Smoking Cessation Research Articles

Factors Related to Tobacco Cessation Attempts Among Turkish Adolescents: A Structural Equation Model Analysis.

The Turkish Global Youth Tobacco Survey (GYTS) 2017 revealed that 17.9% of students aged 13-15 used tobacco products and 7.7% smoked cigarettes. Given the high prevalence of smoking, it is important to evaluate the factors associated with quit attempts among adolescents. This study aimed to identify the factors associated with Turkish adolescents' attempts to quit smoking using Structural Equation Model (SEM) analyses. This study utilized the data from GYTS 2017, which is a cross-sectional, nationally representative, schoolbased study carried out below 18-year-olds. The study population (n = 18 985) consisted of students who had smoked cigarettes within the past year. After excluding inconsistent responses, 9735 students remained for the analysis. The outcome was an attempt to quit smoking within the past year. Structural Equation Model (SEM) was used for data analysis. The model had good fit (CFI = 0.917, TLI = 0.900, RMSEA = 0.032). Of the 9735 students, 66.4% were male. In the past 12 months, 56.3% (95%CI: 55.3%-57.3%) of smokers attempted to quit. Exposure to anti-tobacco policies (β = 0.114. P < .001) had positive direct effects, whereas sociodemographic factors (β = -0.086. P < .001), nicotine dependency (β = -0.037. P = .008) and exposure to second-hand smoke (β = -0.051. P < .001) had negative direct effects on quit attempts. More than half of the smokers attempted to quit, and nicotine dependence predicted quit attempts. Exposure to secondhand smoke decreased cessation attempts. Anti-tobacco policies such as sale restrictions and warnings of the dangers of tobacco products should be given high priority and enforced fully since they are the strongest predictors of quit attempts.

A Narrative Review of the Digital Equity Gap of Apps for Cigarette Smoking Cessation for Persons Living in the Hispanosphere

Abstract Purpose of Review The Hispanosphere is a vast region of the world that has received little attention in the digital health literature. No study to date has examined the availability and quality of publicly available mobile applications (apps) for cigarette smoking cessation in this region. Three coders utilized the American Psychiatry Association (APA)’s Brief App Evaluation Model Screener (Brief-AEM Screener) to evaluate the quality of the label and public-facing screens of smoking cessation apps in Spanish. Availability of apps in the Hispanosphere was compared to availability of apps in the Anglosphere. Recent Findings We identified and reviewed 19 apps in Spanish in Google Play. The median score using the Brief-AEM Screener was 63 out of 100 suggesting generally acceptable app quality and features according to the quality standards for digital health tools proposed by the APA. However, we found (1) notable inaccurate and misleading labelling claims, (2) poor grammar or incomplete translations, and (3) a lack of cultural and linguistic adaptation to countries in the Hispanosphere. Our comparison of smoking cessation apps between the Hispanosphere and the Anglosphere suggested that there is a large digital equity gap between these two regions, with a four to sevenfold gap in app availability. Summary There is a relative shortage of quality and quantity of digital health apps for smoking cessation in the Hispanosphere. To ensure the cultural appropriateness of those digital interventions, it is essential that developers of digital health tools establish community partners in the region prior to developing apps for smoking cessation.

Exposure to Bupropion-SR vs. Placebo is associated with reductions in smoking among persons receiving methadone with no stated interest in smoking cessation

Smoking is prevalent among individuals receiving methadone treatment. Reducing smoking among this population is needed as smoking is a leading cause of morbidity and preventable death. Smoking cessation interventions for persons receiving medication for opioid use disorder have yielded small changes in abstinence. Bupropion-SR was developed as an anti-depressant medication and is a first-line medication for smoking cessation. There is limited research on the effectiveness of bupropion-SR on smoking cessation among individuals receiving medication for opioid use disorder. This study is a secondary analysis of N = 72 adults enrolled in methadone treatment who endorsed smoking cigarettes. Participants were randomized to receive bupropion-SR 150 mg twice-daily (n = 35) or placebo (n = 37) in the primary study that examined bupropion-SR on cocaine use outcomes over a 30-weeks. Mixed model analyses examined secondary changes in self-reported cigarettes smoked, a self-reported measure of nicotine dependence, and quantitative urinary cotinine values. The longitudinal analysis of self-reported daily cigarettes identified no main effects of group and week however a significant interaction between group and week revealed that persons receiving bupropion-SR group reported less smoking early in the intervention. Longitudinal evaluation of changes in urinary cotinine revealed a significant main effect of week but no main effect of group or group x week interaction. Data suggest that bupropion-SR significantly decreased the number of self-reported cigarettes smoked relative to placebo and reduced nicotine dependence severity by the end of the study. Follow-up studies are needed as these decreases were not identified throughout the full study period or at termination.

Identifying Topics Around Nicotine Gum: A Machine Learning Approach with Twitter Data

Background Nicotine gum products from brands like Lucy and Rogue are relatively new arrivals to the tobacco marketplace. While studies of correlates of nicotine gum use are in their nascent stage, data from social media can be used to stay abreast of user experiences with novel tobacco products. This study leveraged machine learning to identify topics of Twitter posts about nicotine gum from the year 2022. Methods Twitter data was collected using the Twitter Application Programming Interface (API), with search terms “nicotine” AND “gum” OR “nic” AND “gum”. 16,940 tweets from 10,353 unique users were included in the analysis. Topic modeling with Top2Vec was used to identify topics and a string search of popular brands and flavors was also conducted. Results Eight distinct topics were identified. Smoking and vaping cessation was the most common topic, followed by promotion, pricing, and marketing; appeal; product comparisons; perceived benefits; distrust in institutions; health concerns; and COVID-19 misinformation. The most mentioned brand was Nicorette. A tenth of the tweets contained a reference to a flavor. Conclusion The goal of identifying topics in nicotine gum-related conversations is to better understand the public’s perceptions and experiences with nicotine gum. These findings may be used to inform survey-based research, policy targets, and health communication campaigns.

Starting a surgical prehabilitation program: results from a pragmatic nonrandomized feasibility study.

We sought to assess the feasibility and estimate the effects on outcomes of a multimodal prehabilitation service implemented as an ancillary surgical service. We conducted a pragmatic, nonrandomized feasibility study of surgical prehabilitation. Patients were eligible if they were ≥ 18yr of age, fluent in English, and referred by a health professional for prehabilitation. Participants received an individualized program of preoperative exercise, nutrition, psychological, and/or smoking cessation support. The primary outcome was operational feasibility, including referral volume, enrolment rate, prehabilitation window, engagement, completion rate, and safety. Secondary outcomes included surgical complications, length of hospital stay, readmission, quality of life, and physical and mental health. Qualitative data related to intervention feasibility and acceptability. We compared intervention participants with patients who were referred for, but declined, prehabilitation. One hundred and sixteen patients were referred for prehabilitation. The mean age of referred patients was 71yr and 55% were male. Over 90% of referrals were from surgical oncology, and the most common indication for referral was frailty (46%). Of the 116 referred patients, 83 consented to participate in the study. Patient-reported and objectively measured outcomes improved by a clinically important margin from baseline to presurgery, and returned to presurgery levels by 90days postoperatively. Qualitative findings suggest that the prehabilitation intervention was well received. Multimodal surgical prehabilitation is feasible as an integrated clinical service and may be effective for improving physical and psychological outcomes. Further evaluations of clinically integrated prehabilitation programs in Canada are needed to confirm these findings.

Tobacco Quitline Retreatment Interventions Among Adults With Socioeconomic Disadvantage

A single round of standard tobacco quitline treatment may not be sufficient to sustain abstinence, particularly among people experiencing socioeconomic disadvantage. Adaptive retreatment may help more individuals with socioeconomic disadvantage achieve abstinence and reduce disparities in smoking cessation outcomes. To evaluate 4 evidence-based strategies for adults with limited education, no insurance, or Medicaid eligibility who continued smoking after quitline treatment. A factorial randomized clinical trial with 4 factors adapting quitline strategies was conducted for participants enrolled from June 7, 2018, to January 25, 2023, with 6-month follow-up. Adults using the Wisconsin Tobacco Quit Line who were smoking cigarettes 3 to 6 months after prior quitline treatment who were uninsured, Medicaid insured, or had no more than a high school education were included. Quitline retreatment strategies were (1) increased counseling intensity (4 calls vs 1 call), (2) increased nicotine replacement therapy intensity (4 weeks of combination nicotine patch plus nicotine lozenge vs 2 weeks of nicotine patch), (3) text-message support (National Cancer Institute SmokefreeTXT program vs none), and (4) financial incentives for engagement in counseling and SmokefreeTXT ($30/call and/or 6-week SmokefreeTXT retention vs no incentives). Primary outcome was 7-day point-prevalence biochemically confirmed abstinence 26 weeks after the target quit day. Intention-to-treat analysis was performed. Of 6019 people assessed for eligibility, 1316 (21.9%) participants were randomized (mean [SD] age, 53.1 [11.9] years; 760 [57.8%] women), and 919 (69.8%) provided final follow-up. Intention-to-treat analyses showed 162 participants (12.3%) had biochemically confirmed abstinence at 26 weeks (368 [28.0% self-reported abstinence]). There were no significant main effects for the primary outcome: 1 call (11.6% [77 of 662]) vs 4 calls (13.0% [85 of 654]) (odds ratio [OR], 1.04; 95% CI, 0.88-1.24), 2-week patch (11.2% [73 of 654]) vs 4-week combination nicotine replacement therapy (13.4% [89 of 662]) (OR, 1.12; 95% CI, 0.94-1.34), no SmokefreeTXT (13.4% [88 of 657]) vs SmokefreeTXT (11.2% [74 of 659]) (OR, 0.88; 95% CI, 0.74-1.05), and no financial incentives (12.8% [85 of 662]) vs financial incentives (11.8% [77 of 654]) (OR, 0.94; 95% CI, 0.78-1.11). In this randomized clinical trial evaluating enhancements to tobacco quitlines for adults with socioeconomic disadvantage who were smoking after quitline treatment, none of the adaptive treatment strategies robustly improved long-term abstinence. Strategies are needed to enhance quitline retreatment effectiveness for adults with socioeconomic disadvantage. ClinicalTrials.gov Identifier: NCT03538938.

The role of nurses in smoking cessation interventions for patients: a scoping review

BackgroundSmoking is a significant global public health concern, presenting substantial risks to individuals' health. Smoking cessation is essential for improving patients' well-being, and nurses play a critical role in assisting patients to quit smoking. However, there is a lack of research on nurses' specialized roles in smoking cessation interventions for patients.ObjectiveTo define the specific responsibilities of nurses in facilitating smoking cessation among patients, and provide guidance for future nursing interventions in smoking cessation.MethodsThe scoping review process was conducted for Arksey and O’Malley’s framework. Based on the three-step search strategy of Joanna Briggs Institute (JBI), a comprehensive search was performed across ten databases including PubMed, CINAHL, Web of Science, Embase, Cochrane Library, OVID, PsycINFO, CNKI, Wan Fang Data Knowledge Service Platform, and VIP Database for Chinese Technical Periodicals, covering studies from the inception of the databases to February 2024. The inclusion and exclusion criteria were developed using the JBI (participants, content, and context) principle. Randomized controlled trials or quasi-experimental studies with nurse-led or involved smoking cessation interventions for patients were included. Data extraction was conducted independently by two reviewers. The findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR).ResultsIn total, 53 studies were eligible for the final charting and synthesis. The analysis identified six key roles that nurses played in smoking cessation interventions: assessors, educators, practice facilitators, coordinating collaborators, organizers, and supervisors. Among these, the roles of assessors, educators, and practice facilitators were the most commonly reported. The motivation interview and 5A method were the predominant techniques employed for smoking cessation. Nurses primarily promoted smoking cessation through the distribution of pamphlets, face-to-face education, and the provision of smoking cessation guidance. The primary participants in these studies were patients with chronic obstructive pulmonary disease (COPD).ConclusionsNurses play an indispensable role in smoking cessation interventions, occupying multiple critical roles. However, this review identified a gap in the pre-intervention training of nurses, indicating a need for enhanced training programs to better prepare nurses for effective smoking cessation interventions.

Evaluating the Effectiveness of Lifestyle Interventions in Preventing Chronic Diseases: A Systematic Review

This systematic review evaluates the effectiveness of lifestyle interventions, including dietary changes, physical activity, smoking cessation, and alcohol reduction, in preventing chronic diseases such as cardiovascular disease, diabetes, and obesity. Chronic diseases pose a significant burden globally, and lifestyle interventions are increasingly recommended to reduce risk factors. A comprehensive search was conducted in databases like PubMed, Cochrane Library, and Embase, focusing on studies published in the past decade. Included studies assessed adult populations at risk of chronic diseases, using interventions targeting lifestyle modifications with measurable health outcomes. Findings indicate that dietary changes and increased physical activity significantly reduce chronic disease risk, while smoking cessation and alcohol reduction further contribute to improved health outcomes. Combination interventions generally showed the most substantial impact on preventing chronic disease. Although the evidence strongly supports lifestyle changes for disease prevention, variations in intervention type, duration, and adherence remain a limitation. Future research should explore long-term effects and implementation strategies in diverse populations. This review underscores the need for integrating effective lifestyle interventions into healthcare policies to improve public health.

Glucagon‐like Peptide-1 Agonists and Smoking Cessation: A Brief Review

The glucagon‐like peptide 1 (GLP-1) agonists such as semaglutide (Ozempic®, Wegovy®) and tirzepatide (Mounjaro®) have shown efficacy inducing weight loss in both diabetics and non-diabetics. According to the incentive sensitization theory of addiction, these drugs may prove useful in addictive disorders such as nicotine addiction. Animal data has been suggestive of a potential positive effect but early human studies have been mixed. This manuscript reviews the theory of addiction as well as the few animal and human studies available. Further human studies are needed to show GLP-1 agonist efficacy in smoking cessation.

Smoking behavior and the risks of tumor recurrence and progression in patients with non-muscle-invasive bladder cancer.

Studies on the relationship of cigarette smoking with the risks of recurrence and progression of non-muscle-invasive bladder cancer (NMIBC) are inconsistent and prospective data are scarce. Therefore, we aimed to assess the association of smoking behavior with risks of NMIBC recurrence and progression. We used data of the prospective multi-center cohort study UroLife, including 1495 patients with NMIBC who reported information on smoking at 6 weeks post-diagnosis (baseline; reflecting present and pre-diagnosis). This included smoking status (also based on reporting 3 months post-diagnosis), intensity, duration, pack years, and time since smoking cessation, if applicable. Hazard ratios and 95% confidence intervals (CIs) for risks of first recurrence, multiple recurrences, and progression were computed using multivariable proportional hazards regression models. During a total median follow-up period of 4.6 years, 517 patients developed ≥1 recurrence and 163 had progression. Higher versus lowest categories of smoking intensities and pack years up to baseline were significantly associated with a higher risk of first recurrence. No significant linear associations were found, except for smoking intensity among BCG-treated patients (per 10 cigarettes/day increase: HR 1.23, 95%CI 1.02, 1.48). No associations for smoking status, duration, and time since cessation were observed. Analyses of multiple recurrence risk showed comparable results. Regarding progression risk, no consistent associations were found. In conclusion, heavier smoking was associated with higher recurrence risk, particularly among BCG-treated patients. This may be attributable to persistent damage through its carcinogenic compounds. Given the mixed results across different exposures, the effect of smoking behavior on NMIBC prognosis remains unclear.

Nudge theories and strategies influencing adult health behaviors and outcomes in COPD management: a systematic review

ObjectiveChronic obstructive pulmonary disease (COPD) is a chronic respiratory disease with high prevalence and mortality, and self-management is a key component for better outcomes of COPD. Recently, nudging has shown promising potential in COPD management. In the present study, we conducted a systematic review to collate the list of nudges and identified the variables that influence nudging.MethodsWe undertook a systematic review. We employed database searches and snowballing. Data from selected studies were extracted. The risk of bias was assessed using the Cochrane Effective Practice and Organization of Care risk of bias tool. The study is registered with PROSPERO, CRD42023427051.ResultsWe retrieved 4,022 studies from database searches and 38 studies were included. By snowballing, 5 additional studies were obtained. Nudges were classified into four types: social influence, gamification, reminder, and feedback. Medication adherence, inhalation technique, physical activity, smoking cessation, vaccination administration, exercise capacity, self-efficacy, pulmonary function, clinical symptoms, and quality of life were analyzed as targeted health behaviors and outcomes. We found medication adherence was significantly improved by reminders via mobile applications or text materials, as well as feedback based on devices. Additionally, reminders through text materials greatly enhance inhalation techniques and vaccination in patients.ConclusionThis review demonstrates nudging can improve the health behaviors of patients with COPD and shows great potential for certain outcomes, particularly medication adherence, inhalation techniques, and vaccination. Additionally, the delivery modes, the patient characteristics, and the durations and seasons of interventions may influence the successful nudge-based intervention.Clinical trial registrationThis review has been registered in the international Prospective Registry of Systematic Evaluation (PROSPERO) database (identifier number CRD42023427051).

An exploration of attitudes regarding the use of a state tobacco Quitline for smoking cessation among low-income adults with a history of smoking.

Smoking rates among low-income smokers are significantly elevated. State tobacco quitlines offer free and evidence-based treatments for smokers living in that state. This study investigated knowledge, attitudes, and beliefs associated with engagement with the Illinois Tobacco Quitline among confirmed smoking patients at a Federally Qualified Health Center (FQHC). Further goals were to obtain recommendations for strategies to improve patient awareness and engagement. Data for this study were collected from August to October 2021 from patients receiving care in an FQHC in a large midwestern city in the USA. Clinic-based recruitment was used to enroll a sample of adult current smokers. In-depth interviews and brief surveys were completed with a volunteer sample of patients recruited from an FQHC. The interviews took approximately 60 minutes. Data analysis used descriptive statistics to summarize the responses to the study and deductive thematic analysis to analyze the qualitative interviews. Study participants (n=25) were primarily male, African American, and middle-aged (mean age: 52.5 years). The majority were daily smokers. Over half had heard about the Quitline from sources such as radio advertisements, but usage was low. Barriers to use included low motivation to quit, questions about effectiveness, and poor success with prior Quitline attempts. Participants described factors that would increase the appeal of the Quitline, including testimonials, personalization, and an empathetic approach. Participants were asked about the acceptability of receiving information about the Quitline via patient portals, and most were in support. Interventions are needed to raise awareness and utilization of Quitlines among patients receiving care in FQHC settings. Distribution of Quitline information via patient portals is an acceptable strategy for increasing awareness of services.

Sex-Specific Associations Between Lifestyle Factors and Sick Leave in the Serbian Working Population: Findings from the National Health Survey

Background/Objectives: Sick leave is influenced by various modifiable lifestyle factors and sex differences. This study investigates the associations between body mass index, fruit and vegetable consumption, physical activity, smoking, and alcohol consumption and sick leave among Serbia’s working population, with emphasis on sex differences. Methods: Data from the 2019 National Health Survey of Serbia were analyzed, involving a sample of 4652 individuals. Chi-square tests and logistic regression models assessed the relationships between lifestyle factors and sick leave. Results: Among the participants, 15.8% reported sick leave in the past 12 months, with higher rates among women in both short-term (13.9% vs. 10.6%) and long-term (3.4% vs. 2.2%) sick leave. This study identifies obesity (OR = 2.6), poor dietary habits (fruit OR = 2.1; vegetables OR = 2.8), smoking (OR = 1.9), and risky alcohol consumption (OR = 4.1) as key predictors of sick leave in men, while smoking (OR = 1.8) and risky alcohol consumption (OR = 3.1) are major predictors in women. The inconsistent association between diet, physical activity, and sick leave may be attributed to differences in reporting accuracy, differing definitions of healthy intake, or the influence of unmeasured lifestyle factors. Conclusions: Smoking and risky alcohol consumption increase the odds of sick leave for both sexes. Interventions targeting smoking cessation and mitigating risky alcohol consumption could significantly decrease sick leave rates. While fruit and vegetable consumption, along with physical activity, showed inconsistent effects in both sexes, further studies are warranted to elucidate their roles.

A Health Economics Inquiry into Regulatory Constraints on the European Tobacco Market.

Despite the implementation of significant measures by European countries in recent years, smoking rates in Europe remain persistently high. TheEuropean Commission is currently undertaking a comprehensive review of itstobacco regulations. This article aims to address critical inquiries that arise during the amendment of the regulatory framework. We evaluate the effectiveness of existing tobacco control methods and observe a diminishing impact on promoting smoking cessation. Additionally, we explore how individuals of varying genders respond to the regulatory environment. We propose a comprehensive and evidence-based framework for implementing a taxation system in response to the proliferation of emerging products, including e-cigarettes and heated tobacco. This system is designed to align effectively with health policy objectives, providing a strategic approach to curbing tobacco use and promoting public health.

The association between nicotine dependence and sleep quality in patients referred to a smoking cessation outpatient clinic: A cross-sectional study.

Nicotine addiction is one of the most common forms of dependence. It is shown to be associated with many chronic diseases that develop mostly through smoking. The association between sleep quality and smoking or nicotine addiction has not been clarified yet. This study aimed to investigate the association between nicotine addiction and sleep quality. In this cross-sectional study, the Epworth sleepiness scale (ESS), Pittsburgh sleep quality index (PSQI), Fagerström test for nicotine dependence (FTND), and Hospital anxiety-depression scale (HADS) were administered to patients who applied to the smoking cessation outpatient clinic of a reference hospital between April and June 2023. FTND measured nicotine dependence, and its association with sleep quality estimated by PSQI was assessed by binary logistic regression with the potential confounders. In the study group of 280 participants, 67.1% were male, and 57.8% had poor sleep quality. The median (IQR) FNTD score was 7.0 (3.0), and the median global PSQI score was 6.0 (5.0). Poor sleep quality increased by 1.12 times (AOR=1.12; 95% CI: 1.02-1.22, p=0.016) for each unit increase in hospital anxiety score and by 1.22 times (AOR=1.22; 95% CI: 1.05-1.42, p=0.011) for each unit increase in FTND score. Increased nicotine dependence and anxiety are independently associated with poor sleep quality. The findings support smoking cessation efforts. It is recommended to study the effect of combating anxiety and tobacco addiction to improve sleep quality.

Perioperative nutrition in older patients: what are the priorities?

This review aimed to synthesize recent literature on perioperative nutritional interventions for older patients. This review underscores the role of comprehensive preoperative optimization, strategic use of nutritional supplements focusing on calorie, protein, and fluid intake, and active involvement of health consumers in co-designing solutions. Tools like the Geriatric Nutritional Risk Index offer a prediction value for nutrition-related complications in preoperative patients, guiding management strategies. Oral nutritional supplements, particularly those rich in protein and carbohydrates, prevent weight loss and improve functional outcomes postsurgery. However, patient satisfaction with these interventions is inconsistent and often unmeasured. Evidence suggests that prolonged fluid deprivation is harmful and preoperative hydration protocols reduce surgical stress and improve recovery outcomes. Yet, the benefit of preoperative hydration remains under-researched. Multimodal interventions for frail older adults are increasingly considered more effective than single-aspect interventions, which involve combining prehabilitation programs targeting malnutrition with smoking cessation and stabilization of preexisting conditions. Comprehensive preoperative nutritional assessment, evidence-based interventions, and health consumer involvement are crucial for improving perioperative care for elderly patients. Implementing multimodal interventions, including nutritional support and proper hydration, can enhance recovery, reduce complications, and improve the quality of life for older surgical patients.

Novel Risk Factors for Postoperative Hematoma Requiring Reoperation Following Anterior Cervical Discectomy and Fusion.

Retrospective cohort study. To investigate the correlation between comorbid chronic obstructive pulmonary disease (COPD), asthma, tobacco use, and the incidence of postoperative hematoma requiring reoperation after anterior cervical discectomy and fusion (ACDF). Prior studies have identified general risk factors such as multilevel fusion and coagulopathy. However, specific coughing-related factors like COPD, asthma, and tobacco use have not been extensively investigated. Patients who underwent single or multilevel ACDF between 2011 and 2021 were identified using Current Procedural Terminology (CPT) codes in the PearlDiver database. The primary outcome was the occurrence of postoperative hematoma requiring reoperation within 30 days. χ2 tests and t tests compared groups, and multivariable logistic regression identified predictors for postoperative hematoma. Among 399,900 patients with ACDF, 901 (0.2%) developed postoperative hematoma requiring reoperation within 30 days. Patients with postoperative hematoma were older (58 vs. 55, P<0.001) and predominantly male (62.5% vs. 44.9%, P<0.001). After adjustment, tobacco use and comorbid COPD were associated with postoperative hematoma (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.10-1.47; P<0.001 and OR, 1.41; 95% CI, 1.21-1.64; P<0.001, respectively). Comorbid asthma was not a significant risk factor. Additional risk factors included comorbid hypertension (OR, 1.46; 95% CI, 1.18-1.82; P<0.001), coagulopathy (OR, 1.50; 95% CI, 1.24-1.81; P<0.001), anemia (OR, 1.38; 95% CI, 1.17-1.62; P<0.05), and history of deep vein thrombosis (OR, 1.93; 95% CI, 1.44-2.54; P<0.001). Tobacco use and COPD were identified as novel risk factors for postoperative hematoma formation requiring reoperation after ACDF. Recognizing these modifiable factors, providers may consider postponing nonemergent ACDFs until patients undergo smoking cessation programs or receive optimal COPD management.

Long-term trends and future projections of larynx cancer burden in China: a comprehensive analysis from 1990 to 2030 using GBD data

Larynx cancer poses a significant public health challenge in China, with rising incidence and mortality rates over the past decades. Understanding the long-term trends and underlying factors is crucial for effective intervention and policy formulation. Data were utilized from the global burden of disease (GBD) Study 2021 to analyze the incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) due to larynx cancer in China from 1990 to 2021. Joinpoint regression analysis identified key changes in trends, while age-period-cohort (APC) analysis and decomposition analysis quantified the contributions of aging, epidemiological changes, and population growth to these trends. Our study found a significant increase in the incidence and prevalence of larynx cancer in China, particularly among males. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for males were substantially higher than those for females. Decomposition analysis revealed that aging was the primary driver of increasing incidence and mortality rates, while epidemiological changes had a mitigating effect. Joinpoint analysis identified periods of rapid urbanization and economic growth as key turning points for increased incidence. Bayesian APC models projected a continued upward trend in incidence rates up to 2030. The rising burden of larynx cancer in China underscores the need for targeted public health interventions, including smoking cessation programs, environmental pollution control, and early detection strategies. Addressing gender disparities and implementing effective prevention measures are crucial to mitigating the impact of larynx cancer in China.

PREVALENCE OF DENTAL CARIES AMONG SMOKERS OF A TERTIARY CARE HOSPITAL OF LAHORE

Dental caries is a common chronic oral health condition globally, with an increased prevalence among smokers. Smoking contributes to caries risk by affecting saliva production, oral microbiota, and oral hygiene practices. In Pakistan, where smoking is prevalent. Objective: This study aims to assess the prevalence of dental caries among smokers attending a tertiary care hospital in Lahore. Methods: A cross-sectional study was conducted at Jinnah Hospital, Lahore, from January to July 2024. The sample included 100 adult smokers aged 18 years and above. Data on demographics, smoking frequency, oral hygiene practices, and dental caries were collected using structured interviews and clinical examinations. Caries severity was assessed using the Decayed, Missing, and Filled Teeth (DMFT) index. Statistical analyses, including chi-square tests, were conducted to explore associations between smoking habits and caries prevalence. Results: The majority of participants were aged 26-35 (30%), with 35% smoking 6-10 cigarettes daily. Oral hygiene practices were suboptimal, with only 25% brushing twice daily, and 15% reporting no regular hygiene routine. The prevalence of dental caries was strongly correlated with smoking frequency and duration. Participants smoking more than 21 cigarettes daily had an 80% caries prevalence, while those with a smoking history of over 16 years had a mean DMFT score of 7.6. These results align with previous studies linking smoking with higher caries risk and severity. Conclusion: The study highlights a high prevalence of dental caries among smokers, with significant associations between smoking frequency, duration, and caries severity. These findings underscore the need for preventive dental health interventions, including smoking cessation programs and targeted oral hygiene education, to mitigate the burden of dental caries in this high-risk population.

Assessment and repeatability of aerobic capacity using the Chester Step Test among current, former, and never smokers.

Cigarette smoking contributes to reduced cardiorespiratory performance, which may improve upon cessation. Consequently, former smokers' cardiorespiratory fitness should not be significantly different from that of never-smokers. This study aims to compare V̇O2max values among current, former, and never smokers and assess the repeatability of measurements using the Chester Step Test (CST). V̇O2max measurements were available from a total of 70 subjects (23 current, 23 former, and 24 never-smokers) and showed significant repeatability. Current smokers had the worst aerobic capacity, with a mean VO2max ± SD of 38.8 ± 4.5, which was significantly lower than the VO2max of 41.62 ± 3.8 in never-smokers (p < 0.0001) and 41.43 ± 4.6 in former smokers (p < 0.0001). No significant differences were observed between never-smokers and former smokers. V̇O2max estimates by CST were reproducible and showed that the aerobic capacity of individuals who smoke is substantially inferior compared to never and former smokers. Improvement in cardiorespiratory performance following smoking cessation may have important implications for smoking cessation, especially for those smokers who perceive enhanced physical performance as a tangible benefit.