People Smoke Research Articles

Comparing cigarette-cue attentional bias between people with HIV/AIDS and people with opioid use disorder who smoke

ABSTRACT Background: Special populations like people living with HIV/AIDS (PLWHA) and people with opioid use disorder (OUD) smoke tobacco cigarettes at rates three to four times greater than the general population. Patients with tobacco use disorder exhibit attentional bias (AB) for cigarette cues. Eye tracking can quantify this bias by measuring fixation time (FT) on cigarette and matched neutral cues, to calculate an AB score. Although previous studies have measured this bias in people who smoke without any other comorbid conditions, no study, to our knowledge, has measured or compared this bias in special populations. Methods: We performed exploratory analyses on eye tracking data collected in two separate randomized clinical trials (RCTs) (NCT05049460, NCT05295953). We compared FT and cigarette-cue AB score (measured by subtracting FT on neutral cues from FT on cigarette cues) between PLWHA and people with OUD who smoke, using a visual probe task and Tobii Pro Fusion eye tracker. We used two cigarette cue types, one encompassing people smoking cigarettes and the other consisting of cigarette paraphernalia. We used two cue presentation times, 1000 and 2000 milliseconds (ms). Results: Cues of people smoking cigarettes elicited greater AB than cues of cigarette paraphernalia across both subject groups when cues were presented for 2000 ms, but not 1000 ms. PLWHA who smoke exhibited greater AB for cues of people smoking cigarettes than cigarette paraphernalia when presented for 2000 ms compared to people with OUD who smoke. Conclusion: We use cigarette-cue AB to quantify craving and cigarette consumption in two populations smoking at elevated rates. The addition of social cues potentiates cigarette cue AB, based on cue type and stimulus presentation time. Understanding the neurobiology of this relationship can help design novel smoking cessation treatments that target AB and prevent relapse in these populations with suboptimal response to smoking cessation treatments. Trial registration: Clinical trials that provided the data for post hoc analyses are NCT05049460 and NCT05295953.

Exposure to Tobacco-Specific Nitrosamines Among People Who Vape, Smoke, or do Neither: A Systematic Review and Meta-Analysis.

Smoking exposes people to high levels of Tobacco-Specific Nitrosamines (TSNAs), which include potent carcinogens. We systematically reviewed TSNA exposure between people smoking, vaping, and doing neither. Databases were searched between August 2017-March 2022, using vaping-related terms. Peer-reviewed articles reporting TSNA metabolites (NNAL, NNN, NAB, and NAT) levels in bio-samples among adults exclusively vaping, exclusively smoking, or doing neither were included. Where possible, meta-analyses were conducted. Of 12 781 identified studies, 22 were included. TSNA levels fell substantially when people who smoke switched to vaping in longitudinal studies and were lower among people who vaped compared to smoked in cross-sectional studies. Levels of TSNAs were similar when comparing people who switched from smoking to vaping, to those who switched to no use of nicotine products, in longitudinal studies. Levels were higher among people who vaped compared to people who neither vaped nor smoked in cross-sectional studies.When comparing people who vaped to smoked: pooled urinary NNAL was 79% lower across three randomized controlled trials and 96% lower across three cross-sectional studies; pooled NAB was 87% lower and NAT 94% lower in two cross-sectional studies. When comparing people who neither vaped nor smoked to people who vaped, pooled urinary NNAL was 80%, NAB 26%, and NAT 27% lower in two cross-sectional studies. Other longitudinal data, and NNN levels could not be pooled. Exposure to all TSNAs was lower among people who vaped compared to people who smoked. Levels were higher among people who vaped compared to people who neither vaped nor smoked. As well as TSNAs, there are many other toxicant exposures from smoking and vaping that can increase the risk of disease. However, it is likely that the reduced exposure to TSNAs from vaping relative to smoking reduces the risk to health of those who use vaping products to quit smoking. Future high-quality research, with robust definitions of exclusive vaping and smoking, and accounting for TSNAs half-lives, is needed to fully assess exposure to TSNAs among people who vape.

Parallel trajectories of vaping and smoking cannabis and their associations with mental and physical well-being among young adults

BackgroundVaping and smoking are common modes of using cannabis (THC) among young adults, but little is known about how patterns of cannabis vaping and smoking unfold over time or how using one or both types of products may differently affect mental and physical well-being. This study examines parallel processes of cannabis vaping and smoking over 5 years and mental and physical outcomes in a sample of young adults. MethodsAnnual surveys were conducted between 2016 and 2022 with a mostly California-based cohort of 2428 young adults. Parallel process growth mixture models examined trajectories of past-month frequency of cannabis vaping and smoking from ages 20 – 25. Classes were extracted based on parallel trajectories of vaped and smoked product use. Models assessed differences in self-reported mental (anxiety, depression) and physical (ailments, subjective overall) well-being outcomes in young adulthood across classes, adjusting for demographic characteristics and mental and physical well-being at pre-baseline (average age 19). ResultsFour cannabis vaping/smoking classes emerged: low use of cannabis (84.7%), decreasing smoking, low-moderate vaping (7.1%), stable moderate smoking, decreasing vaping (4.6%), and rapid increasing dual use (3.4%). Classes were similar on physical well-being indicators in young adulthood. The rapid increasing dual use class showed higher anxiety and depressive symptoms compared to other classes. ConclusionProgression to higher frequency of both vaping and smoking cannabis in young adulthood may contribute to poorer mental well-being compared to other use patterns. Targeted efforts to reduce dual vaping and smoking in young people who use cannabis may be needed.

Passive exposure and perceptions of smoke-free policies in hospital and university campuses among nursing students: A cross-sectional multicenter study.

Outdoor smoke-free regulations reduce exposure to secondhand smoke (SHS) and help to denormalize tobacco use. As future key agents in health promotion, nursing students' attitudes should agree with tobacco-control policies. The objectives of this study were: 1) assess nursing students' exposure to SHS in nursing schools, 2) explore their perceptions of compliance with the existing smoke-free regulations in acute-care hospitals; and 3) describe their support for indoor and outdoor smoking bans on hospital and university campuses. This was a cross-sectional multicenter study conducted in 2015-2016 in all 15 university nursing schools in Catalonia, Spain. A questionnaire gathered information on SHS exposure, awareness of the smoke-free regulation in acutecare hospitals, and support for smoke-free policies in indoor and outdoor areas of hospitals and university campuses. Participants were nursing students attending classes on the day of the survey. We performed descriptive analyses and calculated adjusted prevalence ratios (APR) and 95% confidence interval (CI). Of 4381 respondents, 99.1% had seen people smoking in outdoor areas of their university campus, and 75.2% had been exposed to SHS on the campus (6.0% indoors and 69.2% outdoors). Nearly 60% were aware of the smoking regulation in place in acute-care hospitals. There was widespread support for smoke-free indoor hospital regulation (98.7%), but less support (64.8%) for outdoor regulations. Approximately 33% supported the regulation to make outdoor healthcare campuses smoke-free, which was higher among third-year students compared to first-year students (APR=1.41; 95% CI: 1.24-1.62), among never smokers (41.4%; APR=2.84; 95% CI: 2.21-3.64) compared to smokers, and among those who were aware of the regulation (38.4%; 95% CI: 1.37-1.75). Exposure to SHS on university campuses is high. Nursing students express low support for strengthening outdoor smoking bans on hospital and university campuses. Interventions aiming to increase their support should be implemented.

Review on Lung Cancer Lesion Detection and Segmentation Methods

Lung cancer itself and relevant detection and segmentation methods, in the modern society, becomes increasingly popular and significant topics. Scientists believe that people smoke positively may deteriorate their body health themselves, and people who breathe it in second hand may also suffer from this harmful environment. To help people with lung cancer lesions, there are several methods used for cancer treatment. Automated CT imaging can encircle suggested segmentation areas in a 3-D version, and it provides convenience with users when they feel tired after diagnosing for a whole day. Semi-automated CT deep learning model is another technique to detect particular regions in the lung by adjusting pixels. Additionally, few-shot learning based on advanced learning algorithm is an efficient method for lung cancer lesion detection, and Generative Adversarial Networks(GAN) can be used for lung cancer detection by using a small number of medical images as train datasets. However, CNN model cannot obtain global information; therefore, the integration of 2dcnn and 3dcnn solves this limitation in an effective approach.

Chronotype, Social Jetlag, and Nicotine Use.

Late chronotype, which often leads to higher social jetlag (SJL), is strongly associated with the prevalence of smoking. Any circadian disruption, strain, or misalignment, results in people not being able to live according to their biological time as is described by SJL, which we will therefore use as umbrella term. We hypothesized two scenarios potentially explaining the association between smoking and SJL: (A) If smoking delays the clock, circadian phase should advance upon quitting. (B) If people smoke more to compensate the consequences of SJL, circadian phase should not change upon quitting. To distinguish between these two hypotheses, we accompanied participants of a smoking cessation program (not involving nicotine replacement products) across the cessation intervention (3 weeks prior and 6 weeks after) by monitoring their circadian behavior, sleep quality, and daytime sleepiness via questionnaires and actimetry. Our results show no effects of cessation on SJL, chronotype, sleep quality, or daytime sleepiness, thereby favoring scenario (B). Thus, smoking may be a consequence of rather than a cause for SJL. Daytime sleepiness was a significant predictor for the outcome in our model but did not improve with cessation.

Correlation of Salivary Melatonin Levels and Many Periodontal Parameters in Cigarette Smokers with Periodontitis

Background: Adults who have periodontitis are more likely to lose teeth, which affects their quality of life and causes masticatory dysfunction. Most people agree that smoking tobacco makes them more likely to get oral mucosal and periodontal diseases and makes the oral microbiome less balanced. Melatonin is a naturally occurring hormone that is released in a variety of organs. Objectives: To examine the relationship between smoking and salivary melatonin levels in periodontitis patients vs healthy people, and to establish a relationship between melatonin levels and periodontal parameters. Materials and Methods: The study was conducted at the College of Dentistry, University of Baghdad, Baghdad, Iraq. The study period was from February to May 2022. There were a total of 74 male subjects aged 35-55 years, and they were divided into four different groups; Group 1: a control group of non-smokers (n = 12), Group 2: a control group of smokers (n = 12), Group 3: a group of individuals with periodontitis (n = 25), Group 4: a group of individuals with both periodontitis and a record of smoking (n = 25). A whole, unstimulated sample of the participant's saliva (5 ml) was taken, and this was followed by an evaluation of clinical periodontal variables (probing pocket depth and clinical attachment level). To measure melatonin concentrations, saliva samples were biochemically analyzed using the Enzyme-Linked Immunosorbent Assay (ELISA).Results: Melatonin concentrations were shown to be lower in groups with periodontitis than in control groups, as well as lower in groups with smoking than in groups without smoking. It was found that there was a strong negative link between periodontal variables and the amount of melatonin in the saliva. Conclusion: According to this study, a reduced melatonin level was noticed in the salivary fluid of the smoker (healthy and periodontitis) groups in comparison with the non-smoker (healthy and periodontitis) groups. This suggests that active cigarette smoking had a retarding effect on the salivary levels of melatonin.

The correlation between strength and range of motion of the neck muscles and opium smoking in Iran.

Opium smoking is commonly practiced via traditional and novel routes in Iran. Both smoking methods are practiced in a non-ergonomic position. According to previous studies and our hypothesis, it can be potentially harmful to the cervical spine. Thus, the present study aimed to investigate the relationship between opium smoking and neck range of motion and neck muscle strength. In this cross-sectional and correlational study, the range of motion and strength of the neck muscles of 120 men with drug use disorder were measured by a CROM goniometer and a hand-held dynamometer. Other data gathering was performed using a demographic questionnaire, the Maudsley Addiction Profile, and the Persian version of Leeds Dependence Questionnaire. The obtained data were analyzed by Shapiro-Wilks test, Pearson's correlation coefficient and stepwise linear regression. There was no significant correlation between the age of drug use onset and range of motion and muscle strength of the neck; however, the daily duration of opium smoking and the number of years of opium smoking were inversely and significantly correlated with the range of motion and muscle strength of the neck in some directions. Daily opium smoking time for decreasing in neck range of motion and total duration of opium smoking for reduction of neck muscles strength are stronger predictor variables. Opium smoking by traditional routes causes non-ergonomic positions and has a moderate significant correlation with reduced range of motion and neck muscle strength, in Iran. - The harm of drug use disorder is not only AIDS and hepatitis, and harm reduction programs should go beyond the prevention of AIDS and hepatitis. According to more than 90% of smoking use of drug compared to other methods (oral and injectable, etc.) musculoskeletal disorders caused by the smoking use of drugs, have a greater cost burden in reducing the quality of life and the need for rehabilitation.- Drug abuse treatment and harm reduction programs should focus more seriously on replacing smoking use of drugs with oral medications assisted treatment.- Although in Iran and some countries in the region, a large number of people smoke opium for many years and sometimes all their lives, daily in a completely non-ergonomic position, but studying the deformation of the posture and musculoskeletal disorders related to the body position in them, is not a scientific concern and neither physical therapy researchers have paid attention to it nor addiction researchers.- Neck muscles strength and range of motion in opium addicts are correlated to the number of years of opium smoking and daily minutes of opium smoking, but not to its oral use.- There is no significant correlation between the onset age of continues and permanent opium smoking and substance dependence severity with neck range of motion and muscles strength.- People with drug use disorder (especially smoking users) as a large group of vulnerable people, should be the target population of musculoskeletal disorders researchers and addiction harm reduction researchers, and more experimental, comparative, cohort, etc. researches should be designed and implemented for them.

COVID-19 and smoking: Considerations after two years

COVID-19 and smoking: Considerations after two years

Prevalence of smoking in adults aged 40 years and above in China, 2019-2020

Objective: To understand the prevalence of smoking and its change in adults aged ≥40 years in China and provide evidence for the development of chronic obstructive pulmonary disease (COPD) prevention and control strategies. Methods: The data of this study were obtained from COPD surveillance in China during 2014-2015 and during 2019-2020. The surveillance covered 31 provinces (autonomous regions and municipalities). A multi-stage stratified cluster random sampling were used to select residents aged ≥40 years, and face-to-face interviews were conducted to collect the information about their tobacco use. After complex sampling weighting of the samples, the current smoking rate, average age to start smoking and average daily cigarette consumption of people with different characteristics during 2019-2020 were estimated, and the changes in the current smoking rate and average daily cigarette consumption were analyzed from 2014-2015 to 2019-2020. Results: During 2019-2020, the current smoking rate in adults aged ≥40 years was 27.2%, and the rate was much higher in men (52.1%) than in women (2.5%).The average age of the smokers to start smoking was 20.0 years old, and men usually started smoking at younger age (19.6 years) compared with women (27.9 years). The average daily cigarette consumption of daily smokers was 18.0 sticks, and the consumption of men (18.3 cigarettes) was higher than that of women (11.1 cigarettes). Compared with the surveillance results during 2014-2015, the current smoking rate had decreased by 2.8 percentage points in the general population, 4.1 percentage points in males, 1.6 percentage points in females, and the urban and rural areas fell by 3.1 percentage points and 2.5 percentage points, respectively. The average daily cigarette consumption decreased by 0.6 sticks. Conclusions: In recent years, the current smoking rate and average daily cigarette consumption in adults aged ≥40 years decreased in China, but smoking is still common in more than quarter of this population and more than half of men aged ≥40 years. It is necessary to take targeted tobacco control measures based on population and regional characteristics to further reduce the smoking level of the population.

The Healthy Schools Stop Smoking and Vaping Service provides ‘Catch Your Breath’ – a school-based smoking and vaping programme for young people in Cambridgeshire and Peterborough, England

The Healthy Schools Stop Smoking and Vaping Service provides ‘Catch Your Breath’ – a school-based smoking and vaping programme for young people in Cambridgeshire and Peterborough, England

Prevalence of tobacco smoking in people at clinical high-risk for psychosis: Systematic review and meta-analysis.

Several hypotheses have been proposed to explain why individuals with psychosis consume more tobacco compared with the general population, but the reasons remain unclear. The phases predating the onset of psychosis could provide an interesting framework to clarify this association. The aim of this systematic review and meta-analysis is to provide an updated and comprehensive synthesis of the association between tobacco smoking and Clinical High Risk for Psychosis (CHRP) status. We performed a multistep systematic PRISMA/MOOSE-compliant electronic search for articles published from inception until October 1st, 2021. Web of Science was searched, complemented by a manual search of original articles reporting the outcome of tobacco consumption (defined as the number of individuals which were smoking tobacco at baseline) in a group of CHR-P patients versus healthy controls (HC). We employed quality assessment of the included studies with Newcastle Ottawa Scale (NOS). The effect size for the primary outcome was the odds ratio (OR) of smoking tobacco in CHR-P samples vs HC. We performed a random-effects model meta-analysis, assessment of heterogeneity with I2 index, sensitivity analyses excluding one study at a time for primary outcome, meta-regressions with four independent moderators (mean age, female ratio, sample size, NOS) and assessment of publication bias with funnel plot and Egger's test. We included 21 independent articles, totalling 2018 CHR-P individuals (mean age of 21.35±2.91years and average female ratio of 41±7%) and 1160 HC (mean age of 22.42±3.70years and average female ratio of 45±11%). The NOS score was 6.52±1.25 (range from 0 to 9). The OR of smoking status was 2.22 (95%CI 1.74-2.84, p<0.01). Heterogeneity (I2) was 24.09 (p=0.16). Sensitivity analyses, removing one study at a time, revealed the robustness of our main finding. Meta-regressions did not reveal any significant association between the moderators and the main outcome. Visual inspection of the funnel plot and Egger's test did not reveal evident publication bias. Our main finding of an increased OR of smokers in the CHR-P individuals compared to healthy controls corroborates the accumulation of unhealthy lifestyles in this vulnerable group. This does not demonstrate any causal association between tobacco smoking and incidence of psychosis, which should be investigated in future prospective cohorts. In conclusion, the window of opportunity represented by CHR-P status should involve more efficient physical health screening and better investigating the aetiological impact of smoking in the development of psychosis.

Status and correlates of children's exposure to secondhand smoke at home: A survey in Chongqing, China.

The home is the primary source of children's exposure to secondhand smoke. This study investigated the status and influencing factors of child exposure to secondhand smoke at home when people smoke in the household. Participants with at least one child living in their household from 10 communities in Chongqing were recruited and provided a self-administered questionnaire using a multistage proportional random sampling design from June to August 2021. The chi-squared test and binary logistic regression analyses were used to identify influencing factors. The questionnaire completed by 1345 families showed that 631 (46.9%) families lived with smokers in their household, and 509 (80.7%) of those families reported that smoking occurred within the home while the children were present. Binary logistic regression analyses demonstrated that the time between waking up and household smokers having the first cigarette of the day (OR=0.44; 95% CI: 0.22-0.85), changes to smoking habits and behaviors within the last six months (OR=1.76; 95% CI: 1.06-2.90), attitudes towards tobacco control in the household (OR=2.91; 95% CI: 1.72-4.92), self-efficacy in maintaining a smoke-free home (OR=2.27; 95% CI: 1.36-3.79), having rules to maintain a smoke-free home (OR=3.25; 95% CI: 1.68-6.29), and the status of providing cigarettes to guests at home (OR=11.0; 95% CI: 1.33-90.8) were associated with exposure to SHS. Education focusing on the impact of smoking on children's health should be encouraged. Smoke-free homes should be established, and smoking restrictions in the household should be enacted. Therefore, information about the available tobacco-control services should be given to family members and be used properly. It is an effective way to decrease the risk of at-home exposure to SHS for children, to overcome any obstacles in tobacco control.

Airport smoking zones: a prospective public health hazard.

Airport smoking zones: a prospective public health hazard.

Cluster Analysis of Cancer Incidence among Smoking Men in China

In recent years, the incidence rate and mortality of lung cancer have shown a rapid growth trend, and its pathogenic factors have also attracted widespread attention. At present, it is universally acknowledged that smoking has a strong correlation with lung cancer. Statistics show that 80% of lung cancer patients have smoking history. At the same time, it is also pointed out that quitting smoking in normal people can change the composition of intestinal flora; And in the normal population and patients with inflammatory bowel disease, the composition of intestinal flora between smokers and non-smokers is different. But now, in colorectal adenoma and colorectal cancer patients, the impact of smoking on intestinal flora is still unclear. To sum up, this topic plans to further study the relationship between smoking, intestinal flora and colorectal tumors. Cluster analysis was used to comprehensively evaluate and classify the incidence data of malignant tumors in 32 tumor registries in China, so as to further understand the regional distribution characteristics of malignant tumors in China. The results showed that compared with normal healthy people, the composition of intestinal flora in patients with colorectal cancer was different, and smoking could also change the intestinal flora. However, whether intestinal flora plays a role in promoting the occurrence and development of colorectal cancer by smoking needs further study.

Does Aging Affect Vitamin C Status Relative to Intake? Findings from NHANES 2017–2018

The aging population is growing and fueling a global increase in chronic diseases and healthcare expenditure. In this study, we examine vitamin C dose-concentration relationships based on data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 to identify a possible age-dependent change in intake vs. concentration relationship among non-supplemented individuals (n = 2828). The vitamin C intake was similar between the younger (18-36 years), middle (37-58 years) and older (59-80+ years) age groups; however, circulating vitamin C concentrations were significantly lower in the middle and older age groups (p < 0.001). For intakes above 75 mg/day, no significant difference in the intake vs. serum concentration relationship was identified between younger and older individuals. However, for intakes below 75 mg/day, we found significantly lower serum concentrations relative to intake for the older compared to younger individuals, despite smoking being more prevalent in the younger compared to older adults (p < 0.001). This effect persisted among non-smokers and was further exacerbated by smoking in older people. Collectively, the present study suggests that healthy aging in non-institutionalized individuals does not increase requirements for vitamin C. In contrast, the lower serum concentrations relative to intake observed in older individuals at intakes < 75 mg/day may suggest that older individuals are more sensitive to a low vitamin C intake, perhaps due to the increased impact of long-term smoking and increased chronic disease prevalence in older adults. This finding may have implications for future intake guidelines in countries with low RDAs and for WHO/FAO, but requires further investigation.

The content of complex psychedelic experiences resulting from inhalation of N,N-dimethyltryptamine

AbstractAimThis study examines narratives describing complex psychedelic experiences after smoking N,N-dimethyltryptamine.MethodsThe narrative accounts examined here were gathered from a variety of online sites and analyzed in order to discover themes, categories and patterns in the phenomenon of the resulting psychedelic experiences.ResultsSubjects reported seeing complex and unusual visual and synesthetic phenomena, leaving this world and entering into extraordinary places, encounters with a variety of strange entities, interactions with unusual objects and a wide variety of powerful feelings. The general categories of Places, Objects, Entities and Feelings were found in the phenomena experienced by people who smoked N,N-Dimethyltryptamine. These provided a framework within which more detailed subcategories were found and the range of most frequent to least frequent experiences were identified.DiscussionWhile DMT experiences are commonly described by people smoking N,N-dimethyltryptamine as indescribable, unique to everyone and taking place in a single domain called Hyperspace or the Hyperdimension, this research found distinct subcategories of frequently visited Places as well as frequently encountered Entities, Objects and Feelings. From these a more comprehensive understanding can be developed of the unusual and profound experiences resulting from inhalation of N,N,-Dimethyltryptamine.

From Villages to Urban Neighborhoods: Urbanization and Health

AbstractWith rapid urbanization, millions of rural villagers have become urban citizens in China. This paper estimates the effect of the in situ urbanization policy on an individual's health by employing the difference‐in‐differences framework and using panel survey data from the China Family Panel Studies. Our findings show that this program, unlike other kinds of urbanization, which have had negative impacts on mental health or made people smoke or drink more, increased people's self‐reported health status significantly. Further mechanism analysis reveals that the in situ urbanization policy affected health by increasing people's confidence in the future, their satisfaction with their current lives, and their medical insurance enrollment. This study highlights the importance of “the city comes to villagers” urbanization in China, and it can play an essential role in advancing the urbanization rate and avoiding the negative impacts of urbanization on health.

The detrimental effects of smoking on the course and outcome in adults with bipolar disorder-A narrative review.

Smoking is a substantial and avoidable risk for physical disability and premature death. Despite a declining tobacco use in the community of developed countries, smoking remains abundant in people with mental disorders. This narrative review highlights the epidemiology, consequences and treatment options of tobacco use disorder (TUD) and nicotine dependence (ND) in people with bipolar disorder (BD). The authors conducted a Medline literature search from 1970 to November 2022 using MeSH terms "bipolar disorder" x "smoking" or "nicotine" or "tobacco" that retrieved 770 results. Search results were complemented by additional literature retrieved from examining cross references and by hand search in text books. Finally, 92 references were considered as essential and selected for the educational purpose of this review. Lifetime and point prevalence of smoking in people with BD is in the range of 45-70% and thus about 2-3 times more frequent in BD than in community samples. Smoking, TUD and ND have a detrimental impact both on mental and physical health as well as mortality in people with BD. In the absence of large controlled studies in comorbid BD and TUD or ND, pharmacological treatment follows the individual guidance for each disorder. Community-based psychosocial interventions for TUD and ND appear to be suitable in people with BD, too, as well as Cognitive Behavioral (CBT) or Acceptance and Commitment (ACT) based psychotherapies. Smoking is a modifiable risk factor causing increased risks both for mental and physical health in BD, and deserves more attention in treatment. More treatment research into pharmacological and psychosocial interventions in comorbid BD and TUD or ND are still needed to deliver evidence-based recommendations to physicians.

Smoking Inequality Trends by Disability and Income in Australia, 2001 to 2020.

While policies to reduce smoking in many countries have been successful, disadvantaged groups (such as low-income groups) have only seen minor gains. People with disability are one such disadvantaged group and are more likely to smoke. However, evidence is limited on trends and inequalities in smoking for disabled people and on whether those also on low incomes are more likely to smoke. We use annual data from 2001 to 2020 of the Household Income and Labour Dynamics in Australia survey. We use a Bayesian model to estimate smoking prevalence trends and inequalities for people with disability (2020, n = 1,370) and without disability (2020, n = 6,229) across the whole population and within income tertiles. To avoid reverse causation (smoking causing disability), we focus on younger people (15-44 years). Absolute reductions (per 100 people, [95% credible intervals]) in smoking were similar for people with (-13 [-16, -11]) and without disability (-15 [-16, -14]), with stable absolute but increasing relative inequalities. In the low-income group, absolute reductions in smoking prevalence for people with disability (-10 [-14, -6]) were smaller than in people without disability (-14 [-15, -12]), resulting in moderate evidence for increasing absolute inequalities (4 [0, 8]) and strong evidence for increasing relative inequalities. In high-income groups, disability-related absolute inequalities narrowed (-6 [-10, -3]), and relative inequalities were stable. Disabled people in Australia, especially those on low incomes, show signs of being left behind in efforts to reduce smoking.