Smoking Men Research Articles

Influence of arterial hypertension, smoking, and their combination on mortality (according to the results of a 27-year cohort prospective study of the unorganized population of Tomsk)

Aim. To study the influence of arterial hypertension (AH), smoking, and their combination on the risk of all cause and cardiovascular mortality.Material and methods. We conducted a 27-year cohort prospective study of the unorganized population of Tomsk (916 women and 630 men aged 20-59 years). At the first stage, we studied the prevalence of AH and smoking (1998-1991), at the second (2015) — the effect of these risk factors (RF) and their combination on the risk of all cause and cardiovascular mortality. AH was diagnosed at a blood pressure level of >140/90 mmHg and <140/90 mm Hg in individuals taking antihypertensive drugs. Smokers were individuals who smoked at least 1 cigarette per day and quit smoking less than one year ago.Results. The study found a significant effect of AH and smoking on mortality: the relative risk (RR) of all-cause mortality in people with hypertension was 2,2, in smokers — 2,3, in those with a combination of RF — 5,0. The RR of cardiovascular mortality in AH individuals was 3,4, in smokers — 1,6, in smoking men and women suffering from AH — 5,2. An increase in the risk of all-cause mortality in people with AH and smoking was observed in all gender-age groups. Smoking was found to increase the risk of all-cause mortality in individuals with high levels of blood pressure by 2,1 times compared with non-smoking hypertensive patients. It reduces the chances of a 27-year survival rate to 64,4%, and more so in the youngest (20-39 years) age group (RR — 3,9). Multivariate analysis showed that AH and smoking make the most significant contribution to the formation of mortality compared to other modifiable RFs.Conclusion. We found that AH and smoking are among the most influential RFs, and their combination increases the RR of all-cause mortality by 5,0 times (cardiovascular — 5,2 times). We also determined an additional risk of smoking in individuals suffering from AH to the all-cause mortality.

Designing an educational intervention on second-hand smoke in smoker men on the exposure of pregnant wives: a protocol for a randomized controlled trial

BackgroundComplications of exposure to second-hand smoke (SHS) are known to affect the health of pregnant women; it requires designing an educational program to reduce the exposure of pregnant women to smoke. Therefore, the purpose of this study was to design an educational program to reduce the exposure of pregnant women with the second-hand smoke of their husband.MethodsThis research-based program is designed in three phases, in the first phase of the study, the level of knowledge, attitude, and practice of men regarding SHS will be measured using a questionnaire. The questionnaire will be based on a literature review and experts opinions. In the next phase the educational program will be designed based on the results of the first phase of the study on the level of knowledge, attitude, self-efficacy, and practice of men, as well as a literature review and experts opinions, and the research team will finalize it according to priorities. To follow up the training will be sent reminders messages. Pregnant women will also be trained to protect themselves and support their husbands to quit smoking. The third phase includes the implementation of educational intervention with pretest-posttest with two intervention and control groups.DiscussionThe present study provides strong information and data regarding the needs and strategies for reducing the exposure to second-hand smoke in pregnant women. Therefore, designing a program, and a review article and updated evidences can lead to avoid pregnant women the exposure to second hand smoke and reducing smoking in smoker husbands. It can also reduce their medical and treatment costs.Trial registrationRegistration of this randomized control trial has been completed with the Iranian Registry of Clinical Trials, IRCT20180722040555N1.

Global Epidemiology of Lung Cancer.

While lung cancer has been the leading cause of cancer-related deaths for many years in the United States, incidence and mortality statistics – among other measures – vary widely worldwide. The aim of this study was to review the evidence on lung cancer epidemiology, including data of international scope with comparisons of economically, socially, and biologically different patient groups. In industrialized nations, evolving social and cultural smoking patterns have led to rising or plateauing rates of lung cancer in women, lagging the long-declining smoking and cancer incidence rates in men. In contrast, emerging economies vary widely in smoking practices and cancer incidence but commonly also harbor risks from environmental exposures, particularly widespread air pollution. Recent research has also revealed clinical, radiologic, and pathologic correlates, leading to greater knowledge in molecular profiling and targeted therapeutics, as well as an emphasis on the rising incidence of adenocarcinoma histology. Furthermore, emergent evidence about the benefits of lung cancer screening has led to efforts to identify high-risk smokers and development of prediction tools. This review also includes a discussion on the epidemiologic characteristics of special groups including women and nonsmokers. Varying trends in smoking largely dictate international patterns in lung cancer incidence and mortality. With declining smoking rates in developed countries and knowledge gains made through molecular profiling of tumors, the emergence of new risk factors and disease features will lead to changes in the landscape of lung cancer epidemiology.

A cross-sectional study to estimate the point prevalence of painful diabetic neuropathy in Eastern Libya

BackgroundPainful Diabetic Neuropathy (PDN) is a complication that affects up to one third of people living with diabetes. There is limited data on the prevalence of PDN from countries in the Middle East and North Africa. The aim of this study was to estimate the point prevalence of PDN in adults in Eastern Libya using the self-report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale.MethodsWe invited patients attending the Benghazi Diabetes Centre who had diabetes for ≥ 5 years to take part in the study. Patients provided consent and completed the Arabic S-LANSS. Anthropometrics, marital status, socioeconomic and education information was recoded and fasting plasma glucose concentration determined.ResultsFour hundred and fifty participants completed the study (age = 19 to 87 years, BMI = 17.6 to 44.2 kg/m2, 224 women). One hundred and ninety five participants (43.3%) reported pain in their lower limbs in the previous 6 months and 190/195 participants (97.4%) reported a S-LANSS score of ≥ 12 suggesting they had neuropathic pain characteristics. Thus, 42.2% (190/450) of participants with diabetes were categorised as experiencing pain with neuropathic characteristics. Mean ± SD duration of diabetes for participants with PDN (20.4 ± 6.5 years) was significantly higher compared with those without PDN (11.1 ± 4.6 years). Participants with PDN smoked tobacco for more years than those without pain (7.9 ± 12.3 years versus 1.1 ± 3.9 years respectively); had significantly higher fasting plasma glucose concentration (143.6 ± 29.3 mg/dl versus 120.0 ± 17.3 mg/dl) and had a significantly higher levels of education and employment status. The most significant predictors of PDN were duration of diabetes (OR = 25.85, 95% CI = 13.56–49.31), followed by smoking for men (OR = 8.28, 95% CI = 3.53–9.42), obesity (OR = 3.96, 95% CI = 2.25–6.96) and high fasting plasma glucose concentration (OR = 3.51, 95% CI = 1.99–6.21).ConclusionThe prevalence of PDN in people with diabetes in Eastern Libya was 42.2%. Risk factors for developing PDN were high fasting plasma glucose concentration, long duration of diabetes, and higher level of educational and employment status.

Marijuana Smoking in Men with HIV Infection: A Cause for Concern

Marijuana Smoking in Men with HIV Infection: A Cause for Concern

Tobacco Smoking, Substance Use, and Mental Health Symptoms in People with HIV in an Urban HIV Clinic.

The prevalence of tobacco smoking among people with HIV (PWH) ranges from 40% to 70%. Additionally, tobacco smoking is higher among low-income individuals, yet few studies have examined tobacco smoking in low socioeconomic status PWH. Using data from a cohort of PWH receiving care in an urban HIV clinic, we characterized factors associated with current and former smoking and with initiation/re-initiation and cessation of tobacco use. Among a study sample of 1,607 PWH, the prevalence of current smoking was 46.6% among men and 46.0% among women. Current smoking in men and women was associated with Medicaid insurance status, substance use, and panic symptoms. In women, but not men, hazardous alcohol use decreased the likelihood of quitting smoking and increased the risk of initiation/re-initiation. Smoking interventions for low-income, urban PWH may need to be tailored to address mental health and substance use comorbidities.

Heavy cigarette smoking and alcohol consumption are associated with impaired sperm parameters in primary infertile men.

We assessed the concomitant impact of cigarette smoking and alcohol consumption in men presenting for primary couple's infertility. Data from 189 infertile men were analyzed. Semen analysis, serum hormones, and sperm DNA fragmentation (SDF) were obtained. Smoking status was categorized as follows: current nonsmoker (−S), moderate smoker (+MS), and heavy smoker (+HS). Alcohol consumption was categorized as follows: abstainer (−D), moderate drinker (+MD), and heavy drinker (+HD). Descriptive statistics and logistic regression models were applied. Among all the participants, 132 (69.8%), 30 (15.9%), and 27 (14.3%) patients were −S, +MS, and +HS, respectively. In addition, 67 (35.4%), 77 (40.7%) and 45 (23.8%) men were -D, +MD and +HD, respectively. Regarding concomitant habits, 52 (27.5%) patients were nonsmokers and abstainers (−S/−D: Group 1), 91 (48.1%) had at least one recreational habit (−S/+D or +S/−D: Group 2), and 46 (24.3%) were both smokers and drinkers (+S/+D: Group 3). Sperm concentration and progressive motility were lower in +HS and +HD, compared with −S and −D (all P < 0.05), respectively. Similarly, both parameters were significantly lower in Group 3 than Groups 1 and 2 (all P < 0.05). SDF values were higher in Group 3 than Groups 1 and 2 (both P < 0.05). In multivariate analysis, follicle-stimulating hormone (FSH) levels and concomitant +S/+D status were independent predictors of impaired sperm concentration and progressive motility (all P < 0.05). Heavy smoking and heavy drinking were associated with worse seminal parameters than moderate smoking/drinking and nonsmoking/abstaining. When concomitant, +S/+D status has an even greater detrimental effect on semen parameters.

Cross-Sectional Study to Characterise Nicotine Dependence in Central Vietnamese Men

Tobacco is legally permitted for adults, easily available, and the prevalence of smoking is high. Tobacco use is the largest preventable risk factor for human disease. To reduce smoking, many countries have introduced public policy to restrict the distribution of tobacco. The aim of this study was to analyse tobacco smoking and nicotine dependence in Central Vietnamese men around Hue and Da Nang cities. Nicotine dependence was measured using the Fagerström Test for Nicotine Dependence (FTND) score. The cohort contained total of 1822 Central Vietnamese men from Hue and Da Nang: 1453 smokers and 369 non-smokers. Individuals completed a questionnaire and factors such as smoking initiation, quitting behaviour, and success in quitting were also recorded. In the smoking group, the average amount of time in which the individual had smoked was 26.4 years. Average FTND value was 4.02, median was 4, the first quartile was 2, and the third quartile was 6. In all, 431 smokers (30%) had an FTND score of 6 or higher; an FTND score of this value is considered to equate to an individual having high nicotine dependence. Therefore, it could be noted that high nicotine dependence is very common in Central Vietnam. High nicotine dependence was significantly correlated with years of smoking. The longer the smoking period, the higher the FTND score. A high FTND score correlated with the individual being less likely to successfully quit smoking. The results of the questionnaire demonstrate that even when there is no restriction in public policy concerning the distribution of tobacco, individuals still wish to quit smoking. This study identified a high prevalence of severe nicotine dependence in Central Vietnamese men and the majority smokers wished to quit smoking. Consequently, the results of this study highlight the acute need for a specific programme to aid smokers in Central Vietnam to quit smoking.

Biochemical significance of ecto-5'-nucleotidase, xanthine oxidase, and glutathione S-transferase determinations in sera of cigarette and water pipe young men smokers

Biochemical significance of ecto-5'-nucleotidase, xanthine oxidase, and glutathione S-transferase determinations in sera of cigarette and water pipe young men smokers

Characteristics and outcomes of cocaine-associated sudden cardiac arrest in the general population

Cocaine use in the general population has increased in recent years and although cardiovascular effects of cocaine have been investigated, cocaine-related sudden cardiac arrest (SCA) in the overall community has been described only through forensic studies. In this prospective ongoing multicentre population-based registry, all SCA alive at hospital admission over a 5-year period were prospectively enrolled. Cocaine-associated SCA were compared to other causes of SCA in terms of characteristics, management and outcomes. Among the 3028 SCAs admitted alive out of a total of 18,622 out-of-hospital cardiac arrests from May 2011 to May 2016, 32 SCAs (1.1%) were eventually associated with cocaine use, including 18 (56.3%) after acute use. Compared to SCA from other cause, cocaine-related SCA victims were younger (44.1 vs. 59.3 years, P < 0.001), with greater proportion of males (87.5 vs. 73.0%, P = 0.058), lesser known coronary artery disease (0 vs. 18.4%, P < 0.001), but significantly more frequent active smokers (65.6 vs. 30.2%, P < 0.001). The main underlying mechanisms of cocaine-associated SCA were acute myocardial ischemia (13/27 cases, 48.1%), including coronary spasm in 8 cases (61.5%), followed by multiple drug intoxication (18.5%), hypoxic causes (11.1%), pulmonary embolism (7.4%) and miscellaneous. SCA characteristics, initial and in-hospital management as well as survival rate (28.1% vs. 26.8%; P = 0.84) were not significantly different in cocaine-associated. In the general population, cocaine-associated SCA is a rare cause of SCA (1.1%), mostly occurring in young actively smoking men, immediately after acute use in more than half of cases. Coronary spasm, though representing the principal underlying mechanism, explains finally only one third of cocaine-associated SCA.

TOBACCO WATER - HIDDEN KILLER IN THE NORTH EAST INDIA!

Usage of tobacco is a global epidemic regardless of age and sex, and all the nitty-gritty of its harmfulness has been documented, taught and spread to every nook and cranny, it is still being considered a social status as a ‘cool quotient’ especially in youth. While, 8-9 lakh deaths every year in India are attributed to have caused by tobacco in varied forms, having a significant implication in the nation’s public health, the use of smokeless tobacco, highly prevalent in India - accounting for 74 percent of the global burden, and exceeds cigarette smoking in both men and women, is to be worried much about too.

Sociodemographic, socioeconomic, clinical and behavioural predictors of body mass index vary by sex in rural South African adults-findings from the AWI-Gen study

ABSTRACTBackground: Despite increasing obesity in South African adults, data on the prevalence and determinants of body mass index (BMI) from rural communities, home to a significant proportion of the population, are scarce.Objectives: To investigate overall and sex-specific determinants of BMI in a rural adult South African population undergoing rapid social and epidemiological transitions.Methods: Baseline cross-sectional demographic, socioeconomic, anthropometric, clinical and behavioural data were collected between 2015 and 2016 from 1388 individuals aged 40–60 years and resident in the Agincourt sub-district of Mpumalanga province, a setting typical of rural northeast South Africa. A Health and Socio-Demographic Surveillance System (HDSS) underpins the sub-district and contributes to the Africa Wits-INDEPTH partnership for Genomic Studies (AWI-Gen). Linear regression was used to investigate univariate associations between log-transformed BMI and individual variables and multiple linear regression was used to investigate independent predictors of BMI overall and in sex-stratified analyses.Results: Median BMI was significantly higher in females (28.7 kg/m2[95% CI 24.2–33.2] vs 23.0 kg/m2[95% CI 20.3–26.8];p < 0.001) with male sex associated with 17% lower BMI. In sex-stratified multiple linear regression models, compared to those never married, BMI was 7% higher in currently married males and 6% in currently married females. Current smoking in men and former smoking in women were associated with reductions in BMI of 13% and 26% respectively, compared with non-smokers. Higher educational attainment in women and higher socioeconomic status in men were both associated with higher BMI, while being HIV-positive and alcohol consumption in women were associated lower BMI.Conclusions: Female sex strongly predicts higher BMI in this rural African population. While some predictors of higher BMI differ by sex, married individuals in both sexes had a higher BMI, suggesting that, in addition to developing sex-specific interventions to combat overweight and obesity, targeting married couples may result in reduction in population BMI.

Which personal, behavioural, environmental, and social factors are important in smoking cessation and relapse in male manual workers? A qualitative study in southeast England

BackgroundIn most developed countries, the prevalence of smoking remains stubbornly high in lower socioeconomic groups. Male manual workers in England are more than twice as likely as those in managerial and professional occupations to smoke (26% vs 11%), find it more difficult to quit, and have the highest relapse rates. We sought to determine perceived factors in smoking cessation and relapse in this hard-to-reach group to inform the development of effective stop smoking services and public health efforts to reduce the health inequality caused by smoking. MethodsIn this qualitative study in southeast England, 12 male manual workers (aged 18–65 years), who had accessed the Sussex Community NHS Trust Stop Smoking Service during the previous 12 months, were recruited into two focus groups (FG 1, n=4; FG 2, n=8). The focus group discussions were guided by structured and prompt questions. The Brighton East Research Ethics Committee approved the study, and written informed consent was obtained from all participants. FindingsParticipants identified three broad themes that influenced their smoking cessation efforts and relapse. First, personal and behavioural factors included effect of smoking on current physical fitness as a stronger motivating factor to quit than long-term health risks, risk of relapse associated with use of recreational substances (drugs, alcohol), positive impact of changing one's daily routine or habits to control smoking triggers, negative impact on children, negative social impact of “smelling of cigarettes”, and perception that women have more willpower and find it easier to quit smoking. Second, environmental factors included triggering effect of stressful life events, increased risk of relapse because of the availability of packs of ten cigarettes, and the beneficial effect of a ban on point-of-sale display and smoking in pubs and bars. Third, social factors included positive impact of support from friends, family, or the local community, and negative impact of perceived greater “social acceptability” of smoking in men and “social acceptability” of smoking versus other addictions (eg, recreational drugs, heroin, alcoholism). InterpretationThis new insight informs the development of public health interventions, which need to address these social norms and attitudes in this group of disadvantaged smokers. Carefully targeted and effective campaigns with appropriate content and tone may reduce the health inequality caused by smoking. FundingBrighton and Sussex Medical School.

Tobacco Smoking: Findings from 20 Years of the Tehran Lipid and Glucose Study.

ContextSmoking is a global public health priority and accurate data of the local population is essential to improve the health policies against its use. Hence, this study aimed to summarize the important findings available on the prevalence of smoking and its association with non-communicable diseases, documented by one of the largest prospective community-based studies of Iran.Evidence AcquisitionAll articles derived from the Tehran Lipid and Glucose Study (TLGS) in the last two decades, from the earliest publications until 30 January 2018 were reviewed for their findings on tobacco smoking.ResultsThe prevalence of smoking in non-diabetic adults ≥ 20 years increased between baseline (phase I, 1999 - 2001) and follow-up (phase V, 2008 - 2011) from 25.5% to 35.4% among men and from 3.4% to 6.8% among women. In TLGS adolescents (10 - 18 years) water pipe use increased between 2003 and 2005 from 35.5% to 40.9% among boys and from 19.7% to 26.1% among girls. Regarding health hazards, smoking in men was associated with increased risk of combined impaired fasting glucose/impaired glucose tolerance [hazard ratio (HR) 1.69; confidence interval (CI) 95% 1.15 - 2.48] and hypertension (HR 1.26; CI 95% 0.98 - 1.63). Moreover, men, even smoking less than 10 cigarettes per day, were at increased risk for cardiovascular diseases by HR 2.12 (CI 95% 1.14 - 3.95). For women, the risk of chronic kidney disease dramatically increased 5.74-fold (CI 95% 2.71 - 12.15) among smokers. In the whole population, smoking contributed to 7.7% of all-cause mortality with HR 1.75 (CI 95% 1.38 - 2.22). Other health aspects of tobacco smoke, including its impact on metabolic status, thyroid function, female reproductive system and life style have also been reviewed.ConclusionConsidering hazards of smoking, there is the urgency for more effective preventive measures in Iran; emphasizing the need for further local studies on the hazards of smoking with special attention to women and adolescents and the independent hazards of water pipe use.

Cigarette Smoking and Secondhand Smoke Exposure Before and After a Tobacco-Free Olympic Policy Period: Qingdao, China.

We explored the impact of a temporary tobacco-free public policy for the 2008 Summer Olympics on the smoking prevalence and secondhand smoke exposure among the population of a co-hosting city, Qingdao, China. The Qingdao Diabetes Survey was analyzed for 2006 (n = 4599) and 2009 (n = 4680), which are survey years before and after the tobacco-free Olympics public policy period (July 2007 to January 2009). We analyzed the differences in self-reported smoking prevalence and exposure to secondhand smoke at home and/or workplace, and compared odds of smoking by survey year and of exposure to secondhand smoke among nonsmokers. From 2006 to 2009, the male smoking prevalence declined from 51.4% (95% confidence interval [CI] = 49.0% to 53.9%) to 42.6% (95% CI = 40.2% to 45.1%), and the proportion of lighter smokers decreased more. Among nonsmokers, the secondhand smoke exposure rate declined from 62.2% (95% CI = 60.5% to 63.9%) to 56.8% (95% CI = 55.1% to 58.6%). Regression analyses show 34% lower odds of men smoking after Olympics (OR = 0.66, 95% CI = 0.57% to 0.77%). Rural residents and individuals who are not retired were more likely to smoke. Female nonsmokers report 17% less exposure to secondhand smoke after Olympics (OR = 0.83, 95% CI = 0.70% to 0.98%). Urban nonsmokers were more likely to be exposed than their rural counterparts. Smoking prevalence among men and secondhand smoke exposure among women significantly decreased in Qingdao, China, after the tobacco-free Olympics public policy period. As only the proportion of lighter smokers decreased, this may help explain why urban nonsmokers reported increased exposure. Unintended increased secondhand smoke exposure and cessation support need to be addressed in large-scale policy campaigns. Hosting the Olympic Games can help to initiate large-scale tobacco-free public policies for hosting cities. Although previous studies have demonstrated reduction in nonsmoker exposure to secondhand smoke, the impact on the hosting city's smoking prevalence or exposure rates is unclear. After the Olympic Games in Qingdao, China, smoking prevalence among men significantly decreased, mostly due to light smokers. Secondhand smoke exposure at home and/or workplace significantly decreased among female nonsmokers. Urban nonsmokers had an unintended consequence of increased secondhand smoke exposure after the tobacco-free Olympic policy period. Concurrent promotion of cessation support for heavier smokers may be needed.

A Stranger in the Backyard: a Rare Case of Retroperitoneal Squamous Cell Carcinoma

Malignancies of the retroperitoneum are uncommon; they may either be primary or arise secondarily from contiguous organs. Primary retroperitoneal carcinomas are extremely rare. Squamous cell carcinoma (SCC) of the renal pelvis is a rare upper urinary tract urothelial carcinoma arising in the setting of chronic nephrolithiasis. Due to locally advanced disease or metastases, these aggressive malignancies are often inoperable at presentation. We report a case of a 55-year-old man, a hypertensive and chronic smoker with a history of analgesic abuse, who underwent left nephrectomy for a non-functional kidney (chronic pyonephrosis with stag-horn calculus). Histopathological examination of the specimen was neglected and the patient presented 4 months later with advanced, inoperable retroperitoneal SCC which could only be palliated. This article highlights the prognosis associated with renal SCC and the importance of early detection in improving outcomes; periodic imaging with biopsy of suspicious mass lesions should be advocated in patients with renal calculous disease especially stag-horn calculi. Exclusion of malignancy prior to nephrectomy (when indicated) and HPE of the resected specimen is crucial in management. Radical nephrectomy may merit consideration in patients with non-functional kidneys secondary to long-standing nephrolithiasis when malignancy is suspected.

New onset of depression in aging women and men: contributions of social, psychological, behavioral, and somatic predictors in the community - CORRIGENDUM.

Background Based on the vulnerability-stress model, we aimed to (1) determine new onset of depression in individuals who had not shown evidence of depression at baseline (5 years earlier) and (2) identify social, psychological, behavioral, and somatic predictors. Methods Longitudinal data of N = 10 036 participants (40-79 years) were evaluated who had no evidence of depression at baseline based on Patient Health Questionnaire (PHQ-9), no history of depression, or intake of antidepressants. Multivariate logistic regression models were used to predict the onset of depression. Results Prevalence of new cases of depression was 4.4%. Higher rates of women (5.1%) than men (3.8%) were due to their excess incidence l60 years of age. Regression analyses revealed significant social, psychological, behavioral, and somatic predictors: loneliness [odds ratio (OR) 2.01; 95% confidence interval (CI) 1.48-2.71], generalized anxiety (OR 2.65; 1.79-3.85), social phobia (OR 1.87; 1.34-2.57), panic (OR 1.67; 1.01-2.64), type D personality (OR 1.85; 1.47-2.32), smoking (OR 1.35; 1.05-1.71), and comorbid cancer (OR 1.58; 1.09-2.24). Protective factors were age (OR 0.88; 0.83-0.93) and social support (OR 0.93; 0.90-0.95). Stratified by sex, cancer was predictive for women; for men smoking and life events. Entered additionally, the PHQ-9 baseline score was strongly predictive (OR 1.40; 1.34-1.47), generalized anxiety became only marginally, and panic was no longer predictive. Other predictors remained significant, albeit weaker. Conclusions Psychobiological vulnerability, stress, and illness-related factors were predictive of new onset of depression, whereas social support was protective. Baseline subclinical depression was an additional risk weakening the relationship between anxiety and depression by taking their overlap into account. Vulnerability factors differed between men and women.

New onset of depression in aging women and men: contributions of social, psychological, behavioral, and somatic predictors in the community.

Based on the vulnerability-stress model, we aimed to (1) determine new onset of depression in individuals who had not shown evidence of depression at baseline (5 years earlier) and (2) identify social, psychological, behavioral, and somatic predictors. Longitudinal data of N = 10 036 participants (40-79 years) were evaluated who had no evidence of depression at baseline based on Patient Health Questionnaire (PHQ-9), no history of depression, or intake of antidepressants. Multivariate logistic regression models were used to predict the onset of depression. Prevalence of new cases of depression was 4.4%. Higher rates of women (5.1%) than men (3.8%) were due to their excess incidence &lt;60 years of age. Regression analyses revealed significant social, psychological, behavioral, and somatic predictors: loneliness [odds ratio (OR) 2.01; 95% confidence interval (CI) 1.48-2.71], generalized anxiety (OR 2.65; 1.79-3.85), social phobia (OR 1.87; 1.34-2.57), panic (OR 1.67; 1.01-2.64), type D personality (OR 1.85; 1.47-2.32), smoking (OR 1.35; 1.05-1.71), and comorbid cancer (OR 1.58; 1.09-2.24). Protective factors were age (OR 0.88; 0.83-0.93) and social support (OR 0.93; 0.90-0.95). Stratified by sex, cancer was predictive for women; for men smoking and life events. Entered additionally, the PHQ-9 baseline score was strongly predictive (OR 1.40; 1.34-1.47), generalized anxiety became only marginally, and panic was no longer predictive. Other predictors remained significant, albeit weaker. Psychobiological vulnerability, stress, and illness-related factors were predictive of new onset of depression, whereas social support was protective. Baseline subclinical depression was an additional risk weakening the relationship between anxiety and depression by taking their overlap into account. Vulnerability factors differed between men and women.

The association between smoking and cardiometabolic risk among male adults with disabilities in Taiwan.

Individuals with disabilities have health needs similar to the general population. Smoking and metabolic syndrome have emerged as major cardiovascular risks that contribute to systemic inflammation and mortality. However, few studies have focused on the association between smoking and cardiometabolic risks in adult men with disabilities. This study explored the prevalence of smoking and its association with cardiometabolic risk and associated factors among male adults with disabilities. This study was part of a nurse-led health-promotion program designed to examine the health needs in health programs for adults with disabilities. A community-based, cross-sectional study was conducted between July 2013-December 2014, in Chiayi County, Taiwan. Of the total of 964 male participants enrolled in this study, 874 (90.7%) participants had complete data sets. The prevalence of cigarette smoking and metabolic syndrome were 42%, and 33.3%, respectively. More than half (62.7%) had high blood pressure and 43.5% had central obesity. Compared with non-smokers, smokers tended to engage in less frequent regular exercise ( p<0.001), eat fewer vegetables and fruit ( p<0.05), and drink less water ( p<0.05). After adjusting for potential confounding variables, multivariable logistic regression analysis showed that smoking was an independent factor for cardiometabolic risk. The present findings show a high prevalence of cigarette smoking, unhealthy lifestyle, and cardiometabolic risk among adult men with disabilities. Clinicians and primary healthcare providers should reduce the consequences thereof by initiating innovative health promotion programs.

Secondhand Smoke Exposure in Childhood and Adulthood in Relation to Adult Mortality Among Never Smokers

Secondhand smoke is known to have adverse effects on the lung and vascular systems in both children and adults. It is unknown if childhood exposure to secondhand smoke is associated with adult mortality. The authors examined associations of childhood and adult secondhand smoke exposure with death from all causes, ischemic heart disease, stroke, and chronic obstructive pulmonary disease among 70,900 never smoking men and women, predominantly aged ≥50 years, from the Cancer Prevention Study-II Nutrition Cohort in 1992-1993. There were 25,899 participant deaths during follow-up through 2014. During 2016-2017, Cox proportional hazards regression models were used to calculate multivariable-adjusted hazard ratios and 95% CIs. Childhood secondhand smoke exposure was not associated with all-cause mortality. However, childhood secondhand smoke (living with a smoker for 16-18 years during childhood) was associated with higher mortality from chronic obstructive pulmonary disease (hazard ratio=1.31, 95% CI=1.05, 1.65). Adult secondhand smoke exposure of ≥10 hours/week at enrollment was associated with a higher risk of all-cause (hazard ratio=1.09, 95% CI=1.04, 1.14); ischemic heart disease (hazard ratio=1.27, 95% CI=1.14, 1.42); stroke (hazard ratio=1.23, 95% CI=1.04, 1.45); and chronic obstructive pulmonary disease (hazard ratio=1.42, 95% CI=0.97, 2.09) mortality. These results suggest that childhood secondhand smoke exposure, as well as adult secondhand smoke exposure, increase the risk of chronic obstructive pulmonary disease death in adulthood. Consistent with previous studies, the results also show that adult secondhand smoke is meaningfully associated with higher mortality from vascular disease and all causes. Overall, these findings provide further evidence for reducing secondhand smoke exposure throughout life.