Smoking Patterns Research Articles

Have there been sustained impacts of the COVID-19 pandemic on trends in smoking prevalence, uptake, quitting, use of treatment, and relapse? A monthly population study in England, 2017–2022

BackgroundStudies conducted during the early stages of the pandemic documented mixed changes in smoking behaviour: more smokers quitting successfully but little change in prevalence. This study aimed to examine whether there have been sustained impacts of the COVID-19 pandemic on smoking patterns in England.MethodsData were from 101,960 adults (≥ 18 years) participating in the Smoking Toolkit Study, a monthly representative household survey, between June 2017 and August 2022. Interviews were conducted face-to-face until March 2020 and via telephone thereafter. Generalised additive models estimated associations of the pandemic onset (March 2020) with current smoking, uptake, cessation, quit attempts, and use of support. Models adjusted for seasonality, sociodemographic characteristics, and (where relevant) dependence and tobacco control mass-media expenditure.ResultsBefore the COVID-19 pandemic, smoking prevalence fell by 5.2% per year; this rate of decline slowed to 0.3% per year during the pandemic (RRΔtrend = 1.06, 95% CI = 1.02, 1.09). This slowing was evident in more but not less advantaged social grades (RRΔtrend = 1.15, 1.08, 1.21; RRΔtrend = 1.00, 0.96, 1.05). There were sustained step-level changes in different age groups: a 34.9% (95% CI = 17.7, 54.7%) increase in smoking prevalence among 18–24-year-olds, indicating a potential rise in uptake, in contrast to a 13.6% (95% CI = 4.4, 21.9%) decrease among 45–65-year-olds. In both age groups, these step-level changes were followed by the pre-pandemic declines stopping, and prevalence remaining flat. There were sustained increases in quitting among past-year smokers, with a 120.4% (95% CI = 79.4, 170.9%) step-level increase in cessation and a 41.7% (95% CI = 29.7, 54.7%) increase in quit attempts. The main limitation was the change in modality of data collection when the pandemic started; while this may have contributed to the step-level changes we observed, it is unlikely to explain changes in the slope of trends.ConclusionsIn England, the rate of decline in adult smoking prevalence stagnated during the COVID-19 pandemic through to 2022. At the start of the pandemic, a potential reduction in smoking prevalence among middle-aged adults and increases in quitting among smokers may have been offset by an increase in smoking among young adults. The slowing in the rate of decline was pronounced in more advantaged social grades.

Frequency and characteristics of asthma in smokers attending smoking cessation units in Spain

Introduction The interaction between smoking and asthma impairs lung function and increases airflow obstruction severity. The identification of smoking patterns in smokers with and without asthma is crucial to provide the best care strategies. The aims of this study are to estimate asthma frequency, describe asthma features, and characterize smoking in smokers attending smoking cessation units. Material and methods We carried out a cross-sectional study in five smoking cessation units with different geographical distribution to estimate asthma frequency in smokers, characterize asthma features in smokers, as well as smoking in asthmatic smokers. Results Asthma frequency among smokers was 18.6%. Asthmatic smokers presented high passive exposure, low smoking self-efficacy and will to quit smoking, as well as a high exacerbation frequency, severe symptoms, and frequent use of long-acting beta agonists, inhaled steroids, and short-acting beta agonists. Discussion Smokers with asthma constitute a high-risk group with worsened evolution of pulmonary involvement. All smokers should be regularly screened for asthma. Effective smoking cessation strategies should be proposed to smokers with asthma in order to reverse the harmful effects of smoking on the airway, together with a comprehensive and integral approach.

Prevalence, Risk Factors, and Awareness of Electronic-Cigarette Use among Medical Students at King Khalid University, Saudi Arabia

Objectives: To determine the prevalence, pattern of smoking, and associated factors as well as attitudes toward E-cigarettes among medical students. Methods: A cross-sectional study was conducted among 340 medical students. An online questionnaire was used in data collection. It consists of socio-demographic characteristics, smoking history, awareness of E-cigarettes, the prevalence of their use, beliefs regarding E-cigarettes, and reasons for E-cigarette use Results: Males represented 58.8%, with a mean age of 22.4±1.5 years. The prevalence of current smoking and ex-smoking among participants was 13.5% and 9.1%, respectively. Most participants have heard of E-cigarettes (94.4%); female students have heard about E-cigarettes more than males (99.3% vs. 91%, respectively, p<0.001); 36.8% of participants have tried using E-cigarettes at least once during their lifetime, 15.9% have used them during the last month and 11.8% intended to use them in the next year. Junior students were likelier to try E-cigarettes during their lifetime (44.5% vs. 32.1%, respectively, p=0.020). The commonest reasons for trying E-cigarettes were reducing the number of traditional cigarettes (93.6%), being less dangerous than traditional cigarettes (87.2%), and as an attempt to quit smoking (84.8%). Conclusions: E-cigarettes are tried by a considerable proportion of medical students, mainly to reduce the number of traditional cigarettes, assuming that they are less dangerous than traditional cigarettes, and as an attempt to quit smoking. Key Words: Cigarette smoking, E-smoking, medical students, knowledge, attitude, risk factors.

A Survey: Fire Detection Alarm System Using OpenCV

The Fire Detection Alarm System using OpenCV is a computer vision-based solution designed to provide early detection of fires in real-time video streams. Fires pose substantial threats to both human safety and property, underscoring the importance of timely intervention. This system leverages OpenCV, a powerful computer vision library, to identify flames and smoke patterns in video frames, triggering alerts upon detection. So, we propose a smoke and fire detection method based on YOLOv5 network as a solution to address this problem.

Cigarette smoking trajectories among adolescents and young adults in the Islamic Republic of Iran.

Cigarette smoking follows a progressive pattern throughout the lifetime; most adult smokers started smoking during adolescence. To understand the cigarette smoking trajectories and their predictors among adolescents and young adults in the Islamic Republic of Iran. Using data from the Tehran Lipid and Glucose Study, we followed 1169 adolescents (12-18 years old) into their young adulthood (28-32 years old), from 2002 to 2016. We used cigarette smoking as the outcome variable for group-based trajectory modelling. After detecting the trajectories, we investigated the effects of independent variables, namely, individual employment; education; physical activity; and paternal smoking, employment and education, on the trajectories. We analysed the data using STATA version 16 and SPSS version 26. Three trajectories were detected: non-smokers (79%), experimenters (12%) and escalators (9%). Boys were approximately 3 times (OR = 2.94, 95% CI: 2.32-3.24, P < 0.001) and 25 times (OR = 25.00, 95% CI: 23.92-26.08, P < 0.001), respectively, more likely than girls to be in the experimenter and escalator groups. Receiving a university education decreased the odds of being in the escalator trajectory for 18% (OR = 0.82, 95% CI: -0.04-0.96, P = 0.002) of the study participants. Employment after high school increased the odds by approximately two folds for the experimenter (OR = 2.00, 95% CI: 1.42-2.50, P = 0.01) and escalator (OR = 2.33, 95% CI: 1.33-2.93, P = 0.03) trajectories. Paternal smoking was associated with 1.88 and 2.23, respectively, increased odds of experimenting and escalating smoking among the adolescents. Iranian adolescents follow 3 cigarette smoking trajectories into young adulthood: non-smokers, experimenters and escalators. Male sex, employment after high school, and living with a smoker father were associated with unfavourable smoking patterns. Findings from this study provide valuable insights for designing targeted interventions to reduce cigarette smoking among adults and adolescents in the Islamic Republic of Iran.

KNOWLEDGE AND BELIEF: IMPLICATION FOR SMOKING PATTERN AMONG FIRSTHAND SMOKERS IN CALABAR AND UYO SOUTH, NIGERIA

Smoking has remained a popular behavior among humans even in the 21 st century despite the several legitimate warnings against the practice. The study seeks to find out the relationship the between knowledge, belief and smoking pattern among firsthand smokers in Calabar and Uyo Metropolis, South, South, Nigeria. To achieve this, the study adopts the descriptive survey design with the snowballing sampling technique to secure data through questionnaire from the 376 respondents which constitutes its sample. The study found no significant relationship between knowledge and smoking pattern, but a significant relationship between belief and smoking pattern. In addition, the study found that Arizona is the most smoked substance in the study area. Hence, it is recommended that the production and circulation of smoked substances particularly the outlawed ones should be diligently checked with due sincerity by Nigeria Drug Law Enforcement Agency and its affiliates. Also, campaign against smoking should be targeted towards convincing the populace about the health dangers of smoking rather than just informing them.

Contribution of smoking, disease history, and survival to lung cancer disparities in Black individuals.

Lung cancer is the leading cause of cancer deaths and disproportionately affects self-identified Black or African American ("Black") people, especially considering their relatively low self-reported smoking intensity rates. This study aimed to determine the relative impact of smoking history and lung cancer incidence risk, histology, stage, and survival on these disparities. We used 2 lung cancer models (MichiganLung-All Races and MichiganLung-Black) to understand why Black people have higher rates of lung cancer deaths. We studied how different factors, such as smoking behaviors, cancer development, histology, stage at diagnosis, and lung cancer survival, contribute to these differences. Adjusted for smoking history, approximately 90% of the difference in lung cancer deaths between the overall and Black populations (born in 1960) was the result of differences in the risk of getting lung cancer. Differences in the histology and stage of lung cancer and survival had a small impact (4% to 6% for each). Similar results were observed for the 1950 and 1970 birth cohorts, regardless of their differences in smoking patterns from the 1960 cohort. After taking smoking into account, the higher rate of lung cancer deaths in Black people can mostly be explained by differences in the risk of developing lung cancer. As lung cancer treatments and detection improve, however, other factors may become more important in determining differences in lung cancer mortality between the Black and overall populations. To prevent current disparities from becoming worse, it is important to make sure that these improvements are available to everyone in an equitable way.

Impact of COVID-19 on Patterns of Cigarette Smoking among Adult Smokers in Bangladesh

Background: Bangladesh is a country with high prevalence of smoking which is a contributing factor to cause respiratory diseases. The situation of COVID-19 has become threatening physically for smokers as it is also a respiratory related disease and it can also help altering smoking behaviour because of perception towards this pandemic. Objective: The objectives of this study were to investigate changes in cigarette smoking behaviour during COVID-19 among the adult smokers of Bangladesh according to perception towards COVID-19, and assess association between changes in cigarette smoking behaviour and perception towards COVID-19. Methodology: An online descriptive cross-sectional study was conducted during 16 April, 2021 to 30 April, 2021 using anonymous Google form. Only adult Bangladeshi cigarette smokers were included in this study. Descriptive and co-relational analyses were conducted using SPSS-28.0. Results: Among 373 valid responses, 259(69.43%) reported change in smoking behaviour during COVID-19. Some 313(83.91%) cigarette smokers perceived risk of being infected by COVID-19 and 30(8.04%) smokers were infected by COVID-19. Many (187, 50.13%) participants perceived that smokers have higher risk of contracting infection. In addition, 292(78.28%) smokers believed that smoking can cause more complications if infected, 182(48.79%) felt worried about their smoking behaviour and 225(60.32%) participants thought of lessening smoking during COVID-19. Majority (229, 61.39%) of the respondents tried to quit smoking. Patterns of change in cigarette smoking during COVID-19 were significantly associated with both perceived risks of higher contractibility (p=.001) and higher physical complications (p=.004). Conclusion: Percentage of people with changed smoking behaviour during COVID-19 was very high. Perception towards adverse impact of COVID-19 on smoking behaviour may lead to this change. Journal of Monno Medical College, June 2023; 9 (1): 24-29

Contemporary Medical Management of Peripheral Arterial Disease.

Peripheral arterial disease (PAD) is characterized by atherosclerotic arterial occlusive disease of the lower extremities and is associated with an increased risk of major adverse cardiovascular events (MACE) in addition to disabling clinical sequelae, including intermittent claudication and chronic limb-threatening ischemia (CLTI). Given the growing burden of disease, knowledge of modern practices to prevent MACE and major adverse limb events (MALE) is essential. This review article examines evidence for medical management of PAD and its associated risk factors, as well as wound prevention and care. A thorough review of the literature was performed, with attention to evidence for the management of modifiable atherosclerotic risk factors, claudication symptoms, wound prevention, and wound care. Contemporary management of PAD requires a multi-faceted approach to care, with medical optimization of smoking, hypertension, hyperlipidemia, and diabetes mellitus. The use of supervised exercise therapy for intermittent claudication is highlighted. The anatomic disease patterns of smoking and diabetes mellitus are discussed further, and best practices for diabetic foot ulcer prevention, including offloading footwear, are described. Quality wound care is essential in this patient population and involves strategic use of debridement, wound-healing adjuncts, and skin substitutes, when appropriate. The objective of medical management of PAD is to reduce the risk of MACE and MALE. Atherosclerotic risk factor optimization, appropriate wound care, and management of diabetic foot ulcers, foot infections, gangrene, and chronic, non-healing wounds are critical components of PAD care. Interdisciplinary care is essential to coordinate care, leverage expertise, and improve outcomes.

Risk factors for multimorbidity in adulthood: a systematic review.

Multimorbidity, the coexistence of multiple chronic diseases in an individual, is highly prevalent and challenging for healthcare systems. However, its risk factors remain poorly understood. To systematically review studies reporting multimorbidity risk factors. A PRISMA-compliant systematic review was conducted, searching electronic databases (MEDLINE, EMBASE, Web of Science, Scopus). Inclusion criteria were studies addressing multimorbidity transitions, trajectories, continuous disease counts, and specific patterns. Non-human studies and participants under 18 were excluded. Associations between risk factors and multimorbidity onset were reported. Of 20,806 identified studies, 68 were included, with participants aged 18-105 from 23 countries. Nine risk factor categories were identified, including demographic, socioeconomic, and behavioral factors. Older age, low education, obesity, hypertension, depression, low pysical function were generally positively associated with multimorbidity. Results for factors like smoking, alcohol consumption, and dietary patterns were inconsistent. Study quality was moderate, with 16.2% having low risk of bias. Several risk factors seem to be consistently associated with an increased risk of accumulating chronic diseases over time. However, heterogeneity in settings, exposure and outcome, and baseline health of participants hampers robust conslusions.

The effect of relative humidity on the polarization Mueller matrix under the oil smoke environment

For the variation of the polarized Mueller matrix of oil smoke particles under different relative humidity levels, the polarized single scattering characteristics of oil smoke particles are studied by using the Mie scattering theory, and the multiple scattering simulation is implemented with the Monte Carlo method. Variation in relative humidity is achieved by changing in mixing of the oil smoke and the water fog particles during the same dry particle filling time. Using the 36 sets of polarized Mueller matrices method, the Mueller matrix patterns of oil smoke were calculated for four conditions of 0%, 10%, 40%, and 95% relative humidity, respectively. We can verify the simulation’s correctness from the simulation and the experimental results. Specifically, as the relative humidity increases, the size of the Mueller matrix pattern increases, and the patterns of m22, m33, and m44 related to the depolarization characteristic change significantly. Furthermore, the scattering depolarization coefficients of the Mueller matrix polar decomposition increase with the increasing relative humidity, with the ability of depolarization being continuously enhanced. This method determines differences in relative humidity using intuitive measurements of stabilized scattering patterns, which can present a theoretical basis for the impact of environmental variation on polarization detection.

Metabolic diseases and healthy aging: identifying environmental and behavioral risk factors and promoting public health.

Aging is a progressive and irreversible pathophysiological process that manifests as the decline in tissue and cellular functions, along with a significant increase in the risk of various aging-related diseases, including metabolic diseases. While advances in modern medicine have significantly promoted human health and extended human lifespan, metabolic diseases such as obesity and type 2 diabetes among the older adults pose a major challenge to global public health as societies age. Therefore, understanding the complex interaction between risk factors and metabolic diseases is crucial for promoting well-being and healthy aging. This review article explores the environmental and behavioral risk factors associated with metabolic diseases and their impact on healthy aging. The environment, including an obesogenic environment and exposure to environmental toxins, is strongly correlated with the rising prevalence of obesity and its comorbidities. Behavioral factors, such as diet, physical activity, smoking, alcohol consumption, and sleep patterns, significantly influence the risk of metabolic diseases throughout aging. Public health interventions targeting modifiable risk factors can effectively promote healthier lifestyles and prevent metabolic diseases. Collaboration between government agencies, healthcare providers and community organizations is essential for implementing these interventions and creating supportive environments that foster healthy aging.

Qualitative Study on Youth Smoking and Drinking Patterns in 2019

Qualitative Study on Youth Smoking and Drinking Patterns in 2019

Investigating the Role of Race and Stressful Life Events on the Smoking Patterns of Pregnant and Postpartum Women in the United States: A Multistate Pregnancy Risk Assessment Monitoring System Phase 8 (2016–2018) Analysis

ObjectiveTo examine the smoking patterns of women who experienced stressful life events and the impact of racial disparities on the relationship between stressful life events, and prenatal/ postpartum smoking.MethodsThe study analyzed data from the Pregnancy Risk Assessment Monitoring System Phase 8 (2016–2018) survey across five states (CT, LA, MA, MO, WI). Four stressful life event categories were created using thirteen affiliated questions: financial, trauma, partner, and emotional. We assessed: 1) the association between smoking and stressful life events, 2) the impact of race on the relation between smoking and stressful life events, and 3) the long-term effects of smoking on health by assessing the association between smoking and maternal morbidity. Bivariate statistics and multivariate Poisson regression models were conducted.ResultsA total of 24,209 women from five states were included. 8.9% of respondents reported smoking during pregnancy, and 12.7% reported smoking postpartum. There was a significant association between all stressful life events and smoking. Trauma stressful life event had the strongest association with smoking during pregnancy (adjusted PR=2.01; CI: 1.79-2.27) and postpartum (adjusted PR= 1.80; CI: 1.64-1.98). Race and stressful life event interaction effects on smoking had varied significant findings, but at least one racial/ ethnic minority group (Black, Hispanic, Asian) had a higher smoking prevalence than non-Hispanic White per stressful life event category. Lastly, the prevalence of maternal morbidity was higher for smoking during pregnancy (adjusted PR= 1.28; CI: 1.19-1.38) and postpartum (adjusted PR= 1.30; CI: 1.22-1.38) compared to no smoking.Conclusions for PracticeCulturally congruent, multi-disciplinary care teams are needed to address both clinical and social needs to reduce stressful life events and smoking. Screenings for stress should be standardized with a referral system in place to provide ongoing support.

Association of non-daily hookah tobacco smoking and cardiovascular disease-related exposure biomarkers among U.S. users: The Population Assessment of Tobacco and Health Study

Hookah smoking has grown to become a global tobacco epidemic. While cigarette smoking is a well-established cardiovascular disease (CVD) risk factor, the CVD risks of hookah smoking are unknown, particularly among regular U.S. adult hookah users who are predominantly non-daily users. Herein, we examined the association between hookah smoking and biomarkers of CVD risk among regular exclusive hookah smokers (n = 75), compared to regular exclusive cigarette smokers (n = 1773), dual hookah and cigarette smokers (n = 43) and never tobacco users (n = 757), using data from a nationally representative sample of adults from the Population Assessment of Tobacco and Health Study (2013–2014). Whereas 84% of cigarette smokers reported daily use, only 8% of hookahsmokers reported daily use, with more than a third reporting monthly use. Adjusting for age and sex and as compared to exclusive cigarette smokers, exclusive hookah smokers had significantly lower geometric mean concentrations in serum sICAM-1 and urinary F2-isoprostane (p < 0.05). Although not statistically significant, a signal of increased oxidative stress was observed among hookah smokers as compared to never tobacco users (urinary F2-isoprostane). CVD-related harm biomarkers appear to be lower among hookah smokers than cigarette smokers. These findings represent patterns of hookah smoking predominantly shared among adult U.S. users who report non-daily occasional use and do not reflect solitary, daily use as is common in the Middle East. Future studies with longer exposure and longitudinal hookah use are warranted to explore the association between hookah smoking and CVD risk.

Влияние ограничения или отказа от табакокурения на адаптационные возможности организма в условиях антарктической зимовки

The research was conducted by a member of the 60th Russian Antarctic Expedition at the all-yearround Mirny Station. The purpose was to study the effect of changed patterns of tobacco smoking on the adaptive capabilities of polar station staff. Materials and methods. Adaptive capabilities were evaluated using the method of cardio-respiratory synchronism, assessing the index of regulatory and adaptive status (IRAS). It is based on recording the synchronization parameters of controlled high respiratory rate and heart rate. IRAS dynamics was compared in four subjects (three regular smokers and one non-smoker as a control) over the course of one year of wintering. The subjects had comparable anthropometric data, health status and working conditions at the station. They were exposed to a similar amount of adverse environmental factors due to their professional activities and lived according to the station’s standard schedule without any personalized changes in their day regimen. Smoking patterns were determined by independent decisions of each expedition member and by the size of personal stocks of tobacco products prepared for the wintering. Results. In polar expedition members faced with smoking cessation or inability to adequately meet this need, IRAS decrease, being a marker of human adaptive capabilities, allowed us to determine the relationship between pronounced changes in the dynamics of regular tobacco smoking and body’s adaptive capabilities. The authors assume that organizational arrangements (sufficient stocks of nicotine-containing products such as cigarettes and tobacco) at the station as well as educational activities (dissuading expedition members from abrupt non-supervised changes in their smoking patterns during Antarctic wintering and properly explaining the reasons why such actions are undesirable) may contribute to improving the health of expedition members and optimizing their living conditions at the polar station. Completing a smoking cessation programme with medical supervision in advance (while preparing for a polar expedition) as well as upon returning from the station (at the end of the adaptation period) can be recommended.

Smoking Dependence, Time-Discounting, and Sustained Cessation Behavior: A Longitudinal Study of Predominantly Light Smokers.

This study aimed to assess whether two established psychosocial predictors of smoking abstinence, nicotine dependence and time-discounting, also apply to a population of predominantly cigarette light smokers, which is the dominant pattern of smoking in countries like Mexico. Relatively infrequent smoking is increasingly prevalent, yet still harmful, making it important to understand the predictors of cessation in this population. Mexican adult smokers recruited from an online consumer panel were surveyed every 4 months between November 2018 and July 2020. We considered respondents who reported a quit attempt in between surveys (n = 1288). Dependence was measured with a 10-item version of the Wisconsin Inventory of Smoking Dependence Motives (WISDM). Time-discounting was assessed with five branching questions about hypothetical reward scenarios. Logistic models regressed sustained quit attempts (≥30 days of abstinence) at time t + 1 on study variables at time t. We found strong interitem reliability (α = 0.92) and intraindividual consistency of our brief WISDM (ρ = 0.68), but moderate intraindividual consistency of the time-discounting measure (ρ = 0.48). Forty-eight percent of the sample reported sustained quit attempts, and 79% were non-daily or light daily smokers (≤5 cigarettes per day). Smokers with higher WISDM-10 had lower odds of sustained quitting and this result remained when controlling for smoking frequency and the Heaviness of Smoking Index (adjusted odds ratio [AOR] = 0.768). Time-discounting was unassociated with sustained quitting. Our findings suggest that a brief, 10-item multidimensional measure of dependence is useful for predicting sustained quitting in a context of relatively light smoking; time-discounting appears less relevant, although our results are not conclusive because of the low test-retest reliability of our measure. Given the increase in non-daily and light daily cigarette smoking in many countries, including in Mexico, and the health risks this still poses, it is important to understand the predictors of cessation among relatively light smokers. The WISDM-10 multidimensional measure seems to be a good instrument to assess dependence and predict successful quitting in this population, and possibly more appropriate than physical dependence measures. As such, it could help design and target more suitable cessation treatments for non-daily and daily light cigarette smokers. While this study did not find time-discounting to be a relevant predictor of smoking abstinence, future studies should explore other measures.

Smoking cessation strategies: An in-depth analysis of nicotine replacement therapy and alternatives

Introduction and purpose: The primary objective of this literature review is to thoroughly investigate the topic of nicotine replacement therapy, considering the latest discoveries and detailing various forms of available nicotine substitution. Materials and methods: Literature review of PubMed and Google Scholar databases. State of Knowledge: Tobacco smoking remains one of the leading causes of premature death worldwide, accounting for millions of deaths each year. Nicotine, the addictive component of tobacco, is responsible for sustaining cigarette smoking patterns and making smoking cessation particularly challenging. Nicotine replacement therapy (NRT) is now considered one of the primary methods to help individuals quit smoking by reducing withdrawal symptoms and cravings associated with cessation. Conclusions: Over the years, extensive research has confirmed the effectiveness and safety of NRT, resulting in the development of different forms of nicotine substitution. The outcomes of using these various forms are similar and premature discontinuation by patients remains a primary reason for NRT failure. Therefore, it is crucial for each patient to select the form of NRT that meets their individual preferences. The best results are obtained by combining multiple forms of substitution simultaneously, as well as integrating them with other therapeutic methods.

Combinations of lifestyle behaviors and cancer risk among Korean adults

Combinations of lifestyle behaviors may lead to different cancer risks. This study aimed to identify the latent classes based on lifestyle behavior trajectories and to investigate the association between these latent classes and cancer risk. Participants in the 2002–2003 National Health Insurance Service general health examination were included. Data on smoking, alcohol drinking, body mass index (BMI), and physical activity measured four times between 2002 and 2009 were analyzed. Incident cancer cases were tracked from 2010 to 2018. Patterns of alcohol drinking, smoking, BMI, and physical activity and latent classes based on trajectories of smoking, alcohol drinking, BMI, and physical activity were identified. Among 2,735,110 adults (1,787,486 men and 947,624 women), 111,218 (69,089 men and 42,129 women) developed incident cancer. Six latent classes of lifestyle behavior were identified, with Class 1 (healthy class) involving only 0.2% of men and 0.5% of women. The highest risk class in males tended to be steady light drinkers and steady moderate smokers, have steady low frequency of physical activity, and be obese. This class showed a 1.47 times higher (95% CI = 1.29–1.69) risk of all cancers than did the healthy class. Among women, there was only an association between the highest risk class (tendency to be non-drinkers, light smokers) and colorectal cancer (HR = 1.70, 95% CI = 1.02–2.83). Only a small percentage of participants maintained a long-term healthy lifestyle. Identifying classes of behavior combinations and their links to cancer development is therefore critical for cancer prevention.

Prospective cohort of pre- and post-diagnosis alcohol consumption and cigarette smoking on survival outcomes: an Alberta Endometrial Cancer Cohort Study.

To examine the independent and joint relationships between cigarette smoking and alcohol consumption with survival outcomes after endometrial cancer diagnosis. Pre- and post-diagnosis smoking and drinking histories were obtained from endometrial cancer survivors diagnosed between 2002 and 2006 during in-person interviews at-diagnosis and at ~ 3 years post-diagnosis. Participants were followed until death or January 2022. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with Cox proportional hazards regression for associations with disease-free survival(DFS) and overall survival (OS). During a median 16.9 years of follow-up (IQR = 15.5-18.1 years), 152 of the 540 participants had a DFS event (recurrence: n = 73; deaths: n = 79) and 134 died overall. Most participants in this cohort were current drinkers (pre = 61.3%; post = 64.7%) while few were current cigarette smokers (pre = 12.8%; post = 11.5%). Pre-diagnosis alcohol consumption was not associated with survival, yet post-diagnosis alcohol intake ≥ 2 drinks/week was associated with worse OS compared with lifetime abstention (HR = 2.36, 95%CI = 1.00-5.54) as well as light intake (HR = 3.87, 95%CI = 1.67-8.96). Increased/consistently high alcohol intake patterns were associated with worse OS (HR = 2.91, 95%CI = 1.15-7.37) compared with patterns of decreased/ceased intake patterns after diagnosis. A harmful dose-response relationship per each additional pre-diagnosis smoking pack-year with OS was noted among ever smokers. In this cohort, smoking and alcohol individually were not associated with DFS and combined pre-diagnosis smoking and alcohol intakes were not associated with either outcome. Endometrial cancer survivors with higher alcohol intakes after diagnosis had poorer OS compared with women who had limited exposure. Larger studies powered to investigate the individual and joint impacts of cigarette smoking and alcohol use patterns are warranted to provide additional clarity on these modifiable prognostic factors.