Smoking Men Research Articles

Deaths from noncommunicable diseases attributable to behavioral risk factors in Italy and Italian regions, 2016

to estimate the number of deaths from noncommunicable chronic diseases (NCD) attributable to behavioural risk factors (tobacco smoking, unhealthy nutrition, physical inactivity, overweight, and excessive alcohol use) in 2016 for Italy and for the Italian regions. descriptive study. mortality data were obtained by the Italian National Institute of Statistics. Causes of deaths from NCD associated with the five RFs were selected. Italian attributable fractions were obtained by the 2016 estimates of the Global Burden of Disease Study and applied to the mortality data. Regional prevalence of risk factors was obtained by the national surveillance system PASSI for the years 2013-2016. absolute number of attributable deaths, joint attributable fraction, proportion of total deaths attributable to RFs (MAprop). about 191,000 out of 614,307 deaths occurred in Italy in 2016 were attributable to combined RFs (about 37% in males; 26% in women). Joint MAprop was between 33% in men (24% in women) from Val d'Aosta and 40% in men (31% in women) from Campania. In Italy, 17% and 6% of the total amount of deaths were attributable to smoking in men and women, respectively; 6% and 3% to alcohol abuse; 7% and 8% to overweight; 13% and 12% to dietary RFs, and 2% and 3% to low physical activity. The higher proportion of attributable deaths by age-group was recorded in people aged 40-59 years (43% in men; 28% in women). Regional differences in attributable deaths are confirmed by regional RF prevalence recorded by the PASSI surveillance system for the years 2013-2016. these are the first estimates of the number of deaths due to NCDs attributable to behavioural RFs estimated for each region and for Italy as a whole. Effective primary prevention policies should be reinforced, since these RFs are potentially modifiable.

Smoking in men and women with type 2 diabetes: A qualitative gender-sensitive exploration of barriers to smoking cessation among people with type 2 diabetes.

ObjectivesDespite growing evidence of the impact of smoking on diabetes complications, people with type 2 diabetes still smoke at high rates and little is known about the specific barriers to quit smoking in this group. The purpose of this article is to explore the perception of smoking, and motivation and barriers to quit among smokers with type 2 diabetes. This exploratory study will help designing a smoking cessation intervention tailored to the needs of people with type 2 diabetes. We hypothesize both that living with diabetes and gender may raise additional difficulties to quit smoking.SettingThe qualitative exploratory research included ten in-depth semi-structured individual interviews and five focus groups conducted in an Ambulatory Care University Hospital in Switzerland. The thematic analysis was conducted with a gender-sensitive focus.ParticipantsBoth current and former smokers recruited from the ambulatory clinic and the community took part in the qualitative interviews. We restricted the analysis to 21 current smokers only.ResultsThe sample included 12 men and 9 women with type 2 diabetes, having a mean age of 59.4 years, who had diabetes for an average of 9 years with a mean HbA1c of 7.4%. We found that harmful effects of tobacco were superficially understood, and participants used several patterns of thinking to minimize the risks. The relation between tobacco and diabetes was poorly known. Readiness to change was related to personal self-image and meaningful engagement in life and social relationships. Barriers could be organized into three groups: dependence, psychological habits and social barriers. Barriers were markedly shaped by gender and living with diabetes.ConclusionsResults suggest that “one -fits-all” smoking cessation interventions do not satisfy the needs of type 2 diabetic smokers. Personalized smoking cessation interventions should be preferred and should pursue positive psychological outcomes addressing contextual factors.

Primary Laryngeal Neuroendocrine Carcinoma: Two Cases of an Unusual Tumor in a Rare Location

Introduction: Neuroendocrine neoplasm is an infrequent tumor in the larynx which can be sub-classified into five different types: typical carcinoid, atypical carcinoid, large cell carcinoma, small cell carcinoma, and paraganglioma. This tumor mostly occurs in smoker men. The common location of neuroendocrine tumor of the larynx is in the supraglottic area. Because of the complex nature of neuroendocrine neoplasms of the larynx, we found it so interesting to present. We emphasized the clinical importance and aggressive nature of this tumor despite its rarity. Case Presentation: In the present study, we presented 2 cases of atypical carcinoid in non-smoker females. Case 1 was a 74-year-old non-smoker woman who was referred with a history of chronic dysphagia and left otalgia since one year ago. Laryngoscopy revealed a nonulcerated supraglottic epitheliomatous lesion. Biopsy showed atypical carcinoid. The patient had no lymphadenopathy or metastasis in the further workup. The second case was a 60-year-old non-smoker woman with a 4-month history of hoarseness, odynophagia accompanied by cervical lymphadenopathy. Laryngoscopy showed a smooth surface non-ulcerated transglottic tumor. Right vocal cord mobility was restricted. Conclusions: Atypical carcinoid tumor is an underdiagnosed laryngeal malignancy. Although neuroendocrine tumor of the larynx is rare, physicians should be familiar with its unspecified presentations, pathology, clinical course, and prognosis.

Cardiovascular mortality and risk behaviours by degree of urbanization before, during and after the economic crisis in Spain

BackgroundTo estimate the relationship of the degree of urbanization to cardiovascular mortality and to risk behaviours before, during and after the 2008 economic crisis in Spain.MethodsIn three areas of residence – large urban areas, small urban areas and rural areas – we calculated the rate of premature mortality (0–74 years) from cardiovascular diseases before the crisis (2005–2007), during the crisis (2008–2010 and 2011–2013) and after the crisis (2014–2016), and the prevalence of risk behaviours in 2006, 2011 and 2016. In each period we estimated the mortality rate ratio (MRR) and the prevalence ratio, taking large urban areas as the reference.ResultsIn men, no significant differences were observed in mortality between the two urban areas, while the MRR in rural areas went from 0.92 [95% confidence interval, 0.90–0.94) in 2005–2007 to 0.94 (0.92–0.96) in 2014–2016. In women, no significant differences were observed in mortality between the rural and large urban areas, whereas the MRR in small urban areas decreased from 1.11 (1.08–1.14) in 2005–2007 to 1.06 (1.02–1.09) in 2014–2016. The rural areas had the lowest prevalence of smoking, obesity and physical inactivity in men, and of obesity in women. No significant differences were observed in smoking or physical inactivity by area of residence in women.ConclusionThe pattern of cardiovascular mortality by degree of urbanization was similar before and after the crisis, although in women the excess mortality in small urban areas with respect to large urban areas was smaller after the crisis. The different pattern of risk behaviours in men and women, according to area of residence, could explain these findings.

This is not a Pipe

Over the course of the Weimar Republic, cigarettes began to replaced pipes and cigars as the preferred method of tobacco consumption among urban-dwelling German men. Simultaneously, gender-specific advertising campaigns increasingly pitched cigarette smoking to German women. Through this visual advertising, the cigarette served as a site of mediated contention for the gendered meaning of a consumptive good. While tobacco ads helped to co-create the often-competing gendered conceptions of the cigarette, the ultimate goal of tobacco companies was to sell their products. Using ego documents, period literature, and advertisements in the Berlin press, this study argues that, in coordination with practical changes in consumer tastes, these ads helped to install cigarettes as a popular method of smoking for men in Weimar Berlin while simultaneously creating a media flashpoint for political and cultural contestations over gender.

Gestational diabetes mellitus in mothers and long term cardiovascular disease in both parents: Results of over a decade follow-up of the Iranian population

Background and aimsWe aimed at evaluating whether the presence of gestational diabetes mellitus (GDM) in mothers is associated with increased risk of incident cardiovascular disease (CVD) in both mothers and fathers. MethodsIn this population-based study, 4308 Iranian women, aged 18–64 years, with at least 1 live-birth delivery, and free of CVD at baseline, were followed. Corresponding spouses were identified in 2547 cases. The association between history of GDM and incident CVD was assessed using multivariate Cox's proportional hazard in 3 models: model 1, unadjusted; model 2, adjusted for age, body mass index, smoking (for men), maternal parity, miscarriage, physical activity, hypertension and hypercholesterolemia, and model 3, further adjusted for diabetes mellitus. ResultsAfter a median follow-up of 14.1 years, 314 mothers and 424 fathers experienced CVD. Women with history of GDM had an adjusted hazard ratio (HR), 95% CI of 1.85 (1.38–2.48) and 1.29 (0.96–1.75) for CVD in models 1 and 2, respectively. Furthermore, an independent association with CVD was observed in fathers with an adjusted HR of 1.35 (1.02–1.79) in the confounder adjusted model and even after further controlling for diabetes [1.36 (1.03–1.80)]. Moreover, all traditional risk factors, excluding BMI, showed an independent risk for CVD in both genders. ConclusionsWomen with prior GDM showed an increased risk of CVD that was not independent of important CVD risk factors. However, among men, spousal history of GDM was an independent risk factor for incident CVD, even after considering important traditional risk factors, including diabetes.

INFLUENCE OF SOLAR ACTIVITY ON THE HUMAN’S CARDIAC RHYTHM UNDER STRESS

The aim: To determine the effect of solar activity on the cardiac rhythm indices of apparently healthy men and women, smokers and non-smokers, depending on the stress load (physical and psycho-emotional). Methods. The registration of myocardium bioelectric activity parameters was carried out in the participants of the experiment (26 people) for 2 years (spring, autumn, 95 days), using ECG sensor «Fazagraf», the cardiosignals were handled on-line (www.geliomed.kiev.ua). Long time-series data were mathematically processed using Microsoft Office Excel and STATISTICA programs. The change of geomagnetic storminess was estimated using Кр-index. Results. Biophysical monitoring data ofcardiac rhythm was analyzed. In accordance with the ergodic hypothesis, a statistical analysis of balance factor values of the T-wave (T) of ECG was performed using time series for 4 groups with common traces - gender and tobacco smoking. Using the Pearson's chi-squared test, it was proved that the samples obeyed the normal distribution law. Significant differences in the cardiac rhythm were revealed after physical and emotional loads in smokers in comparison with non-smokers, regardless of the geomagnetic situation. The mean values of the T-wave balance factor changes were calculated after the stress load relative to the rest state (ΔT) for the indicated groups of subjects, for periods with a quiet geomagnetic environment (Kp < 16) and with high geomagnetic activity (Kp > 16). Significant differences (р < 0.05) in the parameters of cardiac rhythm changes under the load in the magnetic disturbed days in comparison with the unperturbed period were found only in smokers. The greatest differences were recorded in women-smokers under psycho-emotional stress and in men smokers after physical activity. Conclusion. Physical load and psycho-emotional stress are risk factors for the cardiovascular system of smokers, respectively, in days with high sunspot activity.

Smoking and atherosclerotic cardiovascular disease risk in young men: the Korean Life Course Health Study

ObjectiveTo examine the effect of smoking on risk of atherosclerotic cardiovascular disease (ASCVD) in Korean young men and to examine whether serum total cholesterol levels could modify the effect of...

Retrospective evaluation of risk factors for oral cavity and oropharynx cancers in patients under the program of head and neck cancers prevention.

The aim of the study was to analyze the risk factors for oral cavity and pharyngeal cancer in people examined under the Head and Neck Cancer Prophylaxis Program. The study was conducted in a total of 300 patients, including 186 women and 114 men, as part of the Head and Neck Cancer Prevention Program in 2014-2018. Before the laryngological examination, the patients completed a demographic and medical questionnaire regarding the risk factors of head and neck cancer, including education, reported disease symptoms, smoking addiction, number of cigarettes smoked daily, alcohol consumption, frequency of visits in a dental office, oral hygiene measures, number of sexual partners, oral sex, family medical history of head and neck cancer. The subjects reported the following symptoms: hoarseness 43.33%, difficulty swallowing 21.33%, pain or mouth burning 20.33% and other symptoms were observed in 46.33%. The main dental symptoms were: bleeding from the gums during teeth brushing in 48.89%, dry mouth 45.56%. Currently 20.33% of respondents smoke, whereas 54% of patients smoked in the past. In the analyzed material, the majority (80%) consumed alcoholic beverages. 27.67% of respondents admitted having oral sex, including 24.73% of women and 32.46% of men. After performing the extended diagnostics, the tumor was found in 10% of the subjects. C onclusions: Statistical significance of differences was found: between hoarseness and alcohol consumption, both in women and in men, between hoarseness and smoking in women, between difficulty in swallowing and smoking in women, between burning/pain in the mouth and smoking in men, between hoarseness and the cultivation of oral sex in men, between the difficulty of swallowing and the practice of oral sex in the studied men and between burning/pain in the oral cavity and the occurrence of malignancy.

Efek Merokok Berat terhadap Jumlah Leukosit dan Jenis Leukosit pada Pria Usia Produktif di Kelurahan Tanjung Pinang Kota Palangka Raya

Prevalence of productive men smokers in Kalimantan Tengah in 2013 has been reached 64.9% with a mean of smoking about 12.3 cigarettes a day. Cigarette smoke contains 1015 of oxidative free radicals which can cause oxidative stress. It will trigger of activation of inflammatory genes and increase of cytokines release by increasing of leukocytes and activate some of the differential leukocytes. Continual inflammation can cause atherosclerosis and coronary heart disease. This study aimed to determine the effects of heavy smoking on white blood cell count and differential leukocyte count in productive men in Kelurahan Tanjung Pinang, Palangka Raya. This study used a descriptive observational method with a cross-sectional design. The sample obtained by 28 people with purposive sampling technique with criteria: men, active smoker, smoking more than ten years, working as a farmer, fish farmer, or laborer, and willing to become a respondent. White blood cell count and differential leukocyte count were analyzed by an automatic method using Hematology Analyzer. The results showed that 3.6% of active smokers had high white blood cell count and others had low white blood cell count (3.6% ). Whereas differential leukocyte count showed that 2 persons had high of eosinophils (7.10%), 5 people had low of eosinophils (17.9%), one person had little of neutrophils (3.6%), 2 persons had high of lymphocytes (7.20%), 10 people had little of lymphocytes (35.7%), and 15 people had high of monocytes (53.6%). To reduce the risks, preventive and educative actions from medical personnel are needed for active smokers and their families.

Female sex and cardiovascular disease risk in rural Uganda: a cross-sectional, population-based study

BackgroundSex-based differences in cardiovascular disease (CVD) burden are widely acknowledged, with male sex considered a risk factor in high-income settings. However, these relationships have not been examined in sub-Saharan Africa (SSA). We aimed to apply the American Heart Association (AHA) ideal cardiovascular health (CVH) tool modified by the addition of C-reactive protein (CRP) to examine potential sex-based differences in the prevalence of CVD risk in rural Uganda.MethodsIn a cross-sectional study nested within a population-wide census, 857 community-living adults completed physical and laboratory-based assessments to calculate individual ideal CVH metrics including an eight category for CRP levels. We summarized sex-specific ideal CVH indices, fitting ordinal logistic regression models to identify correlates of improving CVH. As secondary outcomes, we assessed subscales of ideal CVH behaviours and factors. Models included inverse probability of sampling weights to determine population-level estimates.ResultsThe weighted-population mean age was 39.2 (1.2) years with 52.0 (3.7) % females. Women had ideal scores in smoking (80.4% vs. 68.0%; p < 0.001) and dietary intake (26.7% vs. 16.8%; p = 0.037) versus men, but the opposite in body mass index (47.3% vs. 84.4%; p < 0.001), glycated hemoglobin (87.4% vs. 95.2%; p = 0.001), total cholesterol (80.2% vs. 85.0%; p = 0.039) and CRP (30.8% vs. 49.7%; p = 0.009). Overall, significantly more men than women were classified as having optimal cardiovascular health (6–8 metrics attaining ideal level) (39.7% vs. 29.0%; p = 0.025). In adjusted models, female sex was correlated with lower CVH health factors sub-scales but higher ideal CVH behaviors.ConclusionsContrary to findings in much of the world, female sex in rural SSA is associated with worse ideal CVH profiles, despite women having better indices for ideal CVH behaviors. Future work should assess the potential role of socio-behavioural sex-specific risk factors for ideal CVH in SSA, and better define the downstream consequences of these differences.

Correlates of hospitalizations in internal medicine divisions among Israeli adults of different ethnic groups with hypertension, diabetes and cardiovascular diseases.

BackgroundDisparities in non-communicable diseases (NCDs) may affect health care utilization. We compared the correlates of hospitalizations in internal medicine divisions, of adults with NCDs, between the main population groups in Israel.MethodsA cross-sectional study was conducted among Jews (N = 17,952) and Arabs (N = 10,441) aged ≥40 years with diabetes, hypertension or cardiovascular diseases, utilizing the computerized database of the largest health maintenance organization in Israel. Information was retrieved on sociodemographics, background diseases, hospitalizations and utilizations of other health services. Multivariable log binomial regression models were performed.ResultsOverall, 3516 (12.4%) patients were hospitalized at least once during a one-year period (2008). Hospitalization in internal medicine divisions was more common among Arab than Jewish patients; prevalence ratio 1.24 (95% CI 1.14–1.35), and increased with age (P<0.001). An inverse association was found between residential socioeconomic status and hospitalization among Jewish patients, but not among Arab, who lived mostly in low socioeconomic status communities. In both population groups, congestive heart failure, arrhythmias, heart surgery, cardiac catheterization, kidney disease, asthma, neurodegenerative diseases, mental illnesses, smoking (in men) and disability were positively related to hospitalization in internal medicine divisions, which was more common also in patients who consulted any specialist and a specialist in cardiology. Emergency room visits, consulting with an ophthalmologist and performing cancer screening tests were inversely related to hospitalizations among Jewish patients only (P = 0.009 and P = 0.067 for interaction, respectively).ConclusionsIn a country with universal health insurance, the correlates of hospitalizations included sociodemographics, multi-morbidity, health behaviors and health services use patterns. Socioeconomic disparities might account for ethnic differences in hospitalizations. Individuals with several NCDs, rather than one specific disease, disability and smoking should be targeted to reduce healthcare costs related to hospitalizations.

FEATURES OF THE ATTITUDE TOWARDS SMOKING IN CONNECTION WITH THE NATURE OF WORK AND MARITAL STATUS IN OPEN URBAN POPULATION: GENDER DIFFERENCES

Aim. To study the attitudes towards smoking in working-age men and women with different nature of work and marital status in Tyumen city.Material and Methods. The cross-sectional epidemiological study was carried out as part of the cardiac screening in open urban male and female population. The study included 850 men (response rate 85.0%) and 704 women (response rate of 70.4%) aged 25–64 years. A self-report questionnaire of the World Health Organization titled «Knowledge and Attitude to Health» with a fixed list of answer options was used to analyze attitudes to smoking. Social status was assessed according to the nature of work (four categories: «unemployed and pensioners», «manual labour», «specialists and technical/engineering employees», and «leaders»), and marital status (have or do not have a life partner). Statistical analysis of the results was conducted using SPSS (11.5) and Statistica 7.0 software packages and Microsoft Excel spreadsheet software. Values were considered statistically significant when p was &lt;0.05.Results. The prevalence of smoking among single men was higher than the corresponding value in men who had a life partner (63.4 vs. 46.6%, р&lt;0.001); the opposite trend was observed in women (13.1 vs. 17.0%, р&gt;0.05). In regard to the nature of work, the highest smoking rate was found among men who were engaged in manual labour (m/f: 60.8/19.8%). Men from the categories of «specialists and technical/engineering employees» and «leaders» (40.7 and 41%) as well as women from the «unemployed and pensioners» category smoked less often (11.6%), (р&lt;0.001). Gender differences in attitudes to smoking depended on marital status and the nature of work. Correlations between the nature of work and attempts to change something in smoking pattern were observed in men (R=0.35, p=0.05) and women (R=0.18, p=0.01).Conclusion. According to the study of open urban population, significant differences were detected between men and women in regard to their attitudes towards smoking. Gender-related differences in the associations of smoking with marital status and the nature of work were identified.

Gender-related incidence, risk factors exposure and survival rates of laryngeal cancers - the 10-years analysis of trends from one institution.

The aim of the study was the analysis of the epidemiology of laryngeal cancer over 10 years in relation to known risk factors and to assess the current survival rates in this group of patients. The data were retrospectively collected from patients' medical records, then entered in the database using dedicated software and a statistical analysis was performed. 512 subjects - 443 men (86.5%) and 69 women (13.5%) were enrolled into the study. The male-to-female ratio was 6.4:1. There were 97.1% smoking women and 98% smoking men, however the history of more than 20 cigarettes per day smoking admitted 81.1 % of women and 94.6% of men. Heavy alcohol consumption was the case in 14 (20.3%) women and in 307 (69.3%) men. For both the size of heavy alcohol consumption and the size of excessive tobacco use, there was found statistically significant difference between women and men with laryngeal cancer (p&lt;0.05). In the majority of male and female subjects, the tumour was located in the supraglottis/glottis area. Apparently this tumour location was much more common among women, accounting for 60.9% of cases , while in men was confirmed in 39.3% of cases. The stages of the laryngeal cancer were similarly of high advancement for both the men and women - stages III and IV were confirmed in 82.6% of women and in 77.6% of men. The over 5-year survival rate was 39.1% among women and 37.2% among men. Conclusions Contradictory to decreased exposure to risk factors and the shorter period for diagnosis, the higher stages of cancer were observed in women. Although in women the advancement was higher and the majority of cases were located in unfavourable supraglottic area, the survival rates were higher. Key words: laryngeal cancer, epidemiology, men and women, risk factors.

Cigarette Smoking among Economically Disadvantaged African-American Older Adults in South Los Angeles: Gender Differences.

The current study aims to explore gender differences in the risk of cigarette smoking among African-American (AA) older adults who live in economically disadvantaged urban areas of southern Los Angeles. This cross-sectional study enrolled 576 older AA adults (age range between 65 and 96 years) who were residing in Service Planning Area 6 (SPA 6), one of the most economically challenged areas in southern Los Angeles. All participants had cardiometabolic disease (CMD). Data were collected using structured face-to-face interviews. Demographic factors (age and gender), socioeconomic status (educational attainment and financial difficulty), health (number of comorbid medical conditions and depressive symptoms), and health behaviors (current alcohol drinking and current smoking) were measured. Logistic regressions were used to analyze the data without and with interaction terms between gender and current drinking, depressive symptoms, and financial difficulty. AA men reported more smoking than AA women (25.3% versus 9.3%; p < 0.05). Drinking showed a stronger association with smoking for AA men than AA women. Depressive symptoms, however, showed stronger effects on smoking for AA women than AA men. Gender did not interact with financial difficulty with regard to current smoking. As AA older men and women differ in psychological and behavioral determinants of cigarette smoking, gender-specific smoking cessation interventions for AA older adults who live in economically deprived urban areas may be more successful than interventions and programs that do not consider gender differences in determinants of smoking. Gender-tailored smoking cessation programs that address drinking for AA men and depression for AA women may help reduce the burden of smoking in AA older adults in economically disadvantaged urban areas. Given the non-random sampling, there is a need for replication of these findings in future studies.

Application of trans-theoretical model for smoking cessation in sample of Iranian men

ABSTRACTThis is a quasi-experimental study conducted on 200 men smokers living in Fasa City, Iran, in 2016. The data gathering tools consisted of five parts: demographical information; questions related to the construct of the stages of change model; assessment of behavioral and cognitive change processes; self-efficacy; the outcomes of smoking; and the obstacles in the way of continual use of smoking; and smoking cessation. The courses consisted of eight sessions each 55-60 min. After six months, data were collected once more by inviting the subjects to the clinics and asking them to fill out the questionnaires. Linear regression showed that the stages of change in variables, pros, cons, the age of starting smoking, experimental processes, and self-efficacy were the predictors of smoking. Moreover, comparison of the control and experiment groups with regard to the change stages before and after the intervention did not show a significant difference between the two groups before the educational intervention. However, we observed a significant difference between the two groups after the educational intervention. The findings revealed the efficiency of the educational intervention, based on stages of change model, in the form of increase in the number of cessation smoking attempts.

Gender Perspective on Drivers of Cigarette Smoking: Two Part Model Approach

An estimated 2.5 million Kenyans which is over 11 percent of the country’s adult population currently use tobacco thus informing the need to take strong action to reduce tobacco use. Therefore, this study conducted a gender analysis on drivers of cigarette smoking in Kenya. The study heavily relied on data from Kenya Global Adult Tobacco Survey 2014. Specifically, two-part model was used to establish the effect of demographic and psychosocial drivers on both smoking participation and intensity among men and women. The study found that price of cigarette had an insignificant effect on men participation in smoking while age and years spent in education had a significant and negative effect on women smoking participation. Smoking rules inside home had a negative effect on women participation in smoking while smoking policy at indoor work place had a negative and significant effect on men smoking participation. Overally, cigarette tax adjustment had a negative and significant effect on both men and women participation in smoking. Work status had a negative and very significant effect on both men and women smoking intensity. The findings, therefore, confirmed the significant effect of smoking policy and cigarette tax adjustment on both smoking participation and smoking intensity among men and women.

Association Between Perceived Discrimination and Alcohol and Tobacco Consumption in ELSA-Brasil Cohort: Focusing on Gender Differences

Background: Discrimination is detrimental to physical and mental health, particularly insofar as health-risk behaviors are concerned. Particular attention has been paid to excess alcohol consumption and smoking in view of the ready availability of these substances in Western societies. Objectives: To determine whether an association exists between perceived discrimination and excess alcohol intake and smoking in women and men enrolled in the ELSA-Brasil cohort study. Methods: The sample included in the ELSA-Brasil cohort consisted of 15,105 civil servants. Data from waves 1 and 2 of the study were used. A multidimensional questionnaire was used to collect sociodemographic characteristics and evaluate perceived discrimination, alcohol consumption, and smoking. Results: An association was found between excess alcohol intake and perceived discrimination only in the men, with this association remaining significant in the youngest age group, in university-educated individuals, and in the group classified as middle-class. An association was found between smoking and lifetime perceived discrimination in women, particularly in those ≥60 years of age, brown-skinned women, those who had completed elementary school, and those classified as upper social class. This same association was found in the men, mainly those of 50–59 years of age, white-skinned males, those who had completed high school, those with a university education, and those classified as upper social class. Conclusions/Importance: Investing in public health policies aimed at combating the different forms of discrimination would appear essential. Not only does discrimination contribute to social injustice, but it also encourages health-risk behaviors such as excess alcohol intake and smoking.

Active and Passive Smoking, BRAFV600E Mutation Status, and the Risk of Papillary Thyroid Cancer: A Large-Scale Case-Control and Case-Only Study.

PurposeThe association between tobacco smoking and thyroid cancer remains uncertain. We evaluated the associations of active and passive smokingwith the risk of papillary thyroid cancer (PTC), the most common type of thyroid cancer, and with the BRAFV600E mutation, the most common oncogenic mutation in PTC related to poor prognosis.Materials and MethodsWe conducted this study with newly diagnosed PTC patients (n=2,142) and community controls (n=21,420) individually matched to cases for age and sex. Information on active and passive smoking and potential confounders were obtained from structured questionnaires, anthropometric measurements, and medical records. BRAFV600E mutation status was assessed in PTC patients. We evaluated the associations of active and passive smoking with PTC and BRAFV600E mutation risk using conditional and unconditional logistic regression models, respectively.ResultsWe did not find associations between exposure indices of active and passive smoking and PTC risk in both men and women, except for the association between current smoking and lower PTC risk. Cumulative smoking ≥ 20 pack-years was associated with lower BRAFV600E mutation risk in male PTC patients (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.30 to 1.00). The CI for the association was wider in female PTC patients (OR, 0.23; 95% CI, 0.02 to 2.62), possibly owing to a smaller sample size in this stratum.ConclusionWe did not find consistent associations between active and passive smoking and PTC risk. Cumulative smoking ≥ 20 pack-years was associated with lower BRAFV600E mutation risk in male PTC patients.

Prevalence of Smoking and Knowledge About the Hazards of Smoking Among 170 000 Chinese Adults, 2013-2014.

Periodic population surveys of smoking behavior can inform development of effective tobacco control strategies. We investigated smoking patterns, cessation, and knowledge about smoking hazards in China. A nationally representative cross-sectional survey recruited 176 318 people aged ≥18 years across 31 provinces of China in 2013-2014, using multi-stage stratified cluster sampling methods. The smoking patterns, cessation, and knowledge about smoking hazards were analyzed, overall and in population subgroups, adjusting for sample selection weight and post-stratification factors. Among men, 60.7% were ever-smokers, with proportions of regular, occasional and former smokers being 46.3%, 5.5%, and 8.8% respectively. Among women, only 2.8% had ever smoked. The prevalence of ever smoking in men was higher in rural than urban areas (63.2% vs. 57.6%) and varied from 39.5% to 67.4% across 31 provinces. Among male regular smokers, the mean daily number of cigarettes smoked was 17.8, with mean age at first starting to smoke daily being 20.1 years. Among current smokers, one-third (32.6% men, 32.1% women) had tried to quit before and 36.8% (36.8% men, 35.5% women) intended to quit in the future. Of the Chinese adults, 75.9% recognized that smoking was hazardous, with the proportions believing that smoking could cause lung cancer, heart attack or stroke being 67.0%, 33.2%, and 29.5%, respectively and with 26.0% reporting that smoking could cause all these conditions. Among Chinese adults, the smoking prevalence remained high in men but was low in women. In both men and women, knowledge about smoking hazards was poor. This study showed that tobacco smoking remained highly prevalent among adult men in China in 2013-2014. Moreover, men born in recent decades were more likely to start smoking at younger ages and to smoke more cigarettes than those born in previous generations. There was a large regional variation in male smoking prevalence, with the least economically developed regions having higher prevalence. In contrast, few women in China smoked, especially among those born in recent decades. The contrasting smoking patterns in men and women is likely to result in an increasingly large gender disparity in life expectancy in the coming decades.