias toward fear appeals. Despite hypervigilance, they had greater psychological reactance toward warnings that the conflict between avoidance and hypervigilance might have contributed to, so the effectiveness of fear appeals may be limited regardless of the increased fixation duration.

Association of Tobacco Dependence Treatment Coverage Expansion with Smoking Behaviors among Medicaid Beneficiaries Living with Substance Use Disorder

Many U.S. states expanded the generosity of Medicaid insurance coverage of tobacco dependence treatment (TDT) over the last fifteen years, but little is known about how coverage impacts cigarette smoking, especially for individuals with substance use disorder (SUD). Data are from the 2009-2018 National Survey on Drug Use and Health (NSDUH) and include Medicaid beneficiaries 18-64 years old with past year SUD who smoked at least 100 cigarettes in their lifetime. Outcomes were smoking cessation, nicotine dependence, and number of cigarettes smoked per month. Difference-in-differences models were estimated for smoking behavior by state and year of comprehensive TDT coverage, estimating multivariable linear probability models, adjusted for sociodemographic characteristics, co-occurring mental illness, and area-level provider supply. All data were analyzed in 2023 and 2024. Rates of nicotine dependence among individuals with past-year SUD increased slightly between 2009 and 2018 among individuals living in states with comprehensive TDT coverage (55.6% to 58.6%) and changed little among individuals living in states with no or partial TDT coverage (60.0% to 59.5%). Quit rates increased for individuals with SUD during this time, with no differences by comprehensive TDT coverage. In adjusted models, no significant association between comprehensive Medicaid TDT coverage and smoking behaviors was identified (e.g., cessation: β=-0.02, CI [-.08, .04]). One-year lagged outcomes and sensitivity analyses accounting for the differential time of initiation of state policies demonstrated similar results. Comprehensive TDT coverage had no differential effect on smoking cessation among ever smokers with or without SUD, and its expansion was not associated with changes in smoking behaviors for Medicaid beneficiaries with SUD. Other multilevel interventions may be needed to impact smoking cessation rates, such as awareness and education campaigns of expanded TDT coverage benefits, and interventions that reduce social and structural barriers to treatment.

Connectivity-Based Real-Time Functional Magnetic Resonance Imaging Neurofeedback in Nicotine Users: Mechanistic and Clinical Effects of Regulating a Meta-Analytically Defined Target Network in a Double-Blind Controlled Trial.

One of the fundamental questions in real-time functional magnetic resonance imaging neurofeedback (rt-fMRI NF) investigations is the definition of a suitable neural target for training. Previously, we applied a meta-analytical approach to define a network-level target for connectivity-based rt-fMRI NF in substance use disorders. The analysis yielded consistent connectivity alterations between the insula and anterior cingulate cortex (ACC) as well as the dorsal striatum and the ACC. In the current investigation, we addressed the feasibility of regulating this network and its functional relevance using connectivity-based neurofeedback. In a double-blind, sham-controlled design, 60 nicotine users were randomly assigned to the experimental or sham control group for one NF training session. The preregistered primary outcome was defined as improved inhibitory control performance after regulation of the target network compared to sham control. Secondary outcomes were (1) neurofeedback-specific changes in functional connectivity of the target network; (2) changes in smoking behavior and impulsivity measures; and (3) changes in resting-state connectivity profiles. Our results indicated no differences in behavioral measures after receiving feedback from the target network compared to the sham feedback. Target network connectivity was increased during regulation blocks compared to rest blocks, however, the experimental and sham groups could regulate to a similar degree. Accordingly, the observed activation patterns may be related to the mental strategies used during regulation attempts irrespective of the group assignment. We discuss several crucial factors regarding the efficacy of a single-session connectivity-based neurofeedback for the target network. This includes high fluctuation in the connectivity values of the target network that may impact controllability of the signal. To our knowledge, this investigation is the first randomized, double-blind controlled real-time fMRI study in nicotine users. This raises the question of whether previously observed effects in nicotine users are specific to the neurofeedback signal or reflect more general self-regulation attempts.

Considerations for Future Research and Methodological Clarifications on Smoking Behavior Change and Heart Failure Risk in Patients With Type 2 Diabetes.

Considerations for Future Research and Methodological Clarifications on Smoking Behavior Change and Heart Failure Risk in Patients With Type 2 Diabetes.

Association Between Temporary Employment and Current Smoking and Change in Smoking Behaviors: A Prospective Cohort Study From South Korea (2009–2018)

Previous studies have suggested that employment insecurity is associated with adverse health outcomes. We explored the association between temporary employment and smoking behaviors. We analyzed 11,795 workers (51,867 observations) from the Korea Health Panel Study (2009-2018). Employment types were categorized as regular, fixed-term, or daily, based on the duration of labor contract. The outcomes were current smoking status and changes in smoking behavior (initiation or cessation) in the following year. Generalized estimating equations were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). The proportions of fixed-term and daily workers were 41.2% and 16.4% for women and 23.6% and 12.4% for men, respectively. Temporary employment was associated with increased odds of current smoking, while also demonstrating prospective associations with changes in smoking behaviors. For instance, in prospective analyses, male workers with fixed-term and daily employments were associated with a decreased likelihood of smoking cessation (OR 0.77; 95% CI, 0.65-0.91 for fixed-term employment and OR 0.66; 95% CI, 0.52-0.83 for daily employment) in the following year compared to those with regular employment. Moreover, those experiencing consecutive temporary employment was most inversely associated with smoking cessation in both men (OR 0.56; 95% CI, 0.44-0.71) and women (OR 0.37; 95% CI, 0.16-0.85) compared to those experiencing consecutive regular employment. However, no clear association between temporary employment and smoking initiation was observed in both men and women. Temporary employment is directly associated with current smoking and inversely associated with smoking cessation. Policies are needed to improve job insecurity among temporary employees.

Shifts in motivation to quit cigarette smoking associated with IQOS use

IntroductionIQOS, a heated tobacco product (HTP), is among a growing number of noncombustible nicotine delivery alternatives marketed to people who smoke combustible cigarettes and are interested in less harmful alternatives. Little is known regarding whether IQOS use and IQOS-associated effects impact motivation to quit cigarette smoking. MethodsNon-treatment-seeking adult daily smokers (n = 87) completed a within-subjects study consisting of a baseline ad-lib smoking period (days 1–5), two laboratory visits (days 6–7) involving IQOS exposure, and a two-week period where participants were instructed to switch from smoking cigarettes to using IQOS (days 8–21). Motivation to quit smoking was measured on days 1 and 22. ResultsA generalized linear model revealed a significant increase in motivation to quit smoking across the 14-day switch phase with an increase of 1.47 ladder steps (Δ=1.47, sd = 1.98, t(86) = 6.92, p < 0.0001), increasing from 5.30 to 6.80. Candidate predictors were identified through a stepwise selection procedure, which resulted in a final model with two predictors, the standardized HeatStick substitution rate (b = 0.54, (CI95% 0.13–0.95), p = 0.01) and standardized relative risk perception score (b = 0.45, (CI95% 0.04–0.85) p = 0.03), ConclusionsAmong those uninterested in quitting cigarette smoking within the next month, IQOS use was associated with increased motivation to quit. Motivation to quit smoking may not be a necessary prerequisite for promoting smoking behavior change but rather bolstered by smoking behavior change in the context of HTP use. Greater perceptions of risk reduction may ultimately aid the transition from combustible to noncombustible tobacco products.

Impact of Pictorial Health Warnings on Cigarette Packs among Current Smokers of Sub-Metropolitan City of Nepal: A Descriptive Cross-sectional Study

Introduction: Pictorial health warning on cigarette packs is one of the strategies undertaken by Nepal Government as per the directive of World Health Organization Framework Convention on Tobacco Control to control smoking. It has been more than a decade since the introduction of pictorial health warnings on cigarette packs in Nepal. The objective of this study was to assess the impact of the pictorial warnings among current smokers of Dharan, Nepal.Methods: A descriptive cross-sectional study was conducted among current smokers visiting local shops located near ward offices of Dharan after obtaining ethical approval from Institutional Review Committee (Reference number: 204/080/01 -IRC). A structured and validated Nepali questionnaire was used to interview the smokers about the impact of the pictorial warnings based on their noticeability, behavioural and cognitive responses. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 20.0. The responses of the participants were tabulated in frequencies and percentages.Results: The pictorial warnings were noticed by 277 (98.93%) participants in past one month out of which 11 (3.93%) smokers had always read or looked closely at them. Smoking less frequently was the behaviour change reported by 70 (25%) participants and smoking less around others was reported by and 56 (20%) participants. In total, 189 (67.50%) smokers had thought about the harms of smoking and 160 (57.14%) had intention to quit smoking due to the pictorial warnings.Conclusions: The pictorial health warnings were not so effective in bringing about changes in smoking behaviour of smokers.

The Role of Health Education by Community Nurses in Reducing Smoking Habits in Adolescents

This study explores the role of health education by community nurses in reducing smoking habits among adolescents through qualitative interview methods. The background of this problem is rooted in the long-term health impact of smoking habits, which are often influenced by factors such as peer influence and advertising, as well as a lack of knowledge about the dangers of smoking. The purpose of this study is to understand how health education can affect changes in adolescents' smoking knowledge, attitudes, and behaviors, as well as to assess the role of social support from the family. The method used was in-depth interviews with 20 adolescents who had participated in a health education program guided by a community nurse. The interview data was analyzed using thematic analysis techniques to identify key patterns and themes. The results showed that health education significantly increased adolescents' knowledge about the dangers of smoking and improved their attitudes towards the habit. Teens also reported gaining practical skills to resist the offer of smoking, and family support played an important role in their success in quitting smoking. The implications of this study emphasize the importance of integrating health education with family support to increase program effectiveness. Health education programs by community nurses must be continued and expanded, involving other elements of society, and adapted to the needs of adolescents and technological developments. Support from various parties, including government policies and health agencies, is critical to strengthening these programs and creating an environment that supports the overall health of adolescents Keywords : Health Education, Community Nurses, Smoking, Adolescents

From prevention to treatment: Prescription medication, information, and health behaviors.

Medical innovations may lessen the perceived risk of disease which can decrease the take-up of healthy behaviors, a phenomenon known as risk compensation. In contrast, a diagnosis provides updated information about the state of one's health which may motivate positive behavior change. In this paper, I consider how behavior changes in response to a diagnosis of cardiovascular disease (CVD) before and after the FDA approval of new classes of drugs to treat high blood pressure and high cholesterol in 1973. I find that individuals diagnosed with CVD are more likely to follow a diet and decrease body-mass index in response to the diagnosis, irrespective of medication approvals. Nonsmoking is a notable exception. Prior to medication availability, there is no change in smoking behavior in response to a CVD diagnosis. Conversely, when medication is available, there is a significant decline in smoking. The empirical complementarity of medication and smoking cessation may be driven by increased exposure to medical professionals (who emphasize the harms of smoking) or because medication decreases the risk of CVD death which heightens the importance of investing in future health.

Pendampingan Remaja untuk Berhenti Merokok dengan Pendekatan Transtheoretical Model (Stages of Change) di Posyandu Remaja Desa Mliwis Boyolali

The partner for community service activities was the youth posyandu in Tambakboyo Hamlet, Mliwis. Adolescent boys at Mitra Posyandu have a smoking habit. There were 25% of teenage boys who have tried to stop smoking but failed. The problems faced by posyandu partners are the difficulty of generating teenagers' intention to stop smoking, teenagers also don't know how to stop smoking, and there are still many teenagers who relapse or smoke again even though they are already at the action stage. The aim of this program was to provide smoking cessation education and health messages with the stages of change in smoking behavior in each adolescent using a transtheoretical model approach and monitoring and strengthening smoking cessation by adolescent cadres. The methods used were socializing activities to youth posyandu, providing media on how to stop smoking, providing education regarding efforts to stop smoking, training youth cadres, designing applications for monitoring efforts to stop smoking, and assisting teenagers to stop smoking. The results of this service were that there was an increase in adolescent knowledge by 0.17% after being given smoking cessation education, the formation of peer counselors consisting of adolescent cadres, the existence of health media in the form of pocket books and booklets, and the creation of the Smoke Stop Step (3S) application to monitor efforts of quit smoking. After using the application and providing health messages according to the smoking cessation stages, there were 3 teenagers who started to intend to stop smoking and 1 teenager entered the preparatory stage (preparing to stop smoking).

A Novel mHealth App for Smokers Living With HIV Who Are Ambivalent About Quitting Smoking: Formative Research and Randomized Feasibility Study.

More people who smoke and are living with HIV now die from tobacco-related diseases than HIV itself. Most people are ambivalent about quitting smoking and want to quit someday but not yet. Scalable, effective interventions are needed to motivate and support smoking cessation among people ambivalent about quitting smoking (PAQS) who are living with HIV. This study aims to develop an app-based intervention for PAQS who are living with HIV and assess its feasibility, acceptability, and potential impact. Results of this study will inform plans for future research and development. In phase 1, PAQS living with HIV (n=8) participated in user-centered design interviews to inform the final intervention app design and recruitment plan for a subsequent randomized pilot study. In phase 2, PAQS living with HIV were randomized to either a standard care control app or a similar experimental app with additional content tailored for PAQS and those with HIV. Participants were followed for 3 months. Feasibility focused on recruitment, retention, and participants' willingness to install the app. The study was not powered for statistical significance. Indices of acceptability (satisfaction and use) and impact (smoking behavior change and treatment uptake) were assessed via automated data and self-report among those who installed and used the app (n=19). Recruitment for both study phases was a challenge, particularly via web-based and social media platforms. Enrollment success was greater among people living with HIV recruited from a health care provider and research registry. Once enrolled, retention for the phase 2 randomized study was good; 74% (14/19) of the participants completed the 3-month follow-up. Phase 1 findings suggested that PAQS living with HIV were receptive to using an app-based intervention to help them decide whether, when, and how to stop smoking, despite not being ready to quit smoking. Phase 2 findings further supported this conclusion based on feedback from people who agreed to use an app, but group differences were observed. Indices of acceptability favored the experimental arm, including a descriptively higher mean number of sessions and utilization badges. Similarly, indices of potential impact were descriptively higher in the experimental arm (proportion reducing smoking, making a quit attempt, or calling free tobacco quitline). No participants in either arm quit smoking at the 3-month follow-up. On the basis of this formative work, PAQS living with HIV may be receptive to using a mobile health-based app intervention to help them decide whether, when, or how to stop using tobacco. Indices of acceptability and impact indicate that additional research and development are warranted. ClinicalTrials.gov NCT05339659; https://clinicaltrials.gov/study/NCT05339659.

Association between Smoking Habit Changes and the Risk of Myocardial Infarction in Ischemic Stroke Patients: a Nationwide cohort study.

Smoking is a well-known risk factor for cardiovascular diseases, including myocardial infarction (MI) and ischemic stroke (IS). While the relationship between smoking and the risk of cardiovascular diseases is established, the impact of changing smoking habits post-IS on the risk of subsequent MI remains unclear. This study aims to elucidate the effects of alterations in smoking behavior following an IS diagnosis on the likelihood of experiencing an MI. Utilizing data from the Korean National Health Insurance Services Database, this nationwide population-based cohort study included 199,051 participants diagnosed with IS between January 2010 and December 2016. Smoking status was categorized based on changes in smoking habits before and after IS diagnosis. The association between changes in smoking behavior and the risk of subsequent MI was analyzed using multivariable Cox proportional hazard regression models. During a median follow-up of 4.17 person-years, a total of 5,734 (2.88%) patients were diagnosed with MI after IS. Smoking quitters (2.93%) or former smokers (2.47%) have a similar or lower rate of MI than the average, even if they have smoked cigarettes, while sustained smokers (3.46%) or new smokers (3.81%) have much higher rates of MI. Among sustained and new smokers, the risk of incident MI were significantly higher than never smokers (new smoker adjusted HR [aHR]: 1.496, 95% CI 1.262-1.774; sustained smoker aHR 1.494, 95% CI 1.361-1.641). Also, among the study participants, approximately two-thirds continued smoking after their IS diagnosis. Changing smoking habits after an IS diagnosis significantly influences the risk of subsequent MI. Specifically, continuing or starting to smoke after an IS diagnosis is associated with a higher risk of MI. These results underscore the importance of targeted smoking cessation interventions for stroke patients to reduce the risk of subsequent myocardial infarction.

Food Resource Management and Healthy Eating Focus Associates with Diet Quality and Health Behaviors in Low-Income Adults.

Nutrition education and food resource management (FRM) can assist food-insecure individuals in acquiring healthy and affordable food. We aimed to assess the relationships between FRM skills and healthy eating focus with diet quality and health-related behaviors in low-income adults during the COVID-19 pandemic. This cross-sectional study was conducted using an online survey of 276 low-income adults living in a low-food-access community in Northeast Connecticut. Through analysis of covariance, adults who usually or always had a meal plan, considered reading nutrition labels important, made a grocery list, were concerned about their food healthiness, and rated their diet quality as very good/excellent reported higher diet quality (frequency-based and liking-based scores) (p < 0.05 for all). Individuals who considered reading food labels very important and reported having a good diet reported less frequent pandemic-related unhealthy behaviors (consumption of candy and snack chips, soda or sugary drinks, weight gain, smoking) (p < 0.001). Furthermore, higher-frequency-based diet quality was associated with lower risk of overweight or obesity (OR: 0.37; 95% CI: 0.18, 0.76; p-trend < 0.01). Thus, FRM skills and healthy eating focus were associated with higher diet quality and healthier self-reported changes in diet, weight, and smoking behaviors during the pandemic.

The Influence of Health Education on Community Knowledge about the Dangers of Smoking in the Working Area of the Paal Merah I Community Health Center, Jambi City in 2024

Smoking is a bad habits that can have a bad impact on your own health and that of others. Cigarettes are wrapped tobacco products that come from plants such as Nicotiana tabacum and Nicotiana rustica, or they can also be synthetic products containing nicotine and tar, with or without the addition of other ingredients. This research aims to determine the effect of health education on public knowledge about the dangers of smoking in the Paal Merah I Community Health Center Working Area, Jambi City in 2024. This research uses the Wilcoxon test which shows that there is a significant difference between before and after the education was implemented. These findings confirm that health education is effective in increasing public knowledge about the dangers of smoking. Using a semi-experimental method, this research involved a pretest and posttest on 19 respondents selected from three areas that had the highest smoking rates, namely RT.11, RT. 25, and RT.35 Paal Merah Village. The results of the normality test showed that the data was not normally distributed, which means there was a correlation between before the counseling was carried out and after the counseling was carried out. Thus, health education efforts have the potential to change smoking behavior and contribute to efforts to prevent tobacco-related diseases. It is hoped that the intervention steps taken will help reduce the prevalence of smoking at the household level and improve overall public health in the area.

Effect of Ramadan fasting on changes in smoking and vaping behaviors and withdrawal symptoms severity: a cross-sectional study

Background Ramadan fasting, an obligatory duty for adult Muslims, entails refraining from eating, drinking, smoking, and vaping from dawn until sunset. Throughout Ramadan, people accept major changes to daily routines. Consequently, Ramadan is associated with abstinence symptoms and changes in smoking or vaping behavior. Aim The study aims to assess the presence of withdrawal symptoms and its severity, as well as smoking or vaping behavior change and its determinants during Ramadan fasting. Methods A cross-sectional study was conducted during Ramadan in 2023. Data were collected online using a Google form, including questionnaires assessing socio-demographic data, nicotine dependence using Fagerstrom Test for Nicotine Dependence, vaping and shisha smoking, presence and severity of physiological and psychological withdrawal symptoms and its coping strategies. Smoking and vaping behavioral change during Ramadan and its contributing factors were also evaluated. Results A total of 251 participants (96% males), mean age ± standard deviation (33 ± 12.1) were surveyed. Withdrawal symptoms were reported among 70.5%, however, their severity was generally low both physiologically and psychologically. Education, nationality, smoking duration, nicotine dependence, and the amount of consumed E-liquid per day were the independent predictors of withdrawal symptoms presence. Attempts to quit smoking and vaping were reported by 54.6% of the participants; young age and higher educational levels were the factors associated with more quitting attempts. Conclusions The withdrawal symptoms severity linked to Ramadan fasting is minimal. Many smokers and vapers made attempts to quit during Ramadan. Ramadan presents a chance for smoking and vaping cessation with some behavioral support.