Smoking Women Research Articles

Osler’s Subacute Infective Endocarditis on Rheumatic Heart: A Complicated Clinical Case That Reflects Four (4) Major Public Health Issues in Sub-Saharan Africa

Endocarditis is an inflammation of the endocardium and its structures (valves), most often of infectious origin, described by William Osler in 1885. In the 21st century, infective endocarditis remains a reality in our countries. We report a complicated case of infective endocarditis (IE). This is a 53-year-old woman, obese and passive smoker who died on the 5th day of her hospitalization following an infective endocarditis (IE) with bacterial strains resistant to the usual antibiotics: daughter of acute lithiasic cholecystitis, mother of major mitral valve perforation, brain abscess, ischemic stroke and atrial fibrillation. All were responsible for septic shock and fatal coma. Surgical management of the infective endocarditis in the first hours of her admission could have improved her prognosis. To conclude, in addition to its interests and its clinical particularities, our present observation has highlighted major public health problems specific to our sub-Saharan African countries, namely: The problem of the double health burden, the problem of delays in seeking care, the problem of resistance to antibiotics and the problem of the insufficiency of reference health technical platforms.

ВЛИЯНИЕ АКТИВНОГО И ПАССИВНОГО КУРЕНИЯ НА РИСК РАЗВИТИЯ ПРЕЖДЕВРЕМЕННЫХ РОДОВ И ДРУГИХ БОЛЬШИХ АКУШЕРСКИХ СИНДРОМОВ

Preterm birth is one of the leading causes of infant and neonatal mortality. Progressive placental and hypertensive disorders and pre-eclampsia often increase the proportion of induced preterm births. The study aims. There is conflicting evidence in the literature about the association of active and passive smoking with the risk of these gestational complications. The present study analysed the complications of pregnancy in smoking and non-smoking women according to the timing of delivery. According to the results, smoking is a significant risk factor for preterm birth, placental and hypertensive disorders. The chances of severe pre-eclampsia and fetal growth retardation were higher in women who smoked. The likelihood of these complications increases with the duration of smoking.

Associations Between Smoking, Alcohol Consumption, Physical Activity and Depression in Middle-Aged Premenopausal and Postmenopausal Women

Background: Changes in lifestyle factors are known to affect mood. However, there is insufficient evidence supporting the association between smoking, alcohol consumption, physical activity and depression in middle-aged women who are likely to experience rapid hormonal changes.Methods: We used a nationwide database of medical records in South Korea. 901,721 premenopausal and 943,710 postmenopausal women aged 40 years or older included in this study. Information on smoking, alcohol consumption, physical activity was identified from health examination data and followed up for the occurrence of depression using claims data.Results: Compared with never-smokers, ex-smokers and current smokers among premenopausal and postmenopausal women showed an increased risk of depression in a dose-dependent manner (aHR 1.13 for ex-smokers; aHR 1.23 for current smokers). Compared with non-drinkers, mild drinkers showed a decreased risk of depression (aHR 0.98 for premenopausal women; aHR 0.95 for postmenopausal women), and heavy drinkers showed an increased risk of depression both among premenopausal (aHR 1.20) and postmenopausal women (aHR 1.05). The risk of depression due to smoking and heavy alcohol consumption was higher in premenopausal women than in postmenopausal women. Compared with those who had not engaged in regular physical activity, those who had engaged showed a decreased risk of depression both among premenopausal (aHR 0.96) and postmenopausal women (aHR 0.95).Conclusions: Smoking and heavy alcohol consumption increased the risk of depression, and the increased risk was prominent in premenopausal than in postmenopausal women. Regular physical activity decreased the risk of depression both in premenopausal and postmenopausal women.

Hair and nail nicotine levels of mothers and their infants as valid biomarkers of exposure to intrauterine tobacco smoke

INTRODUCTIONTobacco use remains the single most modifiable cause of adverse pregnancy outcomes. It is crucial to be able to accurately quantify the burden of tobacco exposure on both the mother and fetus to have better measures of efficacy with interventions being studied.METHODSThis is a descriptive and exploratory study conducted within a randomized controlled trial. Pregnant smoking and non-smoking women were followed from ≤22 weeks’ gestation through delivery with monthly maternal smoking questionnaires, urine cotinine levels, and collection of maternal and infant hair and nail samples, at delivery. Nicotine was extracted and measured (ng/mg) using high-performance liquid chromatography with electrochemical detection.RESULTSForty-six mother–infant dyads (34 pregnant smokers and 12 pregnant non-smokers) had successful completion of maternal and infant hair and nails samples. The median hair nicotine levels of the smoking mothers and their infants was significantly higher than those of the non-smokers (1.015 vs 0.037 ng/ mg, p<0.05 for the mothers; 0.445 vs 0.080 ng/mg, p<0.01 for the infants). Similarly, the median nail nicotine levels for smoking mothers and their infants were significantly higher than the non-smokers (2.130 vs 0.056 ng/mg, p<0.01 for the mothers; 0.594 vs 0.132 ng/mg, p<0.05 for the infants). We found a moderate but significant correlation between maternal hair and nail nicotine (r=0.64, p<0.001), infant hair and nail nicotine (r=0.64; p<0.001), maternal and infant hair nicotine (r=0.61, p<0.001), and maternal and infant nail nicotine levels (r=0.58, p<0.001).CONCLUSIONSOur study shows that both infant hair and nail nicotine levels are valid biomarkers of intrauterine tobacco smoke exposure, and can be used to identify prenatal smoke exposure, correlating well with the level of maternal nicotine exposure.

Impact of Cigarette Smoking on the Expression of Oxidative Stress-Related Genes in Cumulus Cells Retrieved from Healthy Women Undergoing IVF

The female reproductive system represents a sensitive target of the harmful effects of cigarette smoke, with folliculogenesis as one of the ovarian processes most affected by this exposure. The aim of this study was to analyze the impact of tobacco smoking on expression of oxidative stress-related genes in cumulus cells (CCs) from smoking and non-smoking women undergoing IVF techniques. Real time PCR technology was used to analyze the gene expression profile of 88 oxidative stress genes enclosed in a 96-well plate array. Statistical significance was assessed by one-way ANOVA. The biological functions and networks/pathways of modulated genes were evidenced by ingenuity pathway analysis software. Promoter methylation analysis was performed by pyrosequencing. Our results showed a down-regulation of 24 genes and an up-regulation of 2 genes (IL6 and SOD2, respectively) involved in defense against oxidative damage, cell cycle regulation, as well as inflammation in CCs from smoking women. IL-6 lower promoter methylation was found in CCs of the smokers group. In conclusion, the disclosed overall downregulation suggests an oxidant-antioxidant imbalance in CCs triggered by cigarette smoking exposure. This evidence adds a piece to the puzzle of the molecular basis of female reproduction and could help underlay the importance of antioxidant treatments for smoking women undergoing IVF protocols.

Social Predictors of Continued and Indoor Smoking Among Partners of Non-smoking Pregnant Women: The TMM BirThree Cohort Study.

BackgroundSecondhand smoke (SHS) from partners is a major source of exposure for non-smoking women. However, epidemiological studies have rarely examined social factors associated with continued and indoor smoking among pregnant women’s partners.MethodsWe analyzed data on 6,091 partners of non-smoking pregnant women in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Partners’ age, education, income, workplace SHS exposure (almost never or sometimes, almost every day), and pregnant women’s smoking history (never, quit before pregnancy awareness, quit after pregnancy awareness) were used as social factors. Multiple logistic regression analyses were conducted to examine the associations of social factors with partners’ continued smoking and indoor smoking.ResultsAmong 2,432 smoking partners, 2,237 continued to smoke after pregnancy awareness. Workplace SHS exposure was associated with increased risk of partners’ continued smoking: the odds ratio of workplace SHS exposure almost every day compared with almost never or sometimes was 2.08 (95% confidence interval, 1.52–2.83). Women’s quitting smoking after—but not before—pregnancy awareness was associated with decreased risk of partners’ continued smoking: the odds ratio of women’s quitting after pregnancy awareness compared with never smoking was 0.57 (95% confidence interval, 0.40–0.80). About one-third of partners who continued to smoke did so indoors. Older age, lower education, workplace SHS exposure, and women’s quitting smoking after pregnancy awareness were associated with increased risk of partners’ indoor smoking.ConclusionsWorkplace SHS exposure and pregnant women’s smoking history were associated with continued smoking and indoor smoking among partners of non-smoking pregnant women.

Active and Passive Maternal Smoking During Pregnancy and Birth Outcomes: A Study From a Developing Country.

Background:Smoking is one of the modifiable risk factors for adverse maternal and neonatal outcomes and is associated with low birth weight, preterm birth, respiratory, antepartum and intrapartum stillbirth, and perinatal death as well as long-term morbidity in offspring and sudden unexpected infant death. The rate of smoking in low- and middle-income countries is still relevantly high, and Jordan is no exception.Objective:To investigate the effect of active and passive smoking during pregnancy on adverse pregnancy outcomes.Methods:The case-control study was conducted in Jordan in June 2020. Healthy women with full-term singleton pregnancy (n = 180) were interviewed and stratified into three groups: Group I, active smokers; Group II, passive smokers; and Group III, nonsmokers. The study variables included demographic data, current pregnancy history, cotinine level of mothers and newborns, and perinatal outcomes. Statistical analysis was performed using the application package IBM SPSS 25. Various algorithms of statistical analysis were used depending on the type of distribution of feature and data quality. The threshold for statistical significance was set at p < 0.05.Results:Active smokers had significantly lower gestational age at delivery compared to passive and nonsmoking women (p = 0.038 and p = 0.003, respectively). Neonates from active smoking mothers had significantly lower birth weight compared to neonates from passive and nonsmoking women (p = 0.016 and p = 0.019, respectively), significantly lower head and chest circumferences compared to babies from passive smokers (p < 0.001 and p = 0.036, respectively), and significantly lower first-minute Apgar score compared to those from nonsmoking women (p = 0.023). The urine cotinine level was significantly higher in both active and passive smoking women (both p < 0.01), and it was significantly higher in newborns who had been exposed to smoking in utero despite maternal active or passive smoking status (both p < 0.001). There was a weak negative correlation between urine cotinine level and birth weight: r = –0.14 for maternal cotinine level and r = –0.15 for neonate cotinine level.Conclusions:The current study illustrated that smoking during pregnancy leads to offspring with reduced birth weight, birth length, and head and chest circumference; reduces delivery gestational age; and lowers the first-minute Apgar score. Our study findings highlight the need for further research issued to smoking effects on perinatal outcomes, the implementation of actions to develop cessation interventions in the preconception period, and an evaluation of useful interventions to enhance a smoking-free environment during pregnancy.

Sex differences in the association between smoking status and increased incidence of Alzheimer’s dementia

AbstractBackgroundGrowing evidence indicates that smoking, a late life risk factor for Alzheimer’s dementia (AD), is significantly associated with increased prevalence of AD. However, the relationship between sex, smoking, and incident AD has not been well explored. The current study examined the relationship between sex, smoking status, and time to clinical diagnosis of AD.Method387 participants from UK Biobank were included in the study (mean±SE age=67.7±1.5 years, 50.9% female). Participants were over the age of 65 at their baseline visit and subsequently developed AD. Participant smoking status was determined from a baseline lifestyle questionnaire (8.5% current smoker, 45.7% previous smoker). Cox proportional‐hazard models were used to test the association between smoking and conversion. An interaction term and stratification by sex were used to assess the moderating role of sex in the association. Baseline age, APOE‐e4 status, sex, and Townsend deprivation index were included in the analyses.ResultMedian time to conversion was 6.39 years (interquartile range (IQR): 2.75) among never‐smoker participants, 6.36 years (IQR: 2.5) among previous smokers, while current smokers had a median time to conversion of 5.56 years (IQR: 2.59). Never‐smoker men had a shorter median time to conversion than never‐smoker women (6.20 (2.55) vs 6.57 (2.96) years). Current smoker men had a shorter median time to conversion than current smoker women (5.41 (2.69) vs 5.81 (1.87)). Previous smoker men, however, had a longer median time to conversion than previous smoker women (6.47 (2.46) vs 6.0 (2.58)). The hazard ratio (HR) for the current smokers relative to never‐smokers was 1.52 (confidence interval (CI): (1.03, 2.24), p=0.04), indicating that smoking increases the risk of conversion to AD by 52%. Smoking status and sex interaction (HR=0.65, CI: (0.42,0.99), p=0.05) revealed a significant difference between previous smoker men (HR=0.73, CI: (0.53,1), p=0.06) and previous smoker women (HR=1.11, CI: (0.83,1.5), p=0.48). Cessation of smoking had an opposing effect on the relative risk between men (reduced by 27%) and women (increased by 11%).ConclusionCurrent smoking status is associated with increased incidence of AD and differs by sex. Further analyses are needed to understand the causal mechanisms by sex underlying these associations.

Effects of Power Walking on Body Composition and Vascular Compliance in Inactive, Smoking, and Obese Middle-aged Women

본 연구는 파워 워킹이 비활동적이면서 흡연을 하는 비만 중년여성을 대상으로 신체조성과 혈관 탄성에 미치는 영향을 규명 하는데 있다. 대상자들은 D 광역시 콜 센터에 근무하는 자들로 흡연을 시작한 지 6년 이상이었고, 규칙적인 스포츠활동에 참여하지 않았으며, 비만 이외에 어떠한 질환도 없었다. 실험 목적과 절차를 충분히 설명한 후 자발적으로 참여 의사를 밝히 18명을 대상으로 파워 워킹 운동프로그램을 적용하였다. 개인별 운동강도는 폴라 측정기를 이용하여 컨트롤 하였으며, 1-3주 50%HRmax, 4-6주 60%HRmax로 설정하여 다음과 같은 결과를 얻었다. 첫째, 신체조성의 변화는 파워 워킹 참여 후 체중, 체지방율, BMI에서 유의한 감소를 보였다(p<.05). 둘째, 혈관 탄성의 변화는 파워 워킹 참여 후 오른손, 왼손, 오른발, 왼발에서 유의한 증가를 보였다(p<.05) 따라서 비활동적이면서 흡연을 하는 비만 중년여성에게 규칙적인 파워 워킹은 체중과 체지방을 감소시키고, 혈관 기능을 개선 시켜 건강한 일상생활을 하는데 필수적인 운동요법이라고 할 수 있다.This study aims to examine the effects of power walking on body composition and vascular compliance in inactive, smoking, and obese middle-aged women. At the time of this study, the subjects were working for a call center in D metropolitan city, had been smoking for six years or more, were not participating in regular sports activities, and had no diseases besides obesity. After fully explaining the experimental purpose and procedure, a power walking exercise program was conducted with 18 total subjects who voluntarily agreed to participate in the program. The individual exercise intensity was controlled by using a polar measuring instrument. Applying 50% HRmax for 1-3 weeks and 60% HRmax for 4-6 weeks, the results were obtained as follows. First, regarding the change in body composition, there were significant decrease in weight, body fat percentage, and BMI after participating in the power walking (p<.05). Second, regarding the change in vascular compliance, there were significant increase in the right hand, left hand, right foot, and left foot after participating in the program (p<.05). Such results imply that regular power walking may be an essential exercise therapy for healthy daily life by reducing both weight and body fat percentage, as well as improving vascular function in inactive, smoking, and obese middle-aged women.

Influence of Oxidative Stress Generated by Smoking during Pregnancy on Glutathione Status in Mother-Newborn Pairs.

Glutathione plays a key role in maintaining a physiological balance between prooxidants and antioxidants in the human body. Therefore, we examined the influence of maternal smoking as a source of oxidative stress measured by total oxidant capacity (TOC) on reduced glutathione (GSH), oxidized glutathione (GSSG), glutathione peroxidase (GPx-3), and reductase (GR) amount in maternal and umbilical cord blood in 110 (45 smoking and 65 non-smoking) mother-newborn pairs. Concentrations of glutathione status markers and TOC were evaluated by competitive inhibition enzyme immunoassay technique. Plasma TOC levels were significantly higher and the GSH/GSSG ratio, which is considered an index of the cell’s redox status, were significantly lower in smoking women and their offspring than in non-smoking pairs. Decreased GR levels were found in smoking mothers and their newborns compared with similar non-smoking groups. Although plasma GPx-3 concentrations were similar in both maternal groups, in the cord blood of newborns exposed to tobacco smoke in utero they were reduced compared with the levels observed in children of tobacco abstinent mothers. Oxidative stress generated by tobacco smoke impairs glutathione homeostasis in both the mother and the newborn. The severity of oxidative processes in the mother co-existing with the reduced potential of antioxidant systems may have a negative effect on the oxidative-antioxidant balance in the newborn.

Recommendations of the treatment-resistant depression expert center network for promoting tobacco smoking cessation based on the results from the real-world FACE-TRD national cohort

BackgroundTobacco smoking has been associated with suicide, impulsivity and depression in non-clinical populations with differences across sexes. ObjectiveTo determine the role of tobacco smoking in Treatment-Resistant Depression (TRD) according to sex in a precision-medicine approach. MethodThe FACE-TRD cohort is a national cohort of TRD patients recruited in 13 resistant depression expert centers between 2014 and 2021 and followed-up at 6 months. A standardized one-day long comprehensive battery was carried out, including trained-clinician and patient-reported outcomes, and patients were reevaluated at 6 months on their smoking and psychiatric hospitalization outcomes. Results355 TRD participants were included (222 women). The smoking rate was much higher in TRD women compared to the French general population (34% vs 24%) while it was comparable for men (approximately 29%). In multivariate analyses, compared to non-smoking women, female smokers had significantly increased number of lifetime psychiatric hospitalizations (standardized beta B = 0.232, p = 0.014) and electro-convulsive therapy (adjusted odds ratio (aOR) = 2.748, p = 0.005), increased suicidal ideations (aOR = 4.047, p = 0.031), history of suicide attempt (aOR = 1.994, p = 0.033), and increased impulsivity (B = 0.210, p = 0.006) and were more frequently treated by benzodiazepines (aOR = 1.848, p = 0.035) and third- or fourth-line TRD treatments (antipsychotics aOR = 2.270, p = 0.006, mood stabilizers aOR = 2.067 p = 0.044). Tobacco smoking at baseline was predictive of psychiatric hospitalization within 6 months in persistent smoking women (aOR = 2.636, p = 0.031). These results were not replicated in men, for whom tobacco smoking was only associated with increased clinician-rated and self-reported depressive symptoms (respectively B = 0.207, p = 0.022 and B = 0.184, p = 0.048). The smoking cessation rate at 6 months was higher in women than in men (12% vs. 7%). No patient was administered nicotine substitute or varenicline at the two timepoints. InterpretationCombining these results and those of the literature, we recommend that active tobacco cessation should be promoted in TRD to improve depression, suicide and impulsivity especially in women. Female smokers appear as a specific population with heavier mental health outcomes that should be specifically addressed.

Peer-Delivery of a Gender-Specific Smoking Cessation Intervention for Women Living in Disadvantaged Communities in Ireland We Can Quit2 (WCQ2)—A Pilot Cluster Randomized Controlled Trial

IntroductionWe Can Quit” (WCQ) is community-based stop-smoking program delivered by trained community facilitators, based on the socio-ecological framework and developed using a Community-based Participatory Research approach, targeting women living in socioeconomically disadvantaged (SED) areas of Ireland.Aims and MethodsThe We Can Quit2 (WCQ2) pilot trial assessed the feasibility of WCQ. A pragmatic cluster randomized controlled trial with a process evaluation WCQ2, was conducted in four matched pairs of SED districts (8–10 000 women per district). Districts were independently randomized to WCQ (group support + nicotine replacement therapy), or to individual support delivered by health professionals. Participants were adult women smokers interested in quitting, who were living or working in trial districts. Recruitment of districts and 194 women in four waves (49 women per wave); retention at 12 weeks and 6 months; fidelity to intervention delivery and acceptability of trial-related processes were assessed. Validated smoking abstinence at 12-week and 6-month post-intervention was recorded, missing data assumed as continued smoking.ResultsEight districts were recruited. 125/188 (66.5%) eligible women consented. The 49 women target was reached in wave4. Retention at 12 weeks was (Intervention [I]: 55.4%; Control [C]: 51.7%), at 6 months (I: 47.7%; C: 46.7%). Smoking abstinence at 12 weeks was (I: 23.1%, [95% CI: 14.5 to 34.7]; C: 13%, [95% CI: 6.9 to 24.1]). 83.8% of session activities were delivered. Trial-related processes were acceptable to facilitators. Low literacy was highlighted as a barrier for participants’ acceptability.ConclusionsWCQ was feasible to deliver by trained facilitators and indicated a positive direction in abstinence rates. Low literacy will need to be addressed in a future trial design.ImplicationsThis pilot trial showed that a stop-smoking intervention tailored to a group of women smokers living in SED areas which was delivered by trained local women within their local communities was feasible. Furthermore, although not formally compared, more WCQ women were abstinent from smoking at the end of treatment. The results are relevant to enhance the design of a fully powered effectiveness trial, and provide important evidence on the barriers to deliver a tailored smoking cessation service to SED women smokers in Ireland.

Trends in socioeconomic inequalities in smoking in Turkey from 2008 to 2016

BackgroundSmoking inequalities in Turkey were previously demonstrated in an early stage of the smoking epidemic model. This paper aimed to assess the trends for socioeconomic inequalities in smoking in Turkey over the years in the context of the smoking epidemic model using data from the Global Adult Tobacco Survey (GATS) Turkey 2008–2012-2016.MethodsCross-sectional data were analyzed to calculate the association of smoking with, wealth, education, occupation and place of residence using age-standardized prevalence rates, odds ratios, relative index of inequality (RII) and slope index of inequality (SII). The analysis was performed separately for age groups (younger: 20–39 years/older: 40 and above years) and sex.ResultsYounger women with higher wealth and older women with higher wealth and education smoked more. For both age groups, smoking was increased for working class and urban women. Relative wealth inequalities in smoking narrowed and then showed a reversal for younger women (RII2008 = 3.37; 95% CI:1.64–3.40; RII2012 = 2.19; 95% CI:1.48–3.24; RII2016 = 0.80; 95% CI:0.58–1.10, p-for trend < 0.0001). Relative educational inequalities in smoking for older women also showed a narrowing (RII2008 = 21.45; 95% CI:11.74–39.19; RII2012 = 15.25; 95% CI:9.10–25.55; and RII2016 = 5.48; 95% CI:3.86–7.78, p-for trend < 0.0001). For older women, a similar narrowing was observed for wealth (RII2008 = 3.94; 95% CI:2.38–6.53; RII2012 = 2.79; 95% CI:1.80–4.32; and RII2016 = 1.34; 95% CI:0.94–1.91, p-for trend = 0.0001). The only significant trend for absolute inequalities was for younger women by wealth. This trend showed a narrowing and then a reversal (SII2008 = 0.14; 95% CI:0.09–1.20; SII2012 = 0.12; 95% CI:0.06–0.18; and SII2016 = -0.05; 95% CI:-0.12–0.02, p-for trend = 0.0001). Unlike women, smoking in men showed inverse associations for wealth and education, although not statistically confirmed for all years. Smoking was increased in working classes and unemployed men in 2012 and 2016. Inequalities did not show a trend in relative and absolute terms for men.ConclusionsFor smoking inequalities in Turkey, a transition to the next stage was observed, although the previously defined Southern European pattern also existed. Low socioeconomic women deserve special attention as well as stressors at work and drivers of smoking at urban settings.

Relationship between cigarette smoking and blood pressure in adults in Nepal: A population-based cross-sectional study.

Smoking and hypertension are two major risk factors for cardiovascular disease, the leading cause of death in Nepal. The relationship between cigarette smoking and blood pressure (BP) in Nepal is unclear. This study analysed the data from the 2016 Nepal Demographic and Health Survey to explore the differences in systolic BP (SBP) and diastolic BP (DBP) between current daily cigarette smokers and non-smokers in Nepali adults aged 18 to 49 years. A total of 5518 women and 3420 men with valid BP measurements were included. Age, body mass index, wealth quintile (socio-economic status) and agricultural occupation (proxy for physical activity) were included as potential confounders in multivariable linear regression analysis. Women smokers were found to have significantly lower SBP (mean difference 2.8 mm, 95% CI 0.7-4.8 mm) and DBP (mean difference 2.2 mm, 95% CI 0.9-3.6 mm) than non-smokers after adjustment. There were no significant differences in BP between smokers and non-smokers in males, either before or after adjustment. The lower BP in female cigarette smokers in Nepal may be explained by the physiological effect of daily cigarette smoking per se in women, or unmeasured confounders associated with a traditional lifestyle that may lower BP (for example, diet and physical activity). In this nationally representative survey, daily cigarette smoking was not associated with increased BP in males or females in Nepal.

A decreased risk of meningioma in women smokers was only observed in American studies rather than studies conducted in other countries: a systematic review and meta-analysis

BackgroundWhether smoking is related to a decreased risk of meningioma in women is still controversial. We conducted a systematic review and meta-analysis examining the association between smoking and risk of meningiomas in women.MethodsTwo authors independently performed a systematic literature review in the PubMed, Cochrane Library, and EMBASE databases. We identified case-control and cohort studies quantifying associations between smoking and risk of meningioma in women. A meta-analysis by pooling studies was performed according to the multivariate-adjusted risk estimates and 95% confidence intervals (CIs) preferentially. We further conducted additional subgroup and sensitivity analyses to explore possible explanations of the results.ResultsA total of seven observational studies were included, with a total of 2132 female patients diagnosed with meningiomas. Ever smoking was associated with a significantly reduced risk of meningioma in women, with pooled odds ratio (OR) of 0.83 (95% CI 0.70–0.98). Similar findings were noted for current (OR 0.78, 95% CI 0.66–0.93) and past (OR 0.82, 95% CI 0.71–0.94) smokers. However, considering the areas, the OR of ever smoking was 0.77 (95% CI 0.68–0.87) in three American studies, but 0.99 (95% CI 0.73–1.35) in four studies conducted in other countries.ConclusionsBased on limited epidemiological evidence, a decreased risk of meningioma in women smokers was only observed in American studies rather than studies conducted in other countries.

An analysis of the smoking debate ahead of Bernays’ “Torches of Freedom” campaign through the lens of the New York Times coverage (1870–1929)

PurposeThe purpose of this paper is to analyse the social debate on women, health and smoking in the New York Times from 1870 until 1929. The paper aimed to establish whether smoking for women was a form of oppression and whether it was publicly known that smoking is harmful in decades preceding the “Torches of Freedom” campaign run by Edward L. Bernays. This criticism for engineering women’s smoking, and thus harming women’s health up to today causes harm to the reputation of the public relations (PR) industry.Design/methodology/approachArticles were analysed per decade and a total of 294 articles from the New York Times was analysed. The coverage was analysed using two themes, smoking and health and women and smoking and discourse analysis have been carried out on articles in these themes to explore what was known of smoking and whether the social perception of women smoking was oppressive and could be seen as a woman’s issue that “Torches of Freedom” addressed.FindingsFindings show that it was not known that cigarettes were harmful to health and that smoking can be seen as constituting part of women’s oppression in the US before the “Torches of Freedom” campaign. The oppression of women who smoked intensified during the 1920s and Bernays’ Torches of Freedom campaign directly addressed an existing social issue rather than engineering a campaign and manipulating women to start smoking.Practical implicationsThe paper highlights the revolutionary potential in Bernays’ campaign. This could inspire researchers and consumers to keep on critically reflecting on PR campaigns while still appreciating any progressive agenda they might contribute to. Simultaneously, PR practitioners may take away from the article that a message of social relevance may just be more memorable than the advertised brand itself.Originality/valueThis paper engages with the coverage of the New York Times, a newspaper that is often mentioned in the context of the “Torches of Freedom” campaign success and explores in detail what the debate on smoking, health and women were in nearly 60 years preceding the much-criticised campaign.

Factors Associated with the 30-Day and 1-Year Smoking Abstinence of Women in Korea: The Effect of Nicotine Dependency, Self-Efficacy, and Mental Illness.

Despite the success of tobacco control efforts in reducing smoking rates during the past 50 years, data on the factors contributing to quitting success are still lacking. Smoking-related mortality among women has also not declined. Therefore, this study aimed to characterize sociodemographic features, smoking-related behaviors, mental illness, and smoking cessation in woman smokers in Korea who were registered in the Quitline program. Furthermore, factors associated with 30-day and 1-year successful smoking cessation after enrollment in the Quitline program were investigated. A total of 3360 adult woman Quitline users from 2007 to 2018 were included in the final analysis, with information on their age, education level, marital status, body mass index, frequency of alcohol consumption per month, nicotine dependency, self-efficacy for smoking cessation, presence of a smoking cessation supporter, and mental health history collected upon registration with the Quitline program in Korea. Their cessation outcome was investigated with a 1-year follow-up until the end of 2019. A multiple logistic regression analysis was conducted to identify factors associated with smoking cessation at the 30-day and 1-year follow-ups. The results of the multiple logistic regression analysis indicated that lower nicotine dependency, higher self-efficacy, and the presence of a smoking cessation supporter improved the odds of smoking cessation at the 30-day and 1-year follow-ups. In contrast, users with a mental health condition were less likely to achieve smoking cessation. Incorporating methods to increase self-efficacy in women who decide to quit smoking will contribute to facilitating more attempts to quit and achieving greater success in smoking cessation among woman smokers.

Process evaluation of We Can Quit- stop-smoking programme for women in socio-disadvantage in Ireland

Abstract Background Smoking tobacco poses a serious risk of early preventable death and disease for women living with socioeconomic disadvantage (SED). A smoking cessation programme ‘We Can Quit' (WCQ) tailored to women living in four SED areas developed in Ireland included group support delivered by trained lay local women and free nicotine replacement therapy (NRT). The intervention was pilot tested in a community-based, cluster randomised controlled trial, ‘We Can Quit 2'. Results of an embedded process evaluation to assess feasibility and acceptability of the programme and trial processes are presented. Methods The design was qualitative using the Medical Research Council's (MRC) process evaluation framework. Semi-structured interviews with trial participants (N = 18) and Community Facilitators (CFs) who delivered WCQ (N = 8) were conducted. An inductive approach was used and data were analysed using thematic coding. Results Peer-modelling, a non-judgemental environment, and CFs supportive role were viewed as facilitative elements of group support. Potential for broader message diffusion into the social networks of participating women was observed. Participants reported that free access to NRT was helpful for cessation. Some participants expressed concerns about NRT side effects. Community pharmacists provided important guidance relating to NRT and additional support between group sessions. Provision of a saliva samples proved challenging. Low literacy was a barrier to engagement with the programme and completion of trial-related materials. Hypothetical scenarios of direct or indirect observational fidelity assessment for a definitive trial (DT) were acceptable. Conclusions The MRC framework proved useful to capture the experience of women smokers in SED areas of engaging with a community-based smoking cessation trial. Programme and trial-related processes were feasible and acceptable. A future DT will need to address low literacy. Key messages A group-based stop-smoking programme including free NRT was acceptable and feasible to programme deliverers and women smokers living in disadvantaged communities. Women’s low literacy was a barrier to engagement with trial and completion of programme materials.

Menthol Smoking and Nicotine Dependence among Black/African American Women Smokers Living in Low-Resource, Rural Communities.

Black/African American women from low-resource, rural communities bear a disproportionate burden of tobacco-related morbidity and mortality. This study examined associations between menthol smoking and socioeconomic deprivation with nicotine dependence and quitting behaviors among Black/African American women cigarette and/or little cigar/cigarillo smokers, aged 18–50 living in low-resource, rural communities. Baseline survey data from a randomized controlled behavioral/intervention trial (#NCT03476837) were analyzed (n = 146). Outcomes included time to first tobacco product (cigarette/little cigar/cigarillo) use within 5 min of waking, Fagerstrom Test for Nicotine Dependence (FTND) score, and ever attempting to quit cigarettes. Socioeconomic deprivation measures included education, income, and receiving supplemental nutritional assistance (SNAP) program benefits. In adjusted regression analyses, menthol smoking was associated with both greater FTND scores and time to first tobacco product use within 5 min of waking, but not ever attempting to quit cigarettes. Regardless of menthol status, only 25.0% of smokers reported that they would quit smoking if menthol cigarettes were banned. The proportion of smokers who smoked their first tobacco product within 5 min of waking increased slightly with greater socioeconomic deprivation. Additional research and targeted efforts are needed to reduce nicotine dependence among Black/African American women smokers living in rural, low-resource communities where access to cessation services is limited.

Prenatal predictors of postpartum depression trajectories from birth to 24 months amongst smoking women.

We aimed to identify postpartum depression (PPD) trajectories and examine relevant predictors amongst smoking women. PPD can adversely affect families. Predictors of PPD trajectories amongst smoking women are understudied. Longitudinal cohort study. A cohort of 49 U.S. women (current or ex-smoking) completed the Edinburgh Postnatal Depression Scale from birth to 24months postpartum. Latent class growth modelling was used to identify PPD trajectories. Predictors of PPD trajectories were identified, adjusting for confounders. Effect modification by prenatal Patient Health Questionnaire (PHQ) depression score was also assessed. STROBE guidelines were followed in reporting results. Three PPD trajectories were identified: non-PPD, transient PPD and chronic PPD. In multinomial logistic regression, social support was associated with lower odds of membership in the chronic PPD trajectory compared to non-PPD trajectory: being married or having a partner sharing resources (odds ratio OR=.14 [.02, .85], p-value=.03), greater partner support (OR=.87 [.77, .98], p-value=.02) and greater family/friends support (OR=.53 [.34, .82], p-value=.004). Transient PPD showed no differences with non-PPD on any predictors. In ordinal logistic regression models, social support was associated with lower odds of membership in a more severe PPD depression trajectory when prenatal PHQ depression score was in the low range (being married or having a partner sharing resources: p for effect modification=.06; partner support: p for effect modification=.05; and family/friends support: p for effect modification=.005). Compared to the general population, chronic PPD trajectories were more common amongst smoking women. Social support was an important predictor of more severe PPD trajectories, especially when prenatal depression is low. Our findings indicated that social support might decrease likelihood of severe PPD trajectories, especially when prenatal depression was low. Relevant predictors of transient PPD remained elusive.