Smoking-related Factors Research Articles

A Protocol for Modifying Progesterone to Increase Postpartum Cigarette Smoking Abstinence and Reduce Secondhand Smoke Exposure in Infants

New interventions are necessary to increase postpartum abstinence from cigarette smoking. Sex hormones, specifically progesterone, have been found to be protective against drug-taking behaviors. Our pilot double-blind, randomized, controlled trial, although underpowered, suggested a trend toward a higher prevalence of smoking abstinence among postpartum participants receiving exogenous progesterone compared to those receiving placebo. This paper outlines the protocol used in our study to evaluate the efficacy of modifying progesterone to increase postpartum smoking abstinence and, subsequently, decrease secondhand smoke exposure in infants. In the intervention arm, participants will receive open-label exogenous oral progesterone (200 mg twice daily). Using a concurrent control group that does not receive progesterone treatment, we hypothesize that progesterone treatment will increase postpartum smoking abstinence as measured using a 7-day point prevalence at six months post-treatment allocation, as well as reduce smoking-related risk factors. Secondary objectives include examining the impact of this maternal smoking intervention on infant health. In addition to describing the protocol, we also discuss the protocol changes made due to the COVID-19 pandemic. Upon completion, this study will provide new information on how sex hormones may influence smoking cessation in postpartum populations, which can have broad public health implications. Clinical Trials Registration #NCT04783857

From smoke to stroke: quantifying the impact of smoking on stroke prevalence

PurposeThe objective of this study is to assess the impact of smoking on stroke prevalence and to delineate the relationship between smoking-related factors and the risk of stroke, incorporating an analysis of demographic variations influencing this association.MethodsOur analysis encompassed 9,176 participants, evaluating clinical attributes alongside smoking-related characteristics such as duration of cigarette consumption, and levels of nicotine, tar, and carbon monoxide. We employed weighted univariate logistic regression and restricted cubic splines to examine the association between smoking indicators and stroke risk, complemented by subgroup analyses for demographic differentiation.ResultsThe overall prevalence of stroke in our cohort was 3.4%. Statistically significant associations were found between stroke incidence and factors such as age, gender, education, and marital status (p < 0.05). Adjusted logistic regression models showed increased odds ratios (ORs) for stroke with higher nicotine and carbon monoxide levels across progressively adjusted models: Model 1 (unadjusted), Model 2 (adjusted for age, gender), Model 3 (further adjusted for education, marital status, BMI, PIR), and Model 4 (fully adjusted for additional factors including hypertension, hyperlipidemia, diabetes, and drinking). Specifically, ORs for nicotine increased from 2.39 in Model 1 to 2.64 in Model 4; for carbon monoxide, from 1.10 to 1.11 over the same models.​The threshold analysis using restricted cubic splines revealed critical points for stroke risk increase at smoke exposure levels of 410 units, tar 12 mg, nicotine 1.1 mg, and carbon monoxide 12 ppm. Above these thresholds, stroke risk escalates significantly. Additionally, the presence of family smoking history was associated with higher stroke risks compared to those without such history.ConclusionThis study confirms that smoking significantly contributes to increased stroke risk, particularly through exposure to nicotine and carbon monoxide. The findings emphasize the necessity for tailored stroke prevention strategies that specifically address smoking behaviors and consider demographic susceptibilities. Incorporating smoking-related indicators into risk assessment models could enhance the precision of stroke prevention efforts.

Nicotine Dependency Levels Among Adult Electronic Cigarette Smokers in Jeddah, Saudi Arabia: An Analytical Cross-Sectional Study.

Electronic cigarettes (ECs) are a recent method to deliver nicotine with less harmful effects than traditional cigarettes. Studying nicotine dependence in adult EC users is a crucial area, but few measures are available to evaluate nicotine dependence induced by EC. Our study aims to estimate the levels of nicotine dependency among adult EC smokers using a modified Fagerström Test of Nicotine Dependence (e-FTND) in Jeddah, Saudi Arabia, and to identify EC-associated sociodemographic and smoking-related factors affecting nicotine dependency. An analytical cross-sectional study was conducted on adults 18 years of age and older in Jeddah, Saudi Arabia, from December 2023 to March 2024. Data were collected from the participants using a pre-tested structured self-administered questionnaire, and nicotine dependence was assessed using the modified e-FTND. Descriptive statistics such as frequency, mean, and standard deviation were applied. Chi-square was used to assess the association between categorical variables. Ordinal regression was used to predict the nicotine dependency levels with different variables. A total of 344 participants were included in the study. The mean e-FTND score for EC users was 4.14 ± 2.45. Females had a lower likelihood of experiencing higher dependence compared to males (OR = 0.52, 95% CI: 0.32, 0.85). Using ECs for more than three years was associated with higher odds of increased dependence (OR = 3.18, 95% CI: 1.28, 7.98; p < 0.001). The use of Pod system devices lowered the odds of developing high nicotine dependence (OR = 0.32, 95% CI: 0.13, 0.75; p = 0.01) compared to Iqos device users, while mechanical Mod device users exhibited a trend towards higher dependence, although it was not statistically significant. Nicotine concentration in ECs had a significant impact on the degree of nicotine dependence. Higher concentrations were associated with increased odds of higher dependence (12-18 mg: OR = 3.26, 95% CI: 1.55, 6.91; >18 mg: OR = 4.53, 95% CI: 2.37, 8.75; p < 0.001). Most exclusive EC users in the study developed a moderate nicotine dependence level. The EC device type and nicotine concentration were significant drivers of nicotine dependence. Additionally, the personal characteristics of the users, such as male gender and duration of use, were associated with a higher risk of dependence. An in-depth understanding of the magnitude of nicotine dependence among EC users will enhance the opportunity for tailored health-enhancing interventions and policies.

SNP-SNP positive interaction between MMP2 and MMP12 increases the risk of COPD.

Determining SNP-SNP interaction of the disease has become important for further investigation of pathogenesis and experimental research. Although many studies have been published on the effect of MMPs gene polymorphisms on chronic obstructive pulmonary disease (COPD), there is a lack of information on SNP-SNP and SNP-environment interactions. This study aimed to investigate the interaction between the polymorphisms of MMP1, MMP2, MMP9 and MMP12 genes and its combined effect with smoking on the risk of developing COPD. Totally 181 COPD patients and 292 healthy individuals were involved. Blood samples from the participants were tested for genotyping and data were collected through questionnaires. Genotyping was performed with nested allele-specific polymerase chain reaction (AS-PCR) and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). SNP-SNP and SNP-environment interactions were investigated using multifactor dimensionality reduction and logistic regression analysis. The result showed that participants with high nicotine dependence and heavy smokers had a higher risk of COPD than non-smokers. Also, G/G genotype (cOR = 5.83; 95% CI, 1.19-28.4, p = 0.029) of MMP2 rs243864 and T/T genotype (cOR = 1.79; 95% CI, 1.16-2.76, p = 0.008) of MMP12 rs652438 independently contributes to the susceptibility of COPD. For SNP-SNP interaction, the positive interaction between rs243864 G/G genotype of MMP2 and rs652438 T/T genotype of MMP12 was found, and the combination of risk genotypes has a high risk of COPD (OR = 12.92; 95% CI, 1.46-114.4, p = 0.021). Moreover, the combination of T/T genotype of MMP12 rs652438 and smoking-related factors increases the risk of COPD approximately 4.5 to 6-fold. The results suggests that there is a combination of MMP2, MMP12, and smoking-related factors may increase the risk of developing COPD.

Psychometric evaluation of a new instrument to hookah tobacco smoking-related factors in the Iranian female university students based on the Extended Parallel Process Model.

The higher prevalence of hookah tobacco smoking (HTS) has become worrisome in women. Thus, it is essential to identify and measure the perceptions associated with this unhealthy behavior as well as the type of response to risk messages to design the effective programs. This study aimed to psychometric evaluation of a new instrument, named the Extended Parallel Process Model-Hookah Tobacco Smoking Questionnaire (EPPM-HTSQ), for female university students. This methodological study was conducted in 2019-2020 in central and western Iran. The first version of the instrument was developed with 97 items. Face, Content, and construct validity methods were used to assess the EPPM-HTSQ validity. The data viability for factorability was guided through Kaiser-Meyer-Olkin (KMO) measure of sample adequacy (Values >0.7) and Bartlett's test of Sphericity (P < 0.05). The Exploratory Factor Analysis (EFA) method with varimax rotation and SPSS software was performed to identify the main factors of the questionnaire and interpretable factors. The internal consistency and external reliability were determined. The test-retest was used for evaluating the stability of tools. During the assessment of the face and content validity 71 items remained in the questionnaire. EFA led to the extraction of nine dimensions: "Focusing on superior rewards," "Response Efficacy," "Perceived physical threat," "Perceived social threat," "Self-efficacy," "Fear control," "Attitude," "Fear," and "Intention" Kaiser-Meyer-Olkin (KMO) test (0.957) and Bartlett's test (P < 0.001). Cronbach's alpha (0.871-0.951) and ICC (0.985-0.998) were approved for scale dimensions. Important findings of the present study were the development and validation of the EPPM-HTSQ for measuring EPPM variables in relation to HTS; introducing a new variable "focusing on superior rewards"; as well as, the new classification of the concept of "perceived threat." The final version of the EPPM-HTSQ is a valid and reliable tool, but it is suggested to be re-evaluated in other studies with different populations and sample sizes.

Estimating the prevalence of and clarifying factors associated with multiple tobacco product use in Japan: a cross-sectional study in 2022.

BackgroundMultiple tobacco product (MTP) use is a public health concern due to their combined adverse health effects. MTP use may have increased since heated tobacco products (HTPs) became more prevalent in Japan. This study aimed to (1) estimate the recent prevalence of MTP use and clarify the associated factors compared to (2) non-smokers and (3) single-product users.MethodWe used data from an internet survey conducted in February 2022. The prevalence of MTP use in Japan was estimated using inverse probability-weighted scores from this survey and a nationwide survey by the Japanese government. Tobacco products include six types: cigarettes, HTPs, e-cigarettes, cigars, pipe/water pipes, and smokeless tobacco products. MTP use was defined using the outcome variable (no use, single-product use, and MTP use) based on these six types of use. Using multivariate logistic regression, we calculated the adjusted odds ratios and 95% confidence intervals (CI) to clarify factors associated with MTP use compared to non-smokers, adjusting demographic variables, psychological distress, self-rated health, and alcohol use. Using multivariate Poisson regression, we calculated the adjusted prevalence ratios (aPR) and 95%CI to clarify factors associated with MTP use among smokers, adjusting for these covariates and smoking-related factors like workplace and home smoking rules.ResultsWe analyzed 30,141 participants whose mean age was 47.8 years (standard deviation = 17.9), and 14,722 participants were male (48.8%). The estimated prevalence of MTP use was 6.8%. The most common combination of MTP use was cigarettes and HTPs. Compared to non-smokers, being younger, male, low education, poor psychological distress, poor self-rated health, and alcohol use were factors associated with MTP use. Among smokers, workplace smoking rules, such as a partial smoking ban and no smoking ban, were not associated with MTP use compared to the indoor smoking ban. However, participants with no home smoking ban were positively associated with MTP use compared to those with a ban on both cigarettes and HTPs at home (both cigarettes and HTPs allowed aPR=1.36, 95%CI 1.15 to 1.61, HTPs only allowed aPR=1.73, 95%CI 1.43 to 2.10).ConclusionMTP users may account for a high percentage of Japanese smokers.

Factors associated with attempting and succeeding in smoking cessation following a National Tobacco Control Plan: Analysis of two nationwide surveys (2010 and 2017)

IntroductionLower rates of smoking cessation among disadvantaged groups contribute to widening health-disparities. With this recognition, in 2010 free-of-charge/subsidized smoking cessation services became available to all Israeli residents through the not-for-profit health plans. MethodsBased on two cross-sectional National Social Surveys, data on adult ever-smokers were used (n = 2,998 in 2010 and 2,859 in 2017). The outcome variable comprised three categories: no quit attempt, unsuccessful quit attempt and successful quit attempt. Changes over-time and demographic, socioeconomic, health- and smoking-related factors associated with quitting attempts and success were tested in the pooled sample, using multivariable multinomial logistic regression models. ResultsThe pooled sample of the two surveys included 2,611 participants (44.2%) who were successful quitters, 1,941 (32.7%) who reported an unsuccessful quit attempt, and 1,305 (23.1%) smokers who did not attempt to quit. Compared to 2010, ever-smokers in 2017 were less likely to report an unsuccessful quit attempt (adjusted OR = 0.81, 95%CI: 0.70–0.94). The likelihood of successfully quitting was similar in both surveys. Older age and self-reported health problem were associated with higher likelihood of quitting attempt. Meeting living expenses, being overweight/obese, engaging in physical activity and heavy smoking were associated with higher likelihood of successful smoking cessation; while environmental tobacco exposure was associated with 43% lower likelihood of successful cessation. Finally, there was an interaction between education and ethnicity. Higher education level was associated with a greater likelihood both to attempt to quit smoking and to succeed among Jewish participants, while the opposite phenomenon was observed among Arab smokers. ConclusionsDespite the availability of subsidized smoking cessation services, social disparities in smoking cessation rates persist. Efforts should focus on proactively reaching subpopulations with low cessation rates, using tailored strategies for successful smoking cessation. Promoting smoke free homes and workplaces should be prioritized.

Patterns of cigarette and e-cigarette use among UK adolescents: a latent class analysis of the Millennium Cohort Study.

Patterning of cigarette and e-cigarette use among young people remains poorly characterized. We aimed to describe these patterns in the UK Millennium Cohort Study at age 14 and 17 years. Data on cigarette and e-cigarette use come from 9731 adolescents. Latent class analysis assigned participants to membership of classes of product use and multinomial logistic regression analyses assessed differences in the likelihood of belonging to classes by sociodemographic (age, gender, ethnicity, household income, maternal education and country of residence) and smoking-related social factors (caregiver tobacco use, caregiver e-cigarette use and peer smoking). We identified four classes of use: 45.8% of adolescents 'continued to abstain' from cigarettes or e-cigarettes; 21.3% 'experimented' (used once or in the past but not currently) with cigarettes and/or e-cigarettes by age 17 but were not current users; 19.0% were 'late adopters', characterized by low levels of use at age 14 but high levels of experimentation and current use at age 17; and 13.9% were 'early adopters', characterized by high levels of experimentation and current use at ages 14 and 17. At age 17, 70.4% of 'early adopters' smoked cigarettes regularly plus an additional 27.3% experimented with cigarettes. Corresponding percentages for e-cigarettes were 37.9% and 58.9%. Tobacco and e-cigarette use by caregivers, and cigarette use by peers, were associated with being both 'late adopters' and 'early adopters'. Approximately one in seven adolescents in the UK are 'early adopters' of nicotine products. This highlights the need to develop and implement effective policies to prevent nicotine use uptake.

Abstract 6460: Smoking initiation at young age increases risk of gastric cancer among Korean men

Abstract Objective: Early initiation of smoking is associated with adverse health outcomes. This study aimed to investigate the association of various smoking-related factors with the risk of gastric cancer in a population with a high incidence rate of gastric cancer. Method: From 2004 to 2013, Korean adults 40-69 years of age were enrolled in the large-scale prospective cohort, the Health Examinees-Gem study. Incident gastric cancer cases were identified until December 31, 2017, through linkage to the Korea Central Cancer Registry. Participants’ information regarding socio-demographics, smoking-related factors, and other lifestyle factors was obtained via self-reported questionnaires. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for gastric cancer risk associated with smoking-related factors such as smoking duration, amount, pack-years, and age of smoking initiation. Results: Among 44,207 men included in the final analysis, 565 gastric cancer cases were identified during a mean (±SD) follow-up period of 8.6 (±2.0) years. Compared to non-smokers, current smokers who smoked for more than 35 years (HR 1.44, 95% CI 1.06-1.96) or with ≥30 pack-years of smoking (HR 1.40, 95% CI 1.05-1.87) were positively associated with gastric cancer. These associations were shown to be significant with increasing smoking years (p trend 0.019) and pack-years (0.016) as well. Compared to non-smokers, current smokers who initiated smoking at a younger age, before or at 20 years, were at a higher risk of gastric cancer (HR 1.46, 95% CI 1.10-1.93). No significant associations were observed among former smokers. When stratified by smoking duration, increased risk of gastric cancer was observed among those who smoked for more than 25 years in the younger smoking initiation age group (≤20 years; HR 1.50, 95% CI 1.15-1.94). In terms of smoking intensity, those who smoked less than 20 cigarettes or 1 pack a day showed an increased risk of gastric cancer in the younger smoking initiation age group that began smoking before or at 20 years of age (HR 1.78, 95% CI 1.30-2.44). Conclusion: Our findings suggest that earlier initiation of smoking is associated with a greater risk of gastric cancer. Among those who began smoking early, longer duration is an important factor, but increased gastric cancer risk was also observed among those who smoked moderate amount on a daily basis. Thus, measures to manage and control onset age of cigarette smoking among teenagers may be considered when taking actions against the health burden of gastric cancer. Citation Format: Hwi-Won Lee, Woo-Kyoung Shin, Dan Huang, Katherine De la Torre, Jae Jeong Yang, Minkyo Song, Aesun Shin, Kyoung-Mu Lee, Hyuk-Joon Lee, Jong-koo Lee, Daehee Kang. Smoking initiation at young age increases risk of gastric cancer among Korean men. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6460.

Identification of solid fuel use and smoking-related additional factors may increase the accuracy assessment of their impacts on life expectancy

Identification of solid fuel use and smoking-related additional factors may increase the accuracy assessment of their impacts on life expectancy

Smoking Habits and Workplace Health Promotion among University Students in Southern Italy: A Cross-Sectional Pilot Investigation.

The study aimed to investigate the tobacco smoking prevalence, habits and awareness among a cohort of healthcare students from a university hospital in southern Italy and the associations with socio-demographic determinants. A secondary outcome was to estimate the educational needs to receive information on smoking-related risk factors. Five hundred and forty-nine students completed a self-administered questionnaire (180 male and 369 female, average age 25 yo, ±5.9 SD), enrolled from October 2018 to November 2019 at the University of Naples ‘Luigi Vanvitelli’, and the collected data were analysed by descriptive and inferential statistical analysis. The sample’s prevalence of current smokers was 25.3%, without a significant sex difference. The multiple logistic regression model showed the link between smoking habits and alcoholic beverage consumption (p < 0.001) and living with smokers (p = 0.003). The enrolled cohort does not seem to need more information about the risks of cigarette smoking (p = 0.028). The data analysis and the comparison with the current literature allowed the authors to hypothesise a training model to be adopted within a workplace health promotion programme managed by an occupational physician. This model included targeted training for smoking dissuasion, focusing on sex and gender, cohabitant’s influence, and combined addiction management. Further research will focus on the effectiveness of these proposed models.

An online survey on knowledge, attitude and practice among primary healthcare providers towards smoking cessation in Selangor, Malaysia

ObjectiveWe assessed knowledge about the health effects of smoking, attitude, and intention to practice smoking cessation advice. MethodsA cross-sectional online survey was done among 524 healthcare providers in 30 primary care clinics in Selangor State, Malaysia. Association of HCPs’ smoking cessation practices with demographics, service-related and smoking-related factors were tested by Poisson regression. ResultsOverall current smoking prevalence was 3.1 (95%CI 1.6, 4.5), significantly higher among males (14.4 vs 0.2, p < 0.001). Knowledge score was higher (mean 10.8, SD 1.5, maximum 13) than attitude (mean 43.5, SD 13.2, maximum 65) and practice (mean 33.0, SD 9.2, maximum 45) towards smoking cessation. Practice score was associated with female sex [Incidence Rate Ratio (IRR) 1.1, 95%CI 1.09, 1.2], being a nurse (IRR 1.08, 95%Cl 1.04, 1.12), knowledge (IRR 1.02, 95%CI 1.01,1.03), attitude (IRR 0.997, 95%Cl 0.99–1.00) and smoke-free homes (IRR 0.89, 95%CI 0.85,0.94). ConclusionInvolvement of female HCPs (nurses) could improve cessation practices in primary care.

Abstract PO-130: Disparities in risk of second primary lung cancer among lung cancer patients in the United States

Abstract Introduction: Lung cancer is the leading cause of cancer death in the U.S. Despite recent survival improvements, racial and socioeconomic disparities still exist in lung cancer incidence and survival. Furthermore, recent studies showed that lung cancer survivors have a high risk of developing second primary lung cancer (SPLC). While racial and socioeconomic disparities have long been examined for lung cancer survival and incidence, little is known about their impacts on SPLC risk among lung cancer survivors. This study evaluated the disparities in SPLC incidence by calculating the standardized incidence ratio (SIR) of the observed SPLC incidence versus the expected incidence of initial primary lung cancer (IPLC) across different socioeconomic, acculturation, and smoking-related factors using county-level data obtained from the Surveillance, Epidemiology, and End Results Program (SEER). Methods: We identified 158,018 patients diagnosed with IPLC between 2000 and 2013 in SEER. SPLC was defined as a newly developed primary lung cancer after 2 years from IPLC diagnosis and was followed through 2018. The SIR was calculated as the ratio of the observed SPLC incidence versus the expected incidence of IPLC in the general population across different factors. Indicators of socioeconomic status, acculturation factors, and smoking prevalence in SEER were derived from county-level data using the American Community Survey and the Behavioral Risk Factor Surveillance System (BRFSS). The quintiles of these indicators were created using the data obtained across all 3,142 valid U.S. counties. We applied the Pearson's chi-squared test to evaluate the difference in SIRs across quintiles of the indicators we created, applying a statistical significance of α &amp;lt; 0.005 after adjusting for multiple testing. Results: Among 158,018 IPLC patients, 10,650 (6.7%) developed SPLC over 626,853 person-years. The incidence of SPLC was 6 times higher than the IPLC incidence in the general population, with an overall SIR of 6.2 (95% Confidence Interval (CI): 6.09-6.32). Notably, the SIR, i.e., the ratio between the SPLC incidence and the IPLC incidence, was significantly higher among individuals who live in counties with the lowest quintile of median family income (&amp;lt;$51,770) versus the highest quintile (&amp;gt;$74,331) (SIR 7.18 versus 6.10, P&amp;lt;1 × 10−6). Furthermore, the ratio between the SPLC versus the IPLC incidence was highest (SIR 8.01, CI: 7.36-8.71) among those who live in counties with the highest quintile of smoking prevalence (&amp;gt;29.6%) versus SIR of 5.77 (CI: 5.63-5.91) with the lowest quintile of smoking prevalence (&amp;lt;20.4%) (P=3.4 × 10−3). Race/ethnicity and acculturation factors, including immigration status, did not achieve statistical significance. Discussion: Significant disparities exist in SPLC incidence among lung cancer survivors who live in areas with a low median family income and high smoking prevalence. Targeted SPLC surveillance for lung cancer survivors from an underserved population would be needed to reduce the existing disparities. Citation Format: Eunji Choi, Sophia J. Luo, Jacqueline V. Aredo, Joel W. Neal, Leah M. Backhus, Heather A. Wakelee, Summer S. Han. Disparities in risk of second primary lung cancer among lung cancer patients in the United States [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-130.

Smoking prevention in adolescents: a cross-sectional and qualitative evaluation of a newly implemented prevention program in Switzerland

ObjectivesIn 2014, a hospital-based smoking prevention programme ‘Nichtrauchen ist clever!’ (NIC!) for adolescents aged 12–14 was initiated. The aim of the study was to evaluate participants’ smoking behaviour and to...

A Study on Factors Related to Smoking Experience by Sex: Using the National Health and Nutrition Examination Survey (KNHANES IV-VII, 2007-2018)

Objectives: This study aimed to identify factors related to smoking experience among Korean adults according to gender.Methods: The analysis used the data collected from 19,974 who had a smoking experience from The Korea National Health and Nutrition Survey (2007-2018). Collected data were analyzed using descriptive statistics, t-test, Logistic regression.Results: The number of smoking experiences was 77.70% for men and 14.17% for women. Both men and women were more likely to have smoked experiences as the number of drinking, and second-hand smoke experiences in the home, increased. Owning a home, the higher the income, the higher the education, the lower the smoking experience. On the other hand, the relationship between education level and smoking experience according to gender showed a negative response-dose relationship for men and a positive-response-dose relationship for women.Conclusions: The study results showed that smoking-related factors are divided into factors in which men and women have the same tendency and those in which men and women have the opposite direction. This study revealed the distinct smoking experience-related characteristics according to gender in Korea. These characteristics suggest the need for a new approach to reduce the smoking rate by introducing differentiated smoking prevention education, smoking cessation education, and treatment projects by gender to the National Non-smoking Support Project, which was focused on smoking cessation education and treatment.

Age at Smoking Initiation and Prevalence of Cigarette Use Among Youths in Sub-Saharan Africa, 2014-2017

This cross-sectional study examines age at smoking initiation, prevalence of cigarette use, and prevalence of exposure to smoking-related risk factors among youths in sub-Saharan Africa.

Factors Associated with Nursing Interventions for Smoking Cessation: A Narrative Review.

The purpose of this narrative review is to synthesize the factors that are associated with smoking cessation intervention among nurses. We conducted a systematic search of the literature published from database inception through to 22 April 2020, in five electronic databases including Pubmed, CINAHL Plus, Scopus, Web of science, and ProQuest. The search was limited to articles written in English and published in scientific journals. The reference lists of papers identified as being relevant in the above electronic searches were also hand searched. The initial database search yielded 2039 articles and 11 articles were obtained through a manual search. Finally, 24 articles were included in the analysis. Of the 24 included studies, 46 different factors were identified to be significantly associated with nursing interventions for smoking cessation. The identified factors were grouped into the following four conceptually similar categories: (1) socioeconomic factors, (2) smoking-related factors, (3) motivational factors, and (4) enabling factors and barriers. In the future, nursing interventions for smoking cessation will need to be improved based on the identified factors.

The Prevalence of Chronic Obstructive Pulmonary Disease (COPD) and the Heterogeneity of Risk Factors in the Canadian Population: Results from the Canadian Obstructive Lung Disease (COLD) Study

PurposeTo determine the spirometric-based prevalence of COPD across different regions in Canada and to evaluate the site heterogeneity of risk factors.Patients and MethodsIn this cross-sectional, population-based study, random samples of non-institutionalized adults aged ≥40 years were generated by random digit dialling. Participants answered an interviewer-administered questionnaire and performed spirometry before and after bronchodilator administration. COPD was defined as post-bronchodilator FEV1/FVC <0.70 (fixed ratio, FR) and as FEV1/FVC <5th percentile (lower limits of normal, LLN). Separate logistic regression models were used to compute the risk (adjusted odds ratio, aOR) for COPD. I2 and Tau2 analyses were used to evaluate heterogeneity.ResultsOut of 5176 (95%) participants, 4893 (47% male with mean age 56.6 years (95% confidence interval, 56.0–57.2)) had spirometry that satisfied ATS criteria. The population prevalence of COPD was 16.2% (95% CI, 14.5–17.8) by FR and 11.2% (95% CI, 9.7–12.6) by LLN. Male predominance in prevalence was shown by FR but not by LLN criteria. Patient characteristics associated with an increased risk of COPD included: age (OR 1.56; 95% CI 1.33–1.84); history of physician-diagnosed asthma (OR 3.30; 95% CI 2.42–4.49); and childhood hospitalization for respiratory illness (OR 1.81; 95% CI 1.17–2.80). In terms of smoking-related risk factors, current smoking status had the highest odds ratio (OR 3.49; 95% CI 2.55–4.80). Variance in prevalence among sites was significantly reduced by adjusting for risk factors in Tau2 analyses. Higher odds of exposure for each risk factor was found in more severe COPD, suggesting that a higher risk could be linked to the development of severe disease.ConclusionThis study reports the population prevalence of COPD in nine urban cities which collectively represent the majority of the Canadian population and demonstrates that heterogeneity in prevalence among sites is substantially explained by variation in associated risk factors for COPD.

Health-Promoting Behaviors, Health Literacy, and Levels of Knowledge about Smoking-Related Diseases among Smokers and Non-smokers: A Cross-Sectional Study

BackgroundFor generations, cigarette smoking has presented an important public health concern. This study aimed to compare the health-promoting behavior, exercise capacity, physical activity level, health literacy, and knowledge level of smoking-related diseases between smokers and non-smokers.MethodsThe study included 71 smokers (mean age, 32.69±8.55 years) and 72 non-smokers (mean age, 31.88±9.94 years) between the ages of 20 and 60 years. Assessments included a 6-minute walking test (6MWT), Godin Leisure-Time Physical Activity Questionnaire, Health-Promoting Lifestyle Profile II (HPLP-II), Cardiovascular Risk Factors Knowledge Level Scale (CARRF-KL), Asthma/COPD Awareness Questionnaire, the World Health Organization Quality of Life-Bref questionnaire (WHOQoL-Bref [TR]), and Health Literacy Questionnaire (HLQ).ResultsThe results from the study show that the number of coronary artery disease risk factors measured significantly higher among the smoker group members when compared to that of the non-smoker group members (p=0.001). Smokers had significantly lower %6MWT distance than non-smokers (84.83±4.72 and 93.45±7.16, respectively; p<0.05). However, there were no significant differences between the smokers and non-smokers in terms of physical activity, CARRF-KL, HLQ, WHOQoL-Bref, and HPLP-II subscales or total scores (p>0.05). Additionally, while only forty-one smokers (57.7%) were active, 48 of the non-smoker group was active (66.7%).ConclusionSmokers suffer greater negative effects to their exercise capacity in comparison to non-smokers. Although smokers and non-smokers have similar levels of health literacy and similar levels of knowledge about cardiovascular disease risk factors and obstructive lung diseases, health professionals could continue to further increase individuals’ awareness of smoking-related risk factors and continue to emphasize the importance of physical activity and exercise for protecting cardiopulmonary health.

Indonesian adolescents\u2019 perspectives on smoking habits: a qualitative study

BackgroundThe prevalence of smoking among adolescents is high in Indonesia. Therefore, this qualitative research aimed to explore the perspectives of Muslim adolescents on smoking habits as a reference for developing effective prevention programs.MethodsThree focus group discussions involving 24 junior high school male students (mean age = 13.75 years) were the main source of data for this phenomenological qualitative study. The discussion guide was developed by the researchers based on the reviewed literature and validated by experts. The research findings were analyzed using an inductive content analysis with systematic steps based on the stages of qualitative data analysis.ResultsAdolescent perspectives on smoking were grouped into two themes: perception of smoking and smoking-related factors. The perception of smoking encompassed three sub-themes: smoking as a social habit, contradictive feelings, and the Islamic perspective. The smoking-related factors included peer pressure, the parents’ smoking status, masculinity and curiosity. The results indicated that adolescents consider smoking as a social habit but with contradictory feelings. The smoking habit was also stimulated by peer pressure, imitating parents who smoke, feeling masculine and curiosity.ConclusionWe suggest that health professionals who are interested in developing smoking prevention programs in Indonesia should consider the adolescent perspective on smoking so that the prevention program will be more effective and appropriate for adolescents.