Tobacco Smoking Behavior Research Articles

Associations Between Hookah Tobacco Smoking Knowledge and Behavior Among Southern Technical University Students in Basra, Iraq

The number of US college students using hookahs, including those who wouldn't normally use tobacco, is rising. The idea that hookah is safer than cigarettes is one factor contributing to its popularity. The study's objectives were to evaluate the degree of awareness about the negative exposures linked to hookah smoking as comparison to cigarette smoking and to identify any relationships between this knowledge and the consequences of hookah smoking. A random email sample of 400 Southern Technical University students was used to gather data on demographics, hookah smoking habits, and awareness of five exposures (such as nicotine and tar). Multivariable logistic regression models evaluated the independent relationships between knowledge and the results of hookah smoking. Out of the five questions about factual knowledge. Correct answers to any knowledge item in multivariable models did not correlate with a decreased likelihood of hookah smoking or susceptibility to smoking in the future. Despite the fact that most college students are not aware of the harmful exposures linked to hookah smoking, there is no correlation between awareness and hookah smoking behavior.

Estimating the Association between Alcohol Consumption, Tobacco Smoking, and Sexual Behaviors among Men in Côte d'Ivoire

Estimating the Association between Alcohol Consumption, Tobacco Smoking, and Sexual Behaviors among Men in Côte d'Ivoire

The association of psychological distress and economic and health worries with tobacco smoking behavior during the COVID-19 pandemic: a two-year longitudinal cohort study

BackgroundThe COVID-19 pandemic and other life events may trigger worries and psychological distress. These impacts may lead to unhealthy behaviors, such as tobacco smoking, but the degree of such associations is unclear. The current three-wave longitudinal study examines changes in tobacco smoking in Norway between 2020 and 2022 and their associations with psychological distress as well as health- and economy-related worries.MethodsData were collected in April 2020 (baseline), January 2021, and January 2022 in Bergen, Norway, from an online longitudinal population-based survey. Smoking tobacco (the outcome variable) was dichotomized based on the responses to the question of whether participants smoked cigarettes or not. Tobacco smoking and its associations with psychological distress were assessed among 24,914 participants (response rate 36%) in a mixed model regression presented with coefficients and 95% confidence intervals (CI), adjusting for COVID-19-related worries, home office/study, occupational situation, age, gender, education, having children below 18 years living at home, living alone, and alcohol consumption.ResultsA total of 10% of the study sample were current smokers at baseline. At baseline, smoking tobacco was associated with high levels of psychological distress (absolute difference 13%, 95% CI 10%; 15%), advanced age (50−59 years: 11%, CI 10%; 13%), and hazardous alcohol use (4%, CI 3%; 5%) compared to their counterparts. Higher education (-5%, CI -6%; -4%), working from home (-4%, CI -5%; -4%), and higher physical activity levels (-4%, CI -5%; -3%) were associated with non-smoking. The prevalence of smoking among individuals experiencing severe psychological distress decreased slightly over time (-2% per year, CI -3%; -1%).ConclusionsSmoking was associated with severe psychological distress, advanced age, and hazardous alcohol use at baseline; non-smoking was associated with high education, working from home, and high physical activity. Nevertheless, the smoking rate among individuals experiencing severe psychological distress slightly decreased over the course of the COVID-19 pandemic.

The Impact of Prostate-Specific Antigen Screening on Prostate Cancer Incidence and Mortality in China: 13-Year Prospective Population-Based Cohort Study.

The status of prostate-specific antigen (PSA) screening is unclear in China. Evidence regarding the optimal frequency and interval of serial screening for prostate cancer (PCa) is disputable. This study aimed to depict the status of PSA screening and to explore the optimal screening frequency for PCa in China. A 13-year prospective cohort study was conducted using the Chinese Electronic Health Records Research in Yinzhou study's data set. A total of 420,941 male participants aged ≥45 years were included between January 2009 and June 2022. Diagnosis of PCa, cancer-specific death, and all-cause death were obtained from the electronic health records and vital statistic system. Hazard ratios (HRs) with 95% CIs were estimated using Cox regression analysis. The cumulative rate of ever PSA testing was 17.9% with an average annual percent change (AAPC) of 8.7% (95% CI 3.6%-14.0%) in the past decade in China. People with an older age, a higher BMI, higher waist circumference, tobacco smoking and alcohol drinking behaviors, higher level of physical activity, medication use, and comorbidities were more likely to receive PSA screening, whereas those with a lower education level and a widowed status were less likely to receive the test. People receiving serial screening ≥3 times were at a 67% higher risk of PCa detection (HR 1.67; 95% CI 1.48-1.88) but a 64% lower risk of PCa-specific mortality (HR 0.36; 95% CI 0.18-0.70) and a 28% lower risk of overall mortality (HR 0.72; 95% CI 0.67-0.77). People following a serial screening strategy at least once every 4 years were at a 25% higher risk of PCa detection (HR 1.25; 95% CI 1.13-1.36) but 70% (HR 0.30; 95% CI 0.16-0.57) and 23% (HR 0.77; 95% CI 0.73-0.82) lower risks of PCa-specific and all-cause mortality, respectively. This study reveals a low coverage of PSA screening in China and provides the first evidence of its benefits in the general Chinese population. The findings of this study indicate that receiving serial screening at least once every 4 years is beneficial for overall and PCa-specific survival. Further studies based on a nationwide population and with long-term follow-up are warranted to identify the optimal screening interval in China.

Tobacco smoking related to childhood trauma mediated by cognitive control and impulsiveness in severe mental disorders.

People with severe mental disorders (SMDs) show an increased prevalence of tobacco smoking compared to the general population. Tobacco smoking and other adult adverse health behaviors have been associated with traumatic experiences in childhood. In the present study we investigated the relationship between childhood trauma and tobacco smoking in people with SMDs, including the possible mediating role of cognitive- and personality characteristics, i.e. cognitive control, impulsiveness, affective lability and self-esteem. Enrolled in the study were 871 participants with schizophrenia (SCZ, N=484) and bipolar (BD, N=387) spectrum disorders. We assessed tobacco smoking behavior (yes/no and amount), and history of childhood trauma with the Childhood Trauma Questionnaire. Data on cognitive control, impulsiveness, affective lability, and self-esteem were available in subsamples. We performed linear and logistic regressions, and conducted mediation analyses in PROCESS. All analyses were as standard adjusted for age, sex, and diagnostic group. Experience of one or more subtypes of childhood trauma was significantly associated with smoking tobacco in SMDs (p=0.002). There were no significant associations between childhood trauma and amount of tobacco smoking. Cognitive control and impulsiveness were significant mediators between childhood trauma and tobacco smoking. These findings indicate the experience of childhood trauma as a predisposing factor for tobacco smoking in SMDs. Cognitive control and impulsiveness were suggested as mediating mechanisms, indicating the importance of considering inhibition related self-regulatory aspects in efforts to improve health behavior in individuals with SMDs and childhood trauma.

Association between tobacco control policies and smoking behaviour in Europe

Abstract Background Smoking is an important public health problem. The European Health Interview Survey (EHIS) provides regular data on prevalence and determinants of smoking for the populations of European countries, while the Tobacco Control Scale (TCS) quantifies the implementation of tobacco control measures. The aim is to examine the associations between tobacco control policies at country level and individual-level smoking prevalence. Methods Using multi-level regression modelling, individual data from EHIS 2019/2020 and country-level data from TCS 2019 were analysed. The outcome measure was self-reported current smoking (daily or occasional) at the individual level. Predictor variables were at the individual level: gender, age and education attainment level, and at country level: scores of TCS policy components ‘Price', ‘Public place bans', ‘Advertising bans', ‘Health warnings', ‘Treatment’ and ‘Illicit trade'. Microdata from the 3rd wave of EHIS for 28 European countries were used with a total of n = 66.934 individuals aged >15 years. A weighting factor was applied to consider each country proportionally according to its sample size in EHIS. Results There are large cross-national differences in current smoking prevalence ranged from 12.6% (95% confidence interval (CI) 11.9-13.3) in Sweden to 36.2% (95% CI 35.0-37.4) in Bulgaria. In the final multi-level model besides individual variables (female gender, age 60 years and over, medium or high education level), following variables at country level were significantly associated with lower prevalence of current smoking: ‘Price’ (Odds Ratio (OR)=0.96 (p < 0.05) and ‘Treatment’ OR = 0.88; (p < 0.01). For ‘Public place bans', ‘Advertising bans', ‘Health warnings’ and and ‘Illicit trade’ association were in same direction but without significance. Conclusions Tobacco control policies help to reduce the prevalence of smoking in population, although the different measures have differing impact. Key messages • Our study confirms the link between the implementation of tobacco control policies and smoking prevalence using recent data. • Policy components have different effects on smoking prevalence at population level.

Tobacco retailer density and smoking behaviour: how are exposure and outcome measures classified? A systematic review

IntroductionTo date only a limited number of reviews have focused on how exposure and outcome measures are defined in the existing literature on associations between tobacco retailer density (‘density’) and smoking behaviour (‘smoking’). Therefore this systematic review classified and summarised how both density and smoking variables are operationalised in the existing literature, and provides several methodological recommendations for future density and smoking research.MethodsTwo literature searches between March and April 2018 and April 2022 were conducted across 10 databases. Inclusion and exclusion criteria were developed and keyword database searches were undertaken. Studies were imported into Covidence. Cross-sectional studies that met the inclusion criteria were extracted and a quality assessment was undertaken. Studies were categorised according to the density measure used, and smoking was re-categorised using a modified classification tool.ResultsLarge heterogeneity was found in the operationalisation of both measures in the 47 studies included for analysis. Density was most commonly measured directly from geocoded locations using circular buffers at various distances (n = 14). After smoking was reclassified using a smoking classification tool, past-month smoking was the most common smoking type reported (n = 26).ConclusionsIt is recommended that density is measured through length-distance and travel time using the street network and weighted (e.g. by the size of an area), or by using Kernel Density Estimates as these methods provide a more accurate measure of geographical to tobacco and e-cigarette retailer density. The consistent application of a smoking measures classification tool, such as the one developed for this systematic review, would enable better comparisons between studies. Future research should measure exposure and outcome measures in a way that makes them comparable with other studies.ImplicationsThis systematic review provides a strong case for improving data collection and analysis methodologies in studies assessing tobacco retailer density and smoking behaviour to ensure that both exposure and outcome measures are clearly defined and captured. As large heterogeneity was found in the operationalisation of both density and smoking behaviour measures in the studies included for analysis, there is a need for future studies to capture, measure and classify exposure measures accurately, and to define outcome measures in a manner that makes them comparable with other studies.

Association between daily use of social media and behavioral lifestyles in the Saudi community: a cross-sectional study.

This study aimed to investigate the association between nine social media platforms use and health-related behavior, including fruit and vegetable intake, physical activity, tobacco use, and risk factors including depression and obesity. A cross-sectional study was conducted using secondary data from the Sharik Health Indicators Surveillance System (SHISS). Participants 18 years and older were recruited via phone-interviews. The nine social media platform use [Twitter-(X), Facebook, Instagram, WhatsApp, LinkedIn, Snapchat, TikTok, Telegram, and YouTube] were assessed using self-reported use. Health-related variables include behavioral factors including diet, physical activity, and tobacco use including (cigarettes, waterpipes, and e-cigarettes), risk of depression and obesity. Logistic regression analysis was performed to explore the association between social media use and health-related variables. The study indicated that daily Snapchat users had a lower healthy diet (fruit and vegetable intake), whereas daily LinkedIn and WhatsApp users were positively associated with a healthier diet, relative to those with infrequent social media use. Furthermore, daily interaction with Instagram, TikTok, Telegram, and YouTube was significantly associated with increased depression risk. Conversely, Snapchat and WhatsApp usage was significantly linked to a decreased depression risk. Tobacco-smoking behaviors were associated with specific social media platforms: cigarette smoking was associated with Snapchat, TikTok, and YouTube; e-cigarette with Facebook, LinkedIn, Snapchat, and TikTok; and waterpipe smoking with Facebook and TikTok. Interestingly, some platforms, such as Instagram, were associated with reduced cigarette smoking. The relationship between social media activity and health-related outcomes remained significant after adjusting for age and gender. This study highlights the potential negative impact of particular daily social media use on health-related variables, including dietary habits, tobacco use, and depression. Nevertheless, particular daily social media use of some platforms was associated with a potential positive impact on the health-related variables. Social media platforms are tools that can be used to achieve both a positive and negative effect. By knowing which demographic segments have a greater presence on one platform, we are creating opportunities to understand the social phenomena and at the same time use it to reach those segments and communicate with them, because each social media platform has its unique way and framework of user communication.

Smoking behaviour, tobacco sales and tobacco advertising at 40 ‘Smoke Free Hospitals’ in Vietnam

BackgroundTobacco remains the leading cause of preventable death globally. Vietnam’s 2012 Law on Prevention and Control of Tobacco Harms establishes all healthcare facilities as smoke-free environments. We aimed to evaluate...

In Case You Haven't Heard…

Depression and anxiety are thought to increase a person's risk of developing cancer, but research results have been inconclusive, according to a Wiley CANCER News Alert. In an analysis of multiple studies from the Netherlands, the United Kingdom, Norway and Canada, investigators found that depression and anxiety are not linked to higher risks for most types of cancer among this population. The analysis was published by Wiley online in CANCER, a peer‐reviewed journal of the American Cancer Society. Experts have suspected that depression and anxiety may increase cancer risk by affecting a person's health‐related behaviors or by having biological effects on the body that support cancer development. Researchers found no associations between depression or anxiety, and overall, breast, prostate, colorectal and alcohol‐related cancers during a follow‐up of up to 26 years. The presence of depression or anxiety was linked with a 6% higher risk of developing lung cancer and smoking‐related cancers, but this risk was substantially reduced after adjusting for other cancer‐related risk factors including smoking, alcohol use and body mass index. Therefore, this analysis supports the importance of addressing tobacco smoking and other unhealthy behaviors, including those that may develop as a result of anxiety or depression, the news release indicated.

The role of sex hormones in targeting stress-induced tobacco craving, stress-reactivity, and smoking with guanfacine among women who smoke

Women who smoke are particularly vulnerable to tobacco craving, smoking behaviors, and relapse in the context of stress when compared to men who smoke. One factor in this sex difference may be sex hormones, including estradiol and progesterone; however, smoking cessation medication trials often do not explore the impact of sex hormones on drug effects. This secondary analysis of a double-blind, placebo-controlled study explored the impact of levels of actual estradiol and progesterone on guanfacine, a noradrenergic α2a agonist, which attenuates stress-induced smoking behaviors in women. Women who smoke (n = 43) completed a stress induction laboratory paradigm followed by an ad-libitum smoking period. Assessment of tobacco craving, and stress-reactivity (via cortisol response) occurred pre- and post-stress induction. Results indicated that guanfacine attenuated stress-induced tobacco craving (F = 10.94, p = 0.02) and cortisol response (F = 14.23, p < 0.001); however, high levels of estradiol overrode guanfacine's effect on craving (F = 4.00, p = 0.05), cortisol response (F = 14.23, p < 0.001), and smoking during the ad-libitum period (F = 12.23, p = 0.001). Additionally, progesterone proved to be protective against tobacco craving and enhanced guanfacine's medication effect on craving (F = 5.57, p = 0.02). The present study found that sex hormones had a significant impact on medication effects in a smoking cessation trial and thus underscore the importance of examining the role of sex hormones in future medication trials.

The Effects of COVID-19 Pandemic Lockdowns on Alcohol Consumption and Tobacco Smoking Behaviour in South Africa: A National Survey

Introduction: During the first phase of the coronavirus (COVID-19) pandemic lockdowns in South Africa (SA), both alcohol and tobacco were considered non-essential goods and their sales were initially prohibited and further restricted to certain days and timeframes. This study investigates self-reported changes in alcohol consumption and tobacco smoking behaviour in the general population during the COVID-19 pandemic lockdowns in SA. Methods: A cross-sectional national survey was conducted in October 2021 (before the Omicron wave 4 and while SA was in low-level lockdown) among 3,402 nationally representative respondents (weighted to 39,640,674) aged 18 years and older. Alcohol consumption and tobacco use were assessed from the beginning of the lockdown towards the end of March 2020 until October 2021 using the WHO-AUDIT and the US Centre for Disease Control (CDC) Global Adult Tobacco Survey questionnaires, respectively. Results: Among those that drank alcohol (33.2%), 31.4% were classified as having a drinking problem that could be hazardous or harmful and 18.9% had severe alcohol use disorder during the COVID-19 lockdowns. Twenty-two per cent (22.0%) of those that reported alcohol consumption reported that the COVID-19 pandemic lockdowns changed their alcohol consumption habits, with 38.1% reporting a decreased intake or quitting altogether. Among the one in five respondents (19.2%) who had ever smoked, most reported smoking at the time of the survey (82.6%) with many classified as light smokers (87.8%; ≤10 cigarettes/day). Almost a third (27.2%) of those smoking reported that the COVID-19 pandemic lockdowns had changed their use of tobacco products or vaping, with 60.0% reporting a reduction/quitting tobacco use. Given that sales were restricted this indicates that people could still get hold of tobacco products. Heavy smoking was associated with older age (p = 0.02), those classified as wealthy (p < 0.001), those who started or increased tobacco smoking during the pandemic lockdowns (p = 0.01) and residential provinces (p = 0.04). Conclusion: Given restrictions on the sale of alcohol and tobacco in SA between 27 March and August 17, 2020, during the pandemic, respondents reported an overall decline in alcohol consumption and tobacco use which might suggest that the regulatory restrictive strategies on sales had some effect but may be inadequate, especially during times where individuals are likely to experience high-stress levels. These changes in alcohol consumption and tobacco use were different from what was reported in several European countries, possibly due to differences in the restrictions imposed in SA when compared to these European countries.

Substance use among people with severe mental illness during the COVID-19 pandemic and earthquakes: the role of community-based treatment

IntroductionThe COVID-19 pandemic has disrupted mental healthcare delivery in many countries. The restricted access to psychiatric services and double disasters (pandemic and earthquakes) coincided in Croatia, potentially placing people with severe mental illness (SMI) in a very vulnerable position.ObjectivesThe aim of this study was to examine the changes in substance use in people with SMI in the first and the second COVID-19 wave and co-occurring earthquakes. The secondary aim was to explore whether the type of treatment (community mental health teams (CMHT) vs. treatment as usual) influenced those changes.MethodsThis study was nested within the RECOVER-E project (LaRge-scalE implementation of COmmunity based mental health care for people with seVere and Enduring mental ill health in EuRopE, Horizon 2020 research and innovation programme, grant agreement No 779362). The study involved 90 participants with SMI assessed at two time points: in May/June 2020 (during the first COVID-19 wave and after Zagreb earthquake) and in December 2020/January 2021 (during the second COVID-19 wave and after Petrinja earthquake). The changes in the use of psychoactive substances (alcohol, cannabis, other drugs, sedatives) were assessed using self-reported survey.ResultsThe increase in tobacco smoking behavior and the use of sedatives was observed in both COVID-19 waves in people with SMI. No increase was reported in cannabis and other drugs use, while less than 5% of participants reported increase in alcohol consumption. Not receiving CMHT service predicted the increase in sedative use.ConclusionsEnsuring accessible mental health care provided by CMHT is recommended for counteracting the negative effect of external stressors (such as pandemic and co-occurring earthquakes) on the increased substance use among people with SMI.Disclosure of InterestS. Levaj Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., S. Medved Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., J. Gerlach: None Declared, L. Shields-Zeeman Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., F. Bolinski Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., Z. Bradaš Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., Z. Madžarac Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362., I. Rojnić Palavra: None Declared, M. Rojnić Kuzman Grant / Research support from: Project RECOVER-E - European Union’s Horizon 2020 research and innovation programme; Grant Agreement No 779362.

Correlates of motivation to quit waterpipe tobacco smoking among US young adults: implications for cessation interventions.

Waterpipe tobacco smoking is a public health concern that poses many of the same health risks as cigarette smoking, especially among young adults-a subpopulation characterized by the highest prevalence of waterpipe tobacco smoking. Nevertheless, it remains understudied relative to other forms of tobacco use. We examined sociodemographic, behavioral and cognitive factors associated with young adults' motivation to quit waterpipe smoking using a theory-informed approach. We completed a secondary analysis of baseline data on waterpipe tobacco smoking beliefs and behavior collected from 349 US young adults aged 18-30 years. We analyzed sociodemographics, tobacco use and cessation behaviors and perceptions, and theory-related constructs associated with motivation to quit waterpipe tobacco smoking using linear regression. Overall, participants reported low motivation (mean = 2.68, SD = 1.56, scale range 1-7) and high self-efficacy (mean = 5.12, SD = 1.79) to quit waterpipe tobacco smoking. In multivariable analysis, prior quit attempts (β = 1.10, P < 0.01), greater perceived risks of waterpipe tobacco smoking (β = 0.42, P < 0.01) and increasingly negative attitudes toward waterpipe tobacco smoking (β = 0.29, P < 0.01) were associated with higher motivation to quit. These findings highlight the importance of those factors as potential cessation determinants. These findings can help guide the development and refinement of interventions targeting young adult waterpipe tobacco smoking.

The Effects of A Community-based Health Program on Adolescents’ Smoking Prevention – A Quasi-Experimental Study

Background: Tobacco Smoking is considerably high among adolescents in Indonesia, indicating the potential proportion of tobacco smoking effects experienced by young Indonesians in the future and the need of program interventions to halt the tendency. This study aims to investigate effects of a community-based health promotion intervention on smoking prevention among Indonesians’ adolescents.Methods: The quasi-experimental study with a pre-and-posttest control group design involved 104 adolescents aged between 12 to 14 years. The adolescents were convieniently assigned into one intervention (55 adolescents) or a control group group (49 adolescents), with participants in the intervention group received four health promotion sessions using smoking prevention videos for one month. Effects of the intervention were measured by a questionnaire at one week before and after the intervention completed and then analyzed by an approprite data analysis technique.Results: After the intervention completion, there was a significant positive effect of the community-based health promotion intervenstion program in improving adolescents tobacco smoking knowledge, attitude, intention and behavior (p = &lt;0.001).Conclusion: Community-based health promotion program provides positive impact on adolescents smoking prevention and therefore should be considered as one of stretegies for tobacco smoking prevention program.

Chronic tobacco smoking, impaired reward-based decision-making, and role of insular cortex: A comparison between early-onset smokers and late-onset smokers.

IntroductionThe literature suggests that tobacco smoking may have a neurotoxic effect on the developing adolescent brain. Particularly, it may impair the decision-making process of early-onset smokers (<16 years), by rendering them more prone to impulsive and risky choices toward rewards, and therefore more prone to smoking relapses, in comparison to late-onset smokers (≥16 years). However, no study has ever investigated reward-based decision-making and structural brain differences between early-onset smokers and late-onset smokers.MethodsComputerized measures of reward-based decision-making [Cambridge Gambling Task (CGT); 5-trials adjusting delay discounting task (ADT-5)] were administered to 11 early-onset smokers (mean age at regular smoking initiation = 13.2 years), 17 late-onset smokers (mean age at regular smoking initiation = 18.0 years), and 24 non-smoker controls. Voxel-based morphometry (VBM) was utilized to investigate the gray matter (GM) and white matter (WM) volume differences in fronto-cortical and striatal brain regions between early-onset smokers, late-onset smokers, and non-smokers.ResultsEarly-onset smokers displayed a riskier decision-making behavior in comparison to non-smokers as assessed by the CGT (p < 0.01, Cohen’s f = 0.48). However, no significant differences (p > 0.05) in reward-based decision-making were detected between early-onset smokers and late-onset smokers. VBM results revealed early-onset smokers to present lower GM volume in the bilateral anterior insular cortex (AI) in comparison to late-onset smokers and lower WM volume in the right AI in comparison to late-onset smokers.ConclusionImpairments in reward-based decision-making may not be affected by tobacco smoking initiation during early adolescence. Instead, lower GM and WM volume in the AI of early-onset smokers may underline a vulnerability to develop compulsive tobacco seeking and smoking behavior during adulthood.

Acupuncture combined with auricular acupressure for smoking cessation and its effects on tobacco dependence and smoking behavior among Hong Kong smokers: a multicenter pilot clinical study

BackgroundAcupuncture combined with auricular acupressure has been used as a complementary and alternative treatment for smoking cessation in Hong Kong for over 10 years. This study aimed to investigate the success rates of smoking cessation posttreatment, and to evaluate treatment effects on tobacco dependence, smoking behavior, anxiety levels, and sleep disturbances between successful and unsuccessful quit smokers in Hong Kong.MethodsThis prospective, multicenter clinical study conducted between September 2020 and February 2022 in Hong Kong was part of the Guangdong-Hong Kong-Macau Greater Bay Area project on smoking cessation. Thirty eligible current smokers (mean age 47.10 years; 40% female) were recruited and received a combination of standardized acupuncture and auricular acupressure treatments twice weekly for 8 weeks. The primary outcome was the success rate of smoking cessation at week 24. The secondary outcomes were the success rates of smoking cessation at weeks 8 and 16, exhaled carbon monoxide (CO) levels, and changes in scores on the Fagerström Test for Nicotine Dependence (FTND), Autonomy Over Smoking Scale (AUTOS), Hamilton Anxiety Rating Scale (HAM-A), Self-rating Anxiety Scale (SAS), and Pittsburgh Sleep Quality Index (PSQI). Adverse events were also recorded.ResultsOf 30 eligible participants, 28 completed 6 or more treatment sessions; all completed follow-up assessments. At week 24, the success rate of smoking cessation was 46.67%. The successfully quit rates at weeks 8 and 16 were 36.67% and 43.33%, respectively. The overall change in mean FTND scores from baseline improved significantly from weeks 2 to 24 (P < 0.05), with the successful quit group showing significantly greater improvement between weeks 8 and 24 (P < 0.01). Compared with baseline values, there were significant reductions in mean AUTOS scores from weeks 6 to 24 (P < 0.001), with the successful quit group showing greater improvement at weeks 16 (P = 0.04) and 24 (P < 0.001). No significant changes were detected in exhaled CO levels or HAM-A, SAS, and PSQI scores. No study-related adverse events were observed.ConclusionsAcupuncture combined with auricular acupressure could be an effective alternative treatment for smoking cessation and reduction of tobacco dependence among Hong Kong smokers.Trial registration Chinese Clinical Trial Registry, No. ChiCTR2000033650. Registered on June 7, 2020. http://www.chictr.org.cn/showproj.aspx?proj=54866

Multiple Tobacco Product Use among Adolescents with Asthma in Korea.

Few studies have examined the use of multiple tobacco products among adolescents with asthma. The purpose of this study was to examine multiple tobacco product use and smoking behaviors. In this study, data from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) were used, and 57,303 samples from 400 middle schools and 400 high schools in Korea were classified as study participants. Statistical analysis was performed with a complex sample design, using frequency analysis, chi-square test, and multiple logistic regression analysis. Adolescents with asthma had a higher current smoking rate for combustible cigarettes (CC), e-cigarettes (EC), and heated tobacco products (HTPs) than those without asthma (p < 0.001). The rates of dual use (using two types of tobacco; CC + EC or CC + HTPs or EC + HTPs; OR = 2.62, 95% CI: 1.626–4.240, R2 = 26.8%) and triple use (using three types of tobacco; CC + EC + HTPs; OR = 2.61, 95% CI: 1.678–4.065, R2 = 34.9%) were higher in adolescents with asthma than those without asthma, after adjusting for confounders. The smoking rate of new types of tobacco among adolescents with asthma is on the rise. Therefore, the calculation of basic data related to new tobacco smoking among adolescents is essential for establishing a continuous monitoring system to alleviate the burden of disease on national health.

Tobacco smoking changes during the first pre-vaccination phases of the COVID-19 pandemic: A systematic review and meta-analysis

SummaryBackgroundGlobally, tobacco smoking remains the largest preventable cause of premature death. The COVID-19 pandemic has forced nations to take unprecedented measures, including ‘lockdowns’ that might impact tobacco smoking behaviour. We performed a systematic review and meta-analyses to assess smoking behaviour changes during the early pre-vaccination phases of the COVID-19 pandemic in 2020.MethodsWe searched Medline/Embase/PsycINFO/BioRxiv/MedRxiv/SSRN databases (January–November 2020) for published and pre-print articles that reported specific smoking behaviour changes or intentions after the onset of the COVID-19 pandemic. We used random-effects models to pool prevalence ratios comparing the prevalence of smoking during and before the pandemic, and the prevalence of smoking behaviour changes during the pandemic. The PROSPERO registration number for this systematic review was CRD42020206383.Findings31 studies were included in meta-analyses, with smoking data for 269,164 participants across 24 countries. The proportion of people smoking during the pandemic was lower than that before, with a pooled prevalence ratio of 0·87 (95%CI:0·79–0·97). Among people who smoke, 21% (95%CI:14–30%) smoked less, 27% (95%CI:22–32%) smoked more, 50% (95%CI:41%-58%) had unchanged smoking and 4% (95%CI:1–9%) reported quitting smoking. Among people who did not smoke, 2% (95%CI:1–3%) started smoking during the pandemic. Heterogeneity was high in all meta-analyses and so the pooled estimates should be interpreted with caution (I2>91% and p-heterogeneity<0·001). Almost all studies were at high risk of bias due to use of non-representative samples, non-response bias, and utilisation of non-validated questions.InterpretationSmoking behaviour changes during the first phases of the COVID-19 pandemic in 2020 were highly mixed. Meta-analyses indicated that there was a relative reduction in overall smoking prevalence during the pandemic, while similar proportions of people who smoke smoked more or smoked less, although heterogeneity was high. Implementation of evidence-based tobacco control policies and programs, including tobacco cessation services, have an important role in ensuring that the COVID-19 pandemic does not exacerbate the smoking pandemic and associated adverse health outcomes.FundingNo specific funding was received for this study.

Knowledge, attitudes and practices relating to tobacco smoking in undergraduate students in a selected university of Bangladesh

Background: Tobacco smoking is one of the leading causes of preventable morbidity and mortality in the world, and is responsible for many premature deaths. The prevalence of smoking and smoking-related mortality are still high in developing and low-income countries. This survey was aimed to determine knowledge, perception and practices of tobacco smoking behavior in the undergraduate students of Bangladesh University of Health Sciences, Bangladesh.Methods: A descriptive type of cross-sectional study was conducted among the Health Sciences students during January 2018. A self-administered semi-structured questionnaire was used for data collection from 260 undergraduate students. Data was analyzed using SPSS version 25 (Statistical Package for Social Studies).Results: The prevalence of overall current tobacco smokers was 12.3% (21.2% for males and 0.9% for females). Nonsmokers had a better knowledge than smokers regarding smoking as a risk factor for lung cancer (98.4%; versus 92.9%; p=0.038), association between second hand smoke and serious illness (94.2% versus 82.9%; p&lt;0.001) and likelihood of dying earlier than nonsmokers (84.2% versus 61.4%; p&lt;0.001). In general, students had positive antismoking perception.Conclusions: Despite having a good understanding of the detrimental effects of tobacco smoking, smoking prevalence among students at Bangladesh University of Health Sciences is high. To reduce smoking among university students, effective smoking prevention and cessation intervention programs are necessary.