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Introduction: Monitoring tobacco use during pregnancy is critical for achieving the United Nations Sustainable Development Goals. We examined changes between 2013 and 2019 in the relative differences in smoking prevalence rates between pregnant and nonpregnant women aged 18-49 years., Aims and Methods: We used data from a nationally representative health survey conducted in Brazil in 2013 and 2019. A generalized linear model with binomial family and logarithmic link function was used to estimate, for each year of analysis, the crude and adjusted (by age group, educational attainment, place of residence, and status of protection from passive smoking at home) relative differences., Results: In 2013, the proportion point estimate of tobacco use among pregnant women was lower than that observed among nonpregnant women (4.7% vs. 9.6%). However, in 2019 proportion point estimates were virtually the same (8.5% vs. 8.4%). After adjustment for selected variables, in 2013, smoking prevalence among pregnant women was 42% (p-value ≤ .05) lower than that observed among nonpregnant women. On the other hand, in 2019, maternal smoking prevalence was 13% (p-value > .05) higher than that found among nonpregnant women., Conclusions: Ongoing tobacco industry interference and the marketing of tobacco products to vulnerable populations pose serious threats to public health and likely contribute to increasing maternal smoking prevalence. The fact that women smoke in such an important phase of their and their unborn children's lives reinforces the need to strengthen the implementation of concurrent tobacco control actions, including tobacco excise tax policy and prenatal tobacco prevention and cessation interventions as part of health professionals' routine consultation., Implications: The decline in smoking prevalence among nonpregnant women between 2013 and 2019 was accompanied by an increase in maternal smoking prevalence. Monitoring tobacco use during pregnancy is critical for achieving the United Nations Sustainable Development Goals. Ongoing tobacco industry interference and the marketing of tobacco products to vulnerable populations in Brazil pose serious threats to public health. The fact that women smoke in such an important phase of their and their unborn children's lives reinforces the need to strengthen the implementation of concurrent tobacco control actions, including tobacco excise tax policy and primary healthcare professionals´ tobacco-related assistance during interaction with their patients., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Introduction: In this study, we aimed to systematically explore the relationship between smoking and idiopathic pulmonary fibrosis (IPF)., Aims and Methods: The PubMed, Web of Science, and Embase databases were searched to systematically identify eligible studies. The Newcastle‒Ottawa Quality Assessment Scale (NOS) was used to evaluate the quality of the selected studies. The pooled odds ratio (OR) and survival hazard ratio (HR) were calculated with a random effects model using Stata 16.0 software., Results: Thirty studies were enrolled. All of the included studies were considered to have intermediate or high quality. Nine studies were suitable for meta-analysis of ORs, and 21 studies were suitable for meta-analysis of survival HR. The pooled analysis revealed a significant difference in the risk of IPF between the smoking group and the never-smoking group (OR 1.71, 95% CI: 1.27 to 2.30, p < .001), indicating that smoking is a risk factor for IPF. When analyzing pooled survival HRs, never smoking was compared to former smoking or current smoking. Former smoking was shown to be a poor prognostic factor for IPF (HR 1.43, 95% CI: 1.18 to 1.74, p < .001), but current smoking was not a significant factor., Conclusions: Our results indicated that smoking is a risk factor for IPF patients., Implications: In this study, we mainly concluded that smoking is a risk factor for IPF and that former smoking is a poor prognostic factor for IPF. To the best of our knowledge, this is the first meta-analysis report focusing on the association between smoking per se and IPF. Through our current study, we hope to further raise awareness of the relationship between smoking and IPF., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Introduction: Population research indicates that smoking behaviors in Finland have varied over time by sex and birth cohort. Smoking behaviors are influenced by genes and the environment; like the behaviors themselves, these underlying influences are not necessarily stable over time and may be modifiable by national drug policy., Aims and Methods: We utilized longitudinal mixed-effects models and causal-common-contingent twin models to evaluate sex and cohort effects on tobacco consumption and the underlying genetic and environmental variance components in a birth cohort sample of same-sex twins born in Finland between 1880 and 1957, assessed in 1975, 1981, 1990, and 2011., Results: We identified significant main effects of age, sex, and cohort on quantity of cigarette consumption, as well as significant age × cohort and sex × cohort interactions. We also identified sex and cohort effects on the liability to initiate regular smoking and the magnitude of variation underlying quantity of cigarette consumption. That said, heritability and environmental contributions to both traits were not different between the four sex × cohort groups., Conclusions: Our results indicate sex and cohort effects on the prevalence of smoking and its underlying variation. Our results on changing prevalence mirror existing population-level research in Finnish samples, but we did not identify differences in heritability found in other studies of cohort effects in tobacco use, potentially due to power issues. These results highlight the importance of considering age, cohort, and timing of policy changes when evaluating changes in substance consumption across time., Implications: This study identifies sex and cohort effects influencing tobacco consumption in a sample of Finnish adult twins born between 1880 and 1957. Our results are in line with other population-level research in Finland and research on cohort effects influencing alcohol use in the same sample. Our results highlight the intertwining effects of age, cohort, sex, and substance policies on substance use., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.)

Introduction: This study aimed to assess the impact of Greater Manchester's Making Smoking History program-a region-wide smoking cessation programs launched in January 2018-on key smoking and quitting outcomes., Methods: Data were from a nationally representative monthly survey, 2014-2022 (n = 171 281). We used interrupted time-series analyses (Autoregressive Integrated Moving Average [ARIMA] and generalized additive models [GAM]) to examine regional differences between Greater Manchester and the rest of England, before and during the program's first five years. Outcomes were rates of quit attempts and overall quits among smokers, quit success rates among smokers who tried to quit (preregistered outcomes), and current smoking prevalence among adults (unregistered outcome)., Results: Results showed mixed effects of the program on quitting. Primary ARIMA models showed comparative reductions in quit success rates (change in quarterly difference between regions = -11.03%; 95% CI -18.96; -3.11) and overall quit rates in Greater Manchester compared with the rest of England (-2.56%; 95% CI -4.95; -0.18), and no significant change in the difference in the quit attempt rate (+2.95%; 95% CI -11.64; 17.54). These results were not consistently observed across sensitivity analyses or GAM analyses. Exploratory ARIMA models consistently showed smoking prevalence in Greater Manchester declined more quickly than in the rest of England following the initiation of the program (-2.14%; 95% CI -4.02; -0.27)., Conclusions: The first five years of Greater Manchester's Making Smoking History program did not appear to be associated with substantial increases in quitting activity. However, exploratory analyses showed a significant reduction in the regional smoking rate, over and above changes in the rest of England over the same period., Implications: Taken together, these results show a relative decline in smoking prevalence in Greater Manchester but equivocal data on quitting, introducing some uncertainty. It is possible the program has reduced smoking prevalence in the absence of any substantial change in quitting activity by changing norms around smoking and reducing uptake, or by reducing the rate of late relapse. It is also possible that an undetected effect on quitting outcomes has still contributed to the program's impact on reducing prevalence to some degree. It will be important to evaluate the overall impact of the program over a longer timeframe., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.)

Prior research on e-cigarettes' health impacts is inconclusive due to confounding by previous tobacco smoking. Studies of e-cigarette use among people without an established smoking history are informative for this question. A cross-sectional survey was administered across six geopolitical world regions to adults aged 18+ without a history of established cigarette smoking or regular use of other nicotine/tobacco products. Two cohorts were defined based on e-cigarette use: "Vapers Cohort" (N = 491) who used e-cigarettes in the past 7 days and "Control Cohort" (N = 247) who never regularly used e-cigarettes. Frequency of respiratory symptoms (Respiratory Symptom Evaluation Score (RSES)) were compared between cohorts, adjusting for sociodemographics. Tobacco use history and patterns of e-cigarette use was also examined. Respiratory symptoms were rare among both the Vapers and Control Cohorts: 83.3% and 88.4%, respectively, reported "rarely" or "never" experiencing all five RSES items (p = 0.125). The Vapers (vs. Control) Cohort reported modestly more frequent respiratory symptoms (adjusted mean RSES 1.61 vs. 1.43, respectively, p < 0.001); however, this difference (0.18) did not reach the threshold of clinical relevance (0.57). The Vapers (vs. Control) Cohort more often reported former cigarette experimentation (30.8% vs. 12.1%) and former infrequent use of other nicotine/tobacco products (18.1% vs. 5.8%). The Vapers Cohort most often used disposable devices (63.7%) and multiple flavors (approximately 70-80% across primary device type). In this cohort of adults without a history of established combustible tobacco use, e-cigarette use was statistically linked to more frequent respiratory symptoms, though not in a clinically meaningful way. The cross-sectional design of this study cannot establish causality between e-cigarette use and respiratory symptoms., Competing Interests: Declarations Competing interests JZG is the President of Asovape Costa Rica, a Pro-Harm Reduction consumer organization; President of ARDT Iberoamerica, an alliance of Pro-Harm Reduction consumer organizations in Latin America, Spain, and Portugal; Director of Social Media and Audiovisual Producer of INNCO , a global coalition of Pro-Harm Reduction consumer organizations, which received funding from the Foundation for a Smokefree World (FSFW); and a recipient of a scholarship from Knowledge-Action-Change, which received funding from the Foundation for a Smokefree World (FSFW). None of these organizations had any role in, or oversight, of this study. AB is serving Pro Bono as Vice President, American Vapor Manufacturers —Prescott, AZ. Serving Pro Bono as Ambassador, World Vapers Alliance Serving Pro Bono as President, South Carolina Vapor Association, Charleston, SC JJCL is the President of the board of Mexico y el Mundo Vapeando O.N.G. and a scholarship recipient from Knowledge-Action-Change, which received funding from the Foundation for a Smokefree World (FSFW). None of these organizations had any role in, or oversight, of this study. Court Lawyer for vaping industries AM is a recipient of two scholarships from Knowledge-Action-Change, which receives funding from the Foundation for a Smokefree World (FSFW). This organisation has not had any role in, or oversight, of this study. KY is the Co-Founder of the Consumer Advocacy movement Vaping Saved My Life (VSML) Act as a consultant for the Vapour Products Association of South Africa (VPASA), an industry association for vapor product manufacturers and retailers. A member of the Advisory Board for the World Vapers Alliance (W.V.A.), a global consumer advocacy group. Recipient of the Tobacco Harm Reduction Scholarship Programme and Advanced Scholarship Programme from Knowledge Action Change(K.A.C.). K.A.C. receives funding from the Foundation for a Smoke-Free World. MS is a co-founder of Smoke-Free Baltic tobacco harm reduction initiative and a recipient of a scholarship from Knowledge—Action—Change, which received funding from the Foundation for a Smokefree World (FSFW). None of these organizations had any role in, or oversight, of this study. CR is Director of Russell Burnett Research and Consultancy Ltd, which has received research funding and/or consultancy fees from manufacturers of e-cigarettes/vaping products to conduct or consult on studies of individuals’ perceptions and use of tobacco and nicotine products, including e-cigarettes/vaping products. Michael Coughlan is a recipient of a scholarship from Knowledge-Action-Change, which received funding from the Foundation for a Smokefree World (FSFW). None of these organizations had any role in, or oversight, of this study. AS provides consulting services on tobacco harm reduction to Juul Labs, Inc. (JLI) through PinneyAssociates. She also individually provides consulting services on behavioral science to the Center of Excellence for the Acceleration of Harm Reduction (CoEHAR) through ECLAT Srl., which received funding from the Foundation for a Smokefree World (FSFW). None of these funders had any role in, or oversight, of this study. GC declares no conflict. PC declares no conflict. VT declares no conflict. RP is full tenured professor of Internal Medicine at the University of Catania (Italy) and Medical Director of the Institute for Internal Medicine and Clinical Immunology at the same University. He has received grants from U-BIOPRED and AIR-PROM, Integral Rheumatology & Immunology Specialists Network (IRIS), Foundation for a Smoke Free World, Pfizer, GlaxoSmithKline, CV Therapeutics, NeuroSearch A/S, Sandoz, Merk Sharp & Dohme, Boehringer Ingelheim, Novartis, Arbi Group Srl., Duska Therapeutics, Forest Laboratories, Ministero dell Universita’ e della Ricerca (MUR) Bando PNRR 3277/2021 (CUP E63C22000900006) and 341/2022 (CUP E63C22002080006), funded by NextGenerationEU of the European Union (EU), and the ministerial grant PON REACT-EU 2021 GREEN- Bando 3411/2021 by Ministero dell Universita’ e (MUR) – PNRR EU Community. He is founder of the Center for Tobacco Prevention and Treatment (CPCT) at the University of Catania and of the Center of Excellence for the Acceleration of Harm Reduction at the same university. He receives consultancy fees from Pfizer, Boehringer Ingelheim, Duska Therapeutics, Forest Laboratories, CV Therapeutics, Sermo Inc., GRG Health, Clarivate Analytics, Guidepoint Expert Network, and GLG Group. He receives textbooks royalties from Elsevier. He is also involved in a patent application for ECLAT Srl. He is a pro bono scientific advisor for Lega Italiana Anti Fumo (LIAF) and the International Network of Nicotine Consumers Organizations (INNCO); and he is Chair of the European Technical Committee for Standardization on “Requirements and test methods for emissions of electronic cigarettes” (CEN/TC 437; WG4). Ethical approval The study protocol received approval from the Ethics Review Board of the Dipartimento di Scienze della Formazione Sezione di Psicologia at the University of Catania (approval date, 25 November 2020). All participants provided written informed consent., (© 2024. The Author(s).)

Background: Adolescence represents a pivotal period for the initiation of smoking behaviours. While family, peer and social groups serve as significant reference groups influencing adolescents' decision-making process, there remains a paucity of research that examines how diversified reference groups influence their smoking decisions., Objective: The objective is to compare normative and informative influences given by different reference groups on adolescents' smoking decision-making., Design: This study applied reference group theory and used the card sorting technique. Adolescents were presented with 16 cards portraying various reference groups and 27 cards portraying different types of reference group influences. They were asked to construct sentences as smoking-elicited and smoking-inhibited cues and ranked these influences based on their relevance to their smoking decision-making., Participants: The participants were recruited from four cities in the North, Central, South and East regions of Taiwan. The study sample consisted of 297 Taiwanese 11th graders drawn from high schools, vocational high schools and night schools., Primary Outcome Measures: The most influential reference group among smokers, former smokers and never smokers., Results: Our results of multivariable logistic regression show that for current smokers, having a smoking best friend (aOR=7.58, p <0.01), having a smoking colleague (aOR=3.83, p <0.01) and participating in ceremonial dance performances (aOR=4.62, p <0.01) are more likely to smoke. Peers play an important role in providing smoking-elicited cues for current smokers. Families provided the most smoking-inhibited cues for former and never smokers. Normative influences such as encouraging adolescent smoking provided more cues for adolescents than informative influences such as releasing stress by smoking., Conclusions: Adolescent smoking behaviour was influenced by peer norms, while former and non-smoking behaviours are associated with family norms. Therefore, tobacco prevention efforts should focus more on family-level interventions to discourage smoking initiation. Smoking cessation programmes for current smokers should address the reduction of peer pressure to smoke. Moreover, schools and community partners should collaborate to develop effective smoking cessation strategies, particularly for high-risk groups such as adolescents who involved in ceremonial dance performance., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective Esophageal cancer is a gastrointestinal cancer with a poor prognosis. However, it is curable and can be treated endoscopically if it is detected at an early stage. The objective of this study was to identify the factors that contribute to early detection. Methods From April 2011 to December 2019, we retrospectively investigated consecutive patients diagnosed with esophageal squamous cell carcinoma (ESCC) through upper gastrointestinal endoscopy at two hospitals of Kawasaki Medical University based on medical records. The factors contributing to the early detection of ESCC were investigated by comparing patients with ESCC with those undergoing health checkups in whom no organic lesions were found in the upper gastrointestinal tract on endoscopy (controls). Patients Factors contributing to early detection were examined in 402 ESCC cases and 391 sex- and age-matched controls, and early and advanced cancers were compared along with the risk factors for ESCC. Results A multivariate analysis showed that alcohol consumption and smoking, concomitant cancer of other organs, and a low body mass index (BMI) were factors associated with ESCC (odds ratio [OR], 4.65; 95% confidence interval [CI], 2.880-7.520, OR, 3.63; 95% CI, 2.380-5.540, OR, 2.09; 95% CI, 1.330-3.270, OR, 6.38; 95% CI, 3.780-10.800), whereas dyslipidemia was significantly less common in patients with ESCC (OR, 0.545; 95% CI, 0.348-0.853). Comparing early and advanced cancers, a history of endoscopic screening was the only factor involved in early detection (OR, 7.93; 95% CI, 4.480-14.000). Conclusion The factors associated with ESCC include alcohol consumption, smoking, concomitant cancer of other organs, and a low BMI. Endoscopy in subjects with these factors may therefore be recommended for the early detection of ESCC.

Background: Maternal smoking during pregnancy (MSDP) is significantly linked to the short- or long-term health of offspring. However, little research has examined whether MSDP affect the aging rate of offspring., Methods: This study used questionnaires to determine out whether the participants' mothers smoked when they were pregnant. For evaluating aging rate, we used the following several outcome measures: telomere length, frailty index, cognitive function, homeostatic dysregulation score, KDM-age, age-related hospitalization rate, premature death, and life expectancy., Result: After adjusting for covariates, we found that the offspring of the MSDP group had significantly shorter telomere length in adulthood by 0.8 % (β = -0.008,95%CI:-0.009 to -0.006) compared with non-MSDP group. Compared to the non-MSDP group, participants in MSDP group showed higher levels of homeostatic dysregulation (β = 0.015,95%CI: 0.007-0.024) and were frailer (β = 0.008,95%CI:0.007-0.009). The KDM age increased by 0.100 due to MSDP (β = 0.100,95 % CI:0.018-0.181), and the age acceleration of KDM algorithm also increases significantly (β = 0.101, 95%CI:0.020-0.183). Additionally, we found that the risk of aging-related hospitalizations was significantly higher than the non-MSDP group by 10.4 %(HR = 1.104,95%CI:1.066-1.144). Moreover, MSDP group had a 12.2 % increased risk of all-cause premature mortality (HR = 1.122,95%CI:1.064-1.182) and a significant risk of lung cancer-specific premature mortality increased by 55.4 %(HR = 1.554,95%CI:1.346-1.793). In addition, participants in the MSDP group had significantly decreased cognitive function and shorter life expectancies than those in non-MSDP group., Conclusion: Our findings indicated a significant association between MSPD and accelerated aging, elevated hospitalization rates, increased premature mortality rates, and reduced life expectancies in offspring., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Cigarette smoking remains a public health concern and can be influenced within households by relatives or friends who smoke. The mental and physical repercussions of smoking can contribute to intimate partner abuse (IPA)., Objectives: This study assessed smoking in households and its relationship with IPA., Methods: This descriptive cross-sectional study was conducted in Plateau State, Nigeria. Multi-staged cluster sampling was used to select 661 household heads or adult members residing in two districts for at least six months prior to the study. Internally displaced persons (IDPs) were excluded from the study. IPA was assessed with the 30-item Abusive Behaviour Inventory. Data were analyzed with SPSS version 25, which included Chi-square tests and binary logistic regression, with a significance level set at 5%., Results: Most household heads were aged 40-49 years (mean; 44.5 ± 12.7) with 62.5% having post-secondary education. Household heads who currently smoke and households with members who smoke were 12.0% and 18.3% respectively, and the prevalence of household IPA was 58.1%. IPA was significantly higher in households with members who smoke (75.2% vs. 54.3%) and among household heads who were current smokers (79.7% vs. 55.2%). No predictive association was found between smoking by household heads or members and intimate partner abuse (IPA)., Conclusion: Household IPA is prevalent and significantly associated with smoking in household. While smoking alone may not predict IPA prevalence, integrating routine screenings for smoking and other addictive behaviors during IPA assessments at facilities or community levels is recommended., Key Message: Household intimate partner abuse (IPA) in northern Nigeria is influenced by factors such as smoking, which significantly correlates with higher IPV risk as revealed in the current study. There is a need to understand these dynamics while exploring other factors for effective screening and intervention strategies., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)

Introduction: Emerging literature suggests that shisha smoke contains many of the same toxicants as cigarette smoke, including carcinogenic polycyclic aromatic hydrocarbons. A single shisha smoking session may involve inhalation of 50-100 times the smoke volume inhaled with a single cigarette. While tobacco control policies have largely centered on cigarette smoking, other forms like shisha, have largely been ignored., Objectives: The study aimed to assess the prevalence and predictors of shisha smoking among students of Gombe State University in Gombe State., Methods: A cross-sectional study design with mixed methods of data collection was used to study (200) respondents using a multistage sampling technique. Data was collected using interviewer-administered semi-structured questionnaires and Focus Group Discussions (FGD) for qualitative data., Results: The prevalence of shisha smoking was 27% among the respondents with seven out of ten current shisha smokers being males. The majority of the respondents smoked daily. There was a statistically significant association (p=<0.05) between the present year of study, satisfaction with the present course of study, and current level of academic study with knowledge of the harmful effects of shisha smoking. Gender and the present year of study remained independent predictors of shisha smoking among study respondents. Male students were almost two and a half (2.4) times more likely to smoke shisha than females. Peer pressure and fun/pleasure-seeking were found to be motives for shisha smoking from the qualitative review., Conclusion: Restraints should be imposed on shisha bars, cafés, and restaurants in the same way as tobacco control policies for cigarette smoking., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)

Background: The Aotearoa/New Zealand Government is aiming to end the tobacco epidemic and markedly reduce Māori:non-Māori health inequalities by legislating: (1) denicotinisation of retail tobacco, (2) 95% reduction in retail outlets and (c) a tobacco free-generation whereby people born after 2005 are unable to legally purchase tobacco. This paper estimates future smoking prevalence, mortality inequality and health-adjusted life year (HALY) impacts of these strategies., Methods: We used a Markov model to estimate future yearly smoking and vaping prevalence, linked to a proportional multistate life table model to estimate future mortality and HALYs., Results: The combined package of strategies (plus media promotion) reduced adult smoking prevalence from 31.8% in 2022 to 7.3% in 2025 for Māori, and 11.8% to 2.7% for non-Māori. The 5% smoking prevalence target was forecast to be achieved in 2026 and 2027 for Māori males and females, respectively.The HALY gains for the combined package over the population's remaining lifespan were estimated to be 594 000 (95% uncertainty interval (UI): 443 000 to 738 000; 3% discount rate). Denicotinisation alone achieved 97% of these HALYs, the retail strategy 19% and tobacco-free generation 12%.By 2040, the combined package was forcat to reduce the gap in Māori:non-Māori all-cause mortality rates for people 45+ years old by 22.9% (95% UI: 19.9% to 26.2%) for females and 9.6% (8.4% to 11.0%) for males., Conclusion: A tobacco endgame strategy, especially denicotinisation, could deliver large health benefits and dramatically reduce health inequities between Māori and non-Māori in Aotearoa/New Zealand., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Objectives: The DOSE index, which incorporates Dyspnea, Obstruction, Smoking, and Exacerbations, is a widely used tool for assessing the severity and prognosis of Chronic Obstructive Pulmonary Disease (COPD). In addition to risk assessment, it has potential clinical utility in predicting healthcare costs, which are primarily driven by exacerbations. While several indices, such as the BODE (Body-mass index, Obstruction, Dyspnea, Exercise) and ADO (Age, Dyspnea, Obstruction) indices, exist for risk prediction, there is a lack of dedicated tools for forecasting healthcare costs. This study explores the potential of the DOSE index compared to other indices, including BODE, ADO, and the Charlson Comorbidity Index (CCI), for this purpose., Materials and Methods: This cross-sectional retrospective study analyzed data from 396 COPD cases. We examined associations between the DOSE index, BODE index, ADO index, CCI, and healthcare costs, including hospitalizations and emergency room treatments. Healthcare costs were categorized as direct medical expenses., Results: Significant associations were observed between the DOSE index and various healthcare parameters. DOSE quartiles showed strong correlations with outpatient visits (p = 0.013) and outpatient medical expenses (p = 0.011). In addition, hospitalization frequency, duration, and associated costs were significantly correlated with higher DOSE quartiles (p < 0.001). A significant difference was found when comparing DOSE quartiles between patients with high (CCI ≥ 3) and low (CCI < 3) comorbidity scores (p = 0.018). The DOSE index outperformed other indices, likely due to its inclusion of exacerbations, a key driver of healthcare costs., Conclusion: The DOSE index demonstrates potential in predicting healthcare costs, particularly due to its inclusion of exacerbation frequency. This study highlights the importance of considering exacerbations alongside traditional risk factors for more accurate cost forecasting in COPD management. Our findings suggest that the DOSE index may be a valuable tool in both clinical and economic assessments of COPD patients, though further research is warranted to validate these findings in larger datasets., (© 2024. The Author(s).)

Background: Pancreatitis is a significant global health concern with rising incidence, complex management, and substantial mortality. This study aimed to assess global and regional trends in pancreatitis from 1990 to 2021 and project future trends to 2050 using data from the Global Burden of Disease (GBD) Study 2021., Methods: We analyzed GBD 2021 data to evaluate age-standardized incidence (ASIR), mortality (ASMR), and disability-adjusted life years (DALYs) rates of pancreatitis. Regional trends, gender disparities, and correlations with the Socio-demographic Index (SDI) were examined. Key risk factors, including alcohol consumption, smoking, and metabolic disorders such as hyperlipidemia, were extracted and evaluated. A Bayesian age-period-cohort model (BAPC) was used for future projections., Results: From 1990 to 2021, global pancreatitis cases increased from 1.73 million to 2.75 million, representing a rise of 59%. Despite this, ASIR decreased slightly from 37.62 to 32.81 per 100,000, a 12.8% reduction. Deaths rose from 68,490 to 122,416, an increase of 78.7%, while ASMR decreased from 1.69 to 1.45 per 100,000, a reduction of 14.2%. DALYs increased from 2.58 million to 4.10 million (59%). Significant regional variations were found, with Eastern Europe showing the highest ASIR, ASMR, and DALY rates. Projections indicate continued declines in ASIR, ASMR, and DALYs through 2050., Conclusions: While global age-standardized rates of pancreatitis have declined, significant regional and socioeconomic disparities persist. Targeted prevention efforts, particularly in high-burden areas like Eastern Europe, and addressing modifiable risk factors such as alcohol use are crucial for reducing the future burden of pancreatitis., (© 2024. The Author(s).)

Background: Seeing portrayals of tobacco and alcohol in music videos (MVs) may reduce perceived risks, increase susceptibility, and lead to the initiation of tobacco and alcohol use among adolescents and young adults. Previous studies have predominantly concentrated on assessing tobacco and alcohol contents in English-language MVs within Western countries. However, many other countries have not only been influenced by the English music market but have also produced music in their native languages, and this content remains underexamined., Objective: This study aims to investigate the prevalence of tobacco- and alcohol-related content in top Vietnamese MVs on YouTube from 2013 to 2021, to describe how tobacco and alcohol are portrayed in these MVs, and to examine associations between these portrayals and MV characteristics., Methods: A total of 410 Vietnamese MVs, including the top 40 or 50 most viewed released each year between 2013 and 2021, were analyzed. General information, such as the song name, its release date and ranking, age restriction, musical genre, and type of MV, was collected. We examined tobacco and alcohol content in the MVs, with specific details such as tobacco types, their brands, as well as the number, age, sex, and roles of individuals smoking or drinking., Results: Among the 410 MVs, 36 (8.8%) contained tobacco-related content and 136 (33.2%) featured alcohol-related content. Additionally, 28 (6.8%) out of 410 MVs included both tobacco and alcohol content. The prevalence of videos with tobacco and alcohol content fluctuated over the years. In MVs with tobacco-related content, a higher proportion of hip-hop or rap songs contained tobacco-related content (n=6, 30%) compared to other music genres. In MVs with tobacco-related content, cigarettes were the most frequently shown product (n=28, 77.8%), and smoking scenes were often depicted at parties (n=13, 36.1%) and during dancing and singing scenes (n=12, 33.3%). Among the 31 MVs portraying actual tobacco use, tobacco use was typically depicted with 1 person, often a young adult male, while 38.7% (n=12) showed singer(s) smoking. For MVs with alcohol-related content, there was a high proportion showing alcohol images at parties, bars, or pubs (n=96, 70.6%). Among 87 MVs containing drinking scenes, 60.9% (n=53) involved groups of young adults of both sexes, and 64% (n=56) depicted singers drinking. Additionally, only 2 (5.6%) MVs included health warnings about tobacco harm, and 2 MVs (1.5%) included warnings about drinking restricted to individuals 18 years and above., Conclusions: The notable prevalence of tobacco and alcohol content in leading Vietnamese YouTube MVs raises concerns, especially as most of this content is portrayed without any warnings. The study underscores a regulatory gap in addressing such content on the internet, emphasizing the urgent need for stricter regulations and age restrictions on platforms such as YouTube., (©Thi Phuong Thao Tran, Thu Trang Vu, Yachao Li, Lucy Popova. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 08.11.2024.)

Introduction: The Global Adult Tobacco Survey (GATS) shows a drop in tobacco use worldwide. Despite the drop, there still continues to be a significant number of tobacco users in India. Research on tobacco use among young persons is commonly prioritised in India, while studies on tobacco use among middle-aged (45-59 years) and elderly (≥ 60 years) adults are noticeably lacking. We have conducted this study with objective to estimate the distribution, determinants and socioeconomic inequalities of smoking (SM) and smokeless tobacco (SLT) consumption across Indian states and union territories., Methods: This study was based on 66,606 participants aged ≥ 45 years using Longitudinal Aging Study in India (LASI)-1 (2017-2018) data. Distribution of tobacco consumption (any form, smoking (SM), smokeless (SLT) and both) was documented as per Indian states and union territories with spatial distribution by Indian map. Demographic, socioeconomic, health related and behavioural determinants were established using nested multilevel regression modelling. Socioeconomic disparities were documented using concentration curve. P-value < 0.05 was considered as statistically significant., Results: Overall, 36.78% participants documented using any form of tobacco; with higher consumption of SLT (19.88%) than smoking/SM (13.92%). Only 2.98% consumed both. Mizoram had highest consumption of tobacco in any form (78.21%) and smoking (35.18%). Elderly participants had higher odds of consuming tobacco (any 1.23 (1.18-1.28), SM 1.99 (1.14-1.27), SLT 1.08 (1.03-1.14) and both 1.27 (1.14-1.40 times) than middle aged participants. Females, OBC (other backward castes), urban residence had lower odds in all the categories, while being widow/ separated/ divorced, belonging to Muslim community, having clerical and skilled occupation, poor self-rated health, comorbidity and multimorbidity had higher odds. With decrease in the wealth index, educational status and frequency of physical activity the odds of tobacco consumption increased. The odds of higher tobacco consumption were documented from northeast region (2.56 (2.37-2.76) higher than north). Alcohol consumption had the highest odds (4.94 (4.69-5.21)). Participants exposed to media had lower odds (11% lower) of consuming tobacco. The socioeconomic inequalities in tobacco consumption were significantly distributed more among the poorest (any -0.064 (-0.072 to -0.056) and SLT -0.069 (-0.072 to -0.056))., Conclusion: Prioritising tobacco prevention and increasing availability and accessibility of cessation programmes that are suited with unique requirements and circumstances, even for elderly population, are essential focusing on the higher determinants across poorest section in the country., (© 2024. The Author(s).)

Background: Atherosclerosis develops across the life course, and variation in aortic intima-media thickness (IMT) is evident from infancy onward, although most early-life data are cross-sectional. We investigated whether abdominal aortic IMT at age 6 weeks is associated with vascular measures at 4 years and the relationship of prenatal and perinatal exposures with these measures in early childhood., Methods and Results: We analyzed data from 518 participants with 6-week and 4-year vascular measures from the Barwon Infant Study. Aortic IMT was measured at 6 weeks (mean, 6.1±SD 1.5 weeks) and aortic and carotid IMT, carotid-femoral pulse wave velocity, and blood pressure at 4 years of age (4.3±0.3 years). Associations of early-life exposures-maternal enteric microbiome, smoking and low-density lipoprotein cholesterol during pregnancy, birth weight, and gestational age-were also investigated. In the primary model, 6-week aortic IMT (649±66 μm) was associated with small differences in 4-year carotid IMT (453±45 μm) (mean difference in carotid IMT per 100 μm higher 6-week aortic IMT=7.0 μm [95% CI, 0.7-13.3]; P =0.03), with no evidence for associations with 4-year aortic IMT, pulse wave velocity, or blood pressure. Higher birth weight was associated with greater 4-year aortic IMT, and maternal smoking with higher systolic blood pressure., Conclusions: Vascular measures do not show strong evidence of tracking between infancy and early childhood. Longitudinal studies with repeated assessment beyond age 4 years would inform optimal timing of early prevention and targets for primordial prevention.

Objective: To analyze the prevalence and associated factors with chronic diseases among women of reproductive age in primary health care., Method: Cross-sectional study conducted with 397 women of reproductive age living in northern Paraná, Brazil. Data were collected from July 2019 to September 2020. The Women's Clinical Record was used to collect sociodemographic data, risk behaviors, diagnosis of chronic diseases and medication use. Chi-Square test was performed for association analysis, and Logistic Regression estimating Odds Ratio and 95% confidence intervals., Results: The prevalence of chronic diseases among women of reproductive age was 38.53% and the associated factors were: age group from 31 to 40 years old (OR=3.67; p=0.001) and from 41 to 49 years (OR =9.7; p=0.001), incomplete high school education (OR= 2.7; p=0.001), obesity (OR= 2.25; p=0.001) and smoking (OR=2.23; p=0.001)., Conclusion: Age at the end of the reproductive phase, obesity and smoking were associated with the presence of chronic diseases. Knowledge of these factors can assist in screening, monitoring and health education actions provided to women of childbearing age.

This study aimed to determine the longitudinal predictors of lifestyle behaviours among stroke survivors in New South Wales, Australia. This longitudinal study utilised data from the baseline survey (2005-2009) and a sub-study survey (2017) of the 45 and Up Study. Physical activity, alcohol consumption, smoking status, and supplement use were included as dependent variables. Generalised estimating equation models were employed to assess the longitudinal association between the dependent variable and demographic and health status measures. The average age of the participants (n = 576) was 67 (SD = 9) years at baseline and 76 (SD = 9) years at the sub-study survey time, with 54.9% being male. The longitudinal analysis revealed that the likelihood of moderate/high physical activity significantly declined over time and was lower among participants with diabetes, but was higher among those with university education. The likelihood of smoking was significantly higher in females, moderate/high-risk alcohol consumers, and those with depression, but was lower among supplement users. The likelihood of moderate/high-risk alcohol consumption significantly declined with time, and was lower among females, but higher among smokers. The likelihood of supplement use significantly declined over time, but was higher among females and/or those with asthma. Our findings help illustrate that many stroke survivors may benefit from further support in adopting and maintaining a healthy lifestyle as part of their stroke management and long-term rehabilitation, which is crucial to optimising their quality of life and successful secondary stroke prevention., (© 2024. The Author(s).)

Importance: The association between smoking cessation and cardiovascular disease (CVD) risk in relation to cumulative smoking exposure remains poorly understood., Objective: To evaluate the associations among smoking cessation, lifetime smoking burden, and CVD risk according to the number of years elapsed after smoking cessation., Design, Setting, and Participants: This retrospective cohort study of the Korean National Health Insurance Service database investigated smoking duration and intensity between January 2006 and December 2008. Participants were categorized by self-reported smoking habits as current, ex-, or never-smokers. Smoking records were updated every 2 years until December 2019, with participants whose smoking status changed or whose smoking status was unclear excluded. Data analysis was performed between June and December 2022., Exposures: Time-updated self-reported smoking status, years since quitting, and cumulative smoking amount (pack-years [PY])., Main Outcomes and Measures: The primary outcome was incidence and hazard ratio of CVD (composite of cardiovascular death, myocardial infarction, stroke, and heart failure)., Results: Overall, 5 391 231 participants (39.9% male; mean [SD] age, 45.8 [14.7] years; 853 756 [15.8%] current smokers, 104 604 [1.9%] ex-smokers, and 4 432 871 [82.2%] never smokers) were followed up for a mean (SD) of 4.2 (4.4) years. The median (IQR) baseline cumulative smoking amounts were 14.0 (7.5-20.0) PY in current smokers and 10.5 (5.3-20.0) PY in ex-smokers. The median (IQR) duration of smoking cessation was 4 (2-8) years for ex-smokers. Regardless of continued smoking, a dose-dependent association was evident between smoking and incident CVD. Compared with current smokers, ex-smokers with a lifetime smoking burden of less than 8 PY (light ex-smokers) experienced a significant reduction in CVD risk within 10 years of cessation, with a CVD risk similar to that of never-smokers. Conversely, ex-smokers with at least 8 PY (heavy ex-smokers) exhibited a slower decline in CVD risk than light ex-smokers, requiring more than 25 years for the residual CVD risk to disappear., Conclusions and Relevance: In this cohort study, smoking and CVD risk exhibited a dose-dependent association, with light ex-smokers having a CVD risk similar to that of never-smokers relatively soon after smoking cessation. For heavy ex-smokers, greater than 25 years might be required for the residual CVD risk to align with that of never-smokers.

IFO'S communication campaign for the Italian Lung Screening Network (RISP) study, used multiple online and offline channels to engage not only smokers but a diverse audience. Out-reach activities and lifelong learning helped to promote healthy lifestyles, research findings and precision medicine. The campaign has increased the enrollment in the screening program, which in IFO, two years after 'start-up, is 3300. The pilot study targets smokers and former smokers aged 55 to 75, for prevention and early detection of lung cancer. Funded by the Ministry of Health, it involves 19 Italian centers to enroll 10,000 people. The ultimate goal is the inclusion of lung screening in the Essential Levels of Care (LEA) that is, the services that the National Health Service is required to provide to all citizens, free of charge. Subjects involved perform multilayer low-dose CT scan of the chest and blood sampling with liquid biopsy. The success of the campaign rewards the communication strategy, multidisciplinary collaboration, and activities always in synergy with the mission of the IFOs committed to: "spreading" clinical excellence; promoting citizen empowerment; considering correct information an institutional duty because it is part of treatment and prevention.

This retrospective study including 93 patients who presented a new diagnosis of lung cancer at the University Hospital of Liege between January 2023 and April 2023 analyzed the prevalence of smoking cessation following the diagnosis announcement. It was also investigated whether certain factors influenced this rate (stage, histology, type of treatment received, tobacco monitoring,…) and whether the impact of this smoking cessation influenced the progression of the disease and the response to oncological treatments. The results show that 34.8 % of active smokers at diagnosis experienced smoking cessation at 6 months and 32.6 % at 1 year. This success rate of more than 30 % at 1 year is considerably higher than the success rates observed in individuals who attempt to obtain smoking cessation spontaneously and independently, outside of a cancer diagnosis (3-5 %). However, it remains low if one consider that smoking cessation is an important factor for increasing the survival rate for this type of cancer. It should be noted that, among the 51 smokers still active, 42 (82.4 %) did not consult a tobacco specialist. Smoking cessation support should in fact be offered to patients diagnosed with lung cancer more systematically and as early as possible in order to optimize the effectiveness of treatments and to increase the chances of survival.

Abstract: Smoking is a myocardial infarction (MI) risk factor among people with HIV (PWH). Questions persist regarding the role of smoking behaviors and measurements (e.g., intensity, duration) on MI risk. We used Cox proportional hazards regression to compare the association of smoking parameterization with incidents of type 1 and type 2 MI and whether smoking intensity or duration improves MI risk prediction among PWH. Among 11,637 PWH, 37% reported currently smoking, and there were 346 MIs. Current smoking was associated with type 1 (84% increased risk) but not type 2 MI in adjusted analyses. The type 1 MI model with pack years had the best goodness of fit compared with other smoking parameterizations. Ever or never parameterization and smoking diagnosis data had significantly poorer model fit. These results highlight the importance of differentiating MI types and performing patient-based smoking assessments to improve HIV care and research rather than relying on smoking status from diagnoses., (Copyright © 2024 Association of Nurses in AIDS Care.)

This Special Issue (SI) of Preventive Medicine is the 11th in an annual series on behavior change, health, and health disparities. The theme of this 2024 issue is Smoking and Other Tobacco Use among Women and Girls. Cigarette smoking remains the single most preventable cause of death in the U.S., causing the premature death of more than 200,000 U.S. women annually, a mortality rate that far exceeds levels from conditions more commonly associated with premature death in women (e.g., breast cancer). Of course, cigarette smoking among women and girls is also a well-known cause of intergenerational adverse health effects. Women and girls are also using e-cigarettes and many other tobacco products that are flooding the U.S. tobacco marketplace. This SI includes eleven peer-reviewed articles that advance knowledge across a wide range of topics on disproportionate adverse effects, prevalence, and risk factors for cigarette smoking and other tobacco use in women and girls., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The author is an Editorial Board Member/Editor-in-Chief/Associate Editor/Guest Editor for [Journal name] and was not involved in the editorial review or the decision to publish this article., (Copyright © 2024. Published by Elsevier Inc.)

Tobacco use represents the leading preventable risk factor for premature deaths worldwide. A meta-analysis of 74 epidemiological studies, including 3.2 million individuals with type 2 diabetes mellitus (T2DM) from 33 countries, reported a pooled prevalence of smoking of 20.8% among individuals with T2DM. Cigarette smoking further aggravates existing deleterious vascular effects of T2DM. Namely, chronic hyperglycemia and exposure to cigarette smoke cause additive injurious effect on the endothelium, leading to an acceleration of vascular complications seen in persons with T2DM and tobacco use disorders (TUD). In a recent study, Wang and colleagues found that semaglutide use was associated with a significantly lower risk for medical encounters for TUD, when compared to other antidiabetic drug classes; indeed, this effect was strongest compared with insulins and weakest compared with other glucagon-like peptide-1 receptor agonists. Semaglutide was associated with reduced smoking cessation medication prescriptions and counseling. Similar findings were observed irrespective of the presence of obesity. Therefore, semaglutide use might be useful in terms of smoking cessation among individuals with T2DM, thus offering an additional benefit for this constantly growing population. However, those interesting findings should be confirmed through dedicated, large-scale randomized controlled trials.

Rationale: Few studies take a life course perspective to explain if exposure to second-hand smoke in childhood influences mental health in adulthood. Importantly, no study provides empirical evidence on the pathways through which exposure to second-hand smoke in childhood influences mental health in adulthood. There is also limited evidence on the factors that moderate the relationship between second-hand smoke exposure and mental health. To inform policy, it is important to explore the pathways through which second-hand smoke influences mental health and understand factors that are likely to moderate this relationship., Objectives: The objective of this paper is to examine if exposure to parental smoking in childhood influences mental health in adulthood. The study examines general health and smoking status in later life as potential channels and if locus of control (LoC), a personality trait developed in childhood and adolescence, moderates the relationship between exposure to parental smoking in childhood and mental health in adulthood., Methods: Using 21 waves of longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA), the study conducts regression analyses that adjust for the potential effects of confounders and other biases., Results: The results show that exposure to parental smoking in childhood is associated with a decline in mental health in later life, and that general health status and smoking status in adulthood are channels through which exposure to parental smoking in childhood influences mental health in adulthood. Specifically, those who are exposed to parental smoking in childhood tend to have poorer general health and a higher probability of being smokers in adulthood, both of which negatively impact mental health. The findings point to the moderating role of LoC, such that being more internal on LoC dampens the negative effects of exposure to parental smoking on mental health., Conclusion: The findings from this study lend support to the need to address the long-term implications of behaviours that are harmful to health. The findings also suggest that LoC has implications for an individual's psychological resilience against the negative effects from exposure to parental smoking in childhood., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Low- and middle-income countries have increasingly banned e-cigarettes, as in Mexico. In these countries, little is known about where adults obtain e-cigarettes or who uses e-cigarettes with nicotine., Methods: Data were analyzed from eight online surveys of Mexican adults who both smoked and used e-cigarettes (November 2018-March 2021; n = 2,060). For the e-cigarette they used most often, participants reported how they acquired it (social sources=reference; online purchase; vape shop purchase; other retail purchase) and if it contained nicotine (no=reference group; yes; don't know). Multinomial models regressed each of these outcomes on smoking- and e-cigarette-related factors, as well as sociodemographics., Results: Almost half the sample (45.9 %) reported obtaining their e-cigarettes from social sources, with online purchase being the second most common source (28.7 %). Being male, having recently attempted to quit smoking, and more frequent e-cigarette use were positively associated with purchasing e-cigarettes (vs social sources) across all venues. Most reported that their e-cigarettes contained nicotine (58.2 %), a third reported using e-cigarettes without nicotine (35.9 %), and some did not know (5.8 %). More frequent smoking and e-cigarette use, using closed e-cigarette devices and purchasing e-cigarettes online were positively associated with using e-cigarettes with nicotine., Conclusions: Despite Mexico's e-cigarette ban, adults who smoke access e-cigarettes through multiple sources, including online and vape shop purchases. Most participants reported using e-cigarettes with nicotine, though many did not or did not know., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Minimal pleural fluid is often seen incidentally on chest MRI. However, its prevalence and clinical characteristics remain unknown., Methods: This retrospective observational study included 2726 participants who underwent comprehensive medical check-ups for screening, including chest CT and MRI, and transthoracic echocardiography between March 2018 and February 2019. Pleural fluid on MRI was manually measured for maximum thickness. Its distribution, change over time, and relevance to participant characteristics were analyzed. The pulmonary function data of 82 participants and their associations with fluid were also analyzed., Results: Of the 2726 participants (mean age ± standard deviation, 59 ± 11 years), 2009 (73.7%) had minimal pleural fluid (thickness, 1-9 mm) on either side, with right-sided fluid being more frequent than left-sided fluid (P < 0.001). Negligible changes in fluid thickness were observed one year later. The following parameters were associated with less fluid: age, ≥65 years (P < 0.001); male sex (P = 0.006); current smoking (P < 0.001); body mass index, ≥25 kg/m 2 (P < 0.001); and mean arterial pressure, ≥100 mmHg (P = 0.01), whereas a ratio between early mitral inflow velocity and mitral annular early diastolic velocity>14 was associated with more fluid (P = 0.01). The presence of fluid was an independent explanatory variable for a higher percentage of predicted vital capacity (P = 0.048)., Conclusions: MRI was highly sensitive in detecting minimal pleural fluid. Pleural fluid found on MRI for health screening was assumed to be physiological and fluid thickness at the steady state might be variable among participants depending on age, sex, smoking habits, body shape, blood pressure, and cardiac diastolic capacity., Competing Interests: Declaration of competing interest T. Yoshikawa belongs to the Department of Computational Diagnostic Radiology and Preventive Medicine, which is sponsored by HIMEDIC, Inc. and Siemens Japan K.K; KF, HM, TK, T. Yamaguchi, AS, NY and HK have no conflict of interest., (Copyright © 2024 The Author. Published by Elsevier B.V. All rights reserved.)

The incidence of early-onset cancers in adolescents and young adults (AYA) has been increasing worldwide since the 1990s. In Italy, a significant increased rate of 1.6 % per year has been reported for early-onset cancers among females between 2008 and 2016. This is mainly attributable to melanoma, thyroid, breast and endometrial cancer. The aim of our work was to describe temporal trends of the main established lifestyle risk factors (tobacco use, alcohol consumption, obesity, physical inactivity, dietary westernization and reproductive factors) over the last 20 years in the Italian AYA population. Available data on behavioural risk factors, individual and household daily life have been obtained and elaborated from PASSI, ISTAT and Eurostat reports. Lowering age of smoking initiation, an increase in alcohol drinkers among young females, and an obesity and overweight epidemic, particularly among children and adolescents as a result of physical inactivity and dietary habits, may be contributing factors behind this cancer epidemic, especially among females. In-depth investigations are needed to understand the exact role of each contributing factor, the effects of exposure to nicotine-containing products and environmental factors such as endocrine disruptors that could play a role in this phenomenon., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare that are relevant to the content of this manuscript., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Recent guidelines have recognized several factors, including blood pressure (BP), body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), hemoglobin A1c (HbA1c), smoking, and physical activity, as key contributors to stroke risk. However, the impact of simultaneous management of these risk factors on stroke susceptibility in individuals with hypertension remains ambiguous. This study involved 238 388 participants from the UK Biobank, followed up from their recruitment date until April 1, 2023. Cox proportional hazard models with hazard ratios (HRs) and 95% confidence intervals (CIs) were used to illustrate the correlation between the joint modifiable risk factor control and the stroke risk. As the degree of risk factor control increased, a gradual reduction in stroke risk was observed. Hypertensive patients who had the optimal risk factor control (≥5 risk factor controls) had a 14.6% lower stroke risk than those who controlled 2 or fewer (HR: 0.854; 95% CI: 804-0.908; p < 0.001). The excess risk of stroke linked to hypertension slowly diminished as the number of controlled risk factors increased. However, the risk was still 25.1% higher for hypertensive patients with optimal risk factor control as compared to the non-hypertensive population (HR: 1.251; 95% CI: 1.100-1.422; p < 0.001). The protective effect of joint risk factor control against the stroke risk due to hypertension was stronger in medicated hypertensive patients than in those not medicated. This finding leads to the conclusion that joint risk factor control combined with pharmacological treatment could potentially eliminate the excess risk of stroke associated with hypertension., (© 2024 The Author(s). The Journal of Clinical Hypertension published by Wiley Periodicals LLC.)

Objectives: Research shows that smoking persists in sports clubs with smoke-free policies (SFPs). It is unknown to what extent smoking occurs at such clubs and how much that may differ from clubs without SFPs. This study aimed to determine whether and to what extent smoking differs at Dutch football clubs with and without SFPs., Study Design: This cross-sectional study used a purposive sampling method to compare smoking indicators at 117 Dutch football clubs, with 49 clubs (41.8%) having an SFP., Methods: Using a standardised checklist, three smoking indicators were observed (number of people smoking, smoking facilities, and cigarette butts) and combined in a total smoking score (scale 0-9). Multi-level linear regression analysis was used to analyse the association between club SFP, local tobacco control policies (TCPs), and smoking indicators., Results: Significantly fewer smoking facilities were present at clubs with an SFP (-2.35, 95% confidence interval [CI]: -3.61; -1.09), but no significant associations were found between SFP and the number of people smoking and cigarette butts. The total smoking score was 1.74 points lower for clubs with an SFP (95% CI: -2.53; -0.96) and 1.85 points lower for clubs in municipalities with strong local TCPs (95% CI: -2.98; -0.72). Strong local TCPs were associated with significantly fewer people smoking at clubs (-1.79, 95% CI: -3.41; -0.17)., Conclusions: SFPs at sports clubs succeed in limiting the number of smoking facilities but do not show differences in terms of smoking rates or smoking-related litter when compared to clubs without SFPs. Our results highlight the need for enhancing implementation of comprehensive SFPs, including clear guidelines for compliance and enforcement., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background and Objectives: Overactive bladder and its hallmark symptom, urgency, are thought to be multifactorial in pathogenesis. Smoking is a particularly important risk factor to understand because it is modifiable; studies evaluating an association between smoking and urgency have been inconclusive. We therefore sought to rigorously assess the relationship between smoking and urgency in terms of both a temporal and quantitative pack year history of smoking while controlling for other possible confounding factors., Methods: Community-based adult women were recruited using the ResearchMatch website to participate in an online survey of bladder health which included questions to assess urgency symptoms, medical comorbidities, and detailed smoking history. Smoking history was studied as the independent variable in three different formulations: smoking status (never vs. former vs. current), continuous pack year history, and categorical pack year history. The outcomes studied included urgency (any urgency in the past 7 days), moderate urgency (urgency at least half the time), and urgency urinary incontinence (UUI). Chi-square tests were performed to detect associations between smoking and these outcomes, and multivariate regression was then performed to control for possible confounders and to help determine the comparative influence of temporality versus quantity of smoking history., Results: In 1720 women who completed the questionnaire, current smoking status was associated with a 23% increase in the risk of experiencing urgency (RR 1.23) and a 78% increase in the risk of experiencing moderate urgency (RR 1.78) relative to never smokers. The risk of experiencing UUI was 40% higher (RR 1.40). Lifetime pack year history was also significantly associated with urgency outcomes, although only in smokers/former smokers who had a 20+ pack year history (RR 1.15, 1.60, and 1.25 for urgency, moderate urgency, and UUI, respectively). The presence of former smoking history was not significantly associated with urgency outcomes, even when controlling for cumulative pack years., Conclusions: This analysis of a large cross-sectional database of women suggests a strong, consistent link between current smoking status and urinary urgency and UUI. By contrast, no increased risk of urgency was attributed to former smoking status. Analysis of pack year history suggests a dose-response relationship wherein ≥ 20 pack years was significantly associated with a higher risk of all urgency outcomes. In models controlling for pack year history, the association of current smoking with urgency remained significant and former smoking remained nonsignificant. Taken together, this supports greater attention being given to the contribution of current smoking to urgency symptoms, and to the need for further longitudinal work to determine if smoking cessation can be a strategy to treat urgency., (© 2024 The Author(s). Neurourology and Urodynamics published by Wiley Periodicals LLC.)

Context: Tobacco usage accounts for one of the most preventable causes of death., Objective: This study aimed to explore mechanisms linking cigarette pack factors, point-of-sale marketing, and individual factors (psychological reactant trait) to predict smoking intention among school-going adolescents., Design, Setting, and Participants: This was a cross-sectional study conducted among 6 urban secondary schools. A pretested and validated self-administered questionnaire was used. Data analysis for structural equation modeling was done using SMART-PLS v3.2.8., Main Outcome Measure: The main outcome measure was to determine the direct and indirect effects of cigarette pack factors, point-of-sale marketing, and individual factors (psychological reactant trait) to predict smoking intention among school-going adolescents in a theory-based model., Results: A total of 386 adolescents fulfilling the inclusion criteria participated. Pictorial warning message reactance (β = .153, P  ≤ .001), pack receptivity of conventional pack (β = .297, P  = .004), and psychological reactant trait (β = .174, P  ≤ .001) were positively related to smoking intention. Pictorial warning negative affect (β = -.153, P  = .001) was negatively related to smoking intention. The psychological reactant trait was positively related to message reactance (β = .340, P  ≤ .001). However, recall exposure to point-of-sale marketing and pack appraisal of conventional pack was not positively related to smoking intention (β = .038, P  = .22 and β = -.026, P  = .39, respectively). Pictorial warning message reactance also positively mediates the relationship between psychological reactant trait and smoking intention (β = 0.05, p = .001). The model has strong predictive power., Conclusion: In conclusion, cigarette pack factors and psychological reactant traits are essential in predicting smoking intention. Hence, policymakers should consider these factors in developing smoking policies., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Passive exposure to cigarette smoke has negative effects on respiratory health. Childhood cancer survivors (CCS) are at increased risk for respiratory disease due to treatment regimens that may harm the respiratory system. The objective of this study was to assess the prevalence of parental smoking among CCS and investigate its association with respiratory outcomes., Procedure: As part of the Swiss Childhood Cancer Survivor Study, between 2007 and 2022, we sent questionnaires to parents of children aged ≤16 years who had survived ≥5 years after a cancer diagnosis. Parents reported on their children's respiratory outcomes including recurrent upper respiratory tract infections (otitis media and sinusitis), asthma, and lower respiratory symptoms (chronic cough persisting >3 months, current and exercise wheeze), and on parental smoking. We used multivariable logistic regression to investigate associations between parental smoking and respiratory outcomes., Results: Our study included 1037 CCS (response rate 66%). Median age at study was 12 years (interquartile range 10-14 years). Eighteen percent of mothers and 23% of fathers reported current smoking. CCS exposed to smoking mothers were more likely to have recurrent upper respiratory tract infections (OR 2.1; 95%CI 1.1-3.7) and lower respiratory symptoms (OR 2.0; 95%CI 1.1-3.7). We found no association with paternal smoking., Conclusions: A substantial proportion of CCS in Switzerland have parents who smoke. Exposure to maternal smoking was associated with higher prevalence of upper and lower respiratory problems. Healthcare providers can support families by addressing caregiver smoking behaviors and providing referrals to smoking cessation programs., (© 2024 The Author(s). Pediatric Blood & Cancer published by Wiley Periodicals LLC.)

Issues: Health policy makers worldwide have adopted evidence-based legislation, largely directed at consumers, to reduce tobacco-related harm. It is suggested that limiting supply by decreasing retail availability can also reduce cigarette smoking. To inform policy makers this systematic literature review assesses whether reducing availability is associated with smoking behaviours., Approach: Systematic literature searches of five databases were carried out up to January 2023. Included studies had at least one exposure (tobacco retail density, proximity or mixed measures thereof) and outcomes of smoking behaviour. Meta-analysis of effect estimates were undertaken if there were at least three studies with similar population, exposure and outcome measures., Key Findings: Sixty-two studies were included, and positive associations were found between tobacco outlet density and cigarette smoking in pregnancy, youth, adults and cessation. Meta-analyses were undertaken for retail density and ever smoking (odds ratio [OR] 1.20; 95% confidence interval [CI] 1.04, 1.37; I 2  = 87.3%), and current youth smoking (OR 1.23; 95% CI 1.08, 1.40; I 2  = 0.0%), adult smoking (OR 1.11; 95% CI 1.01, 1.22; I 2  = 74.8%); and mixed measures of retail availability near schools and current youth smoking (OR 1.03; 95% CI 1.01, 1.05; I 2  = 0.0%)., Implications and Conclusion: There is evidence higher tobacco retail density is consistently associated with cigarette smoking in pregnant women, young people and adults when ecological studies are included in meta-analysis. Meanwhile, evidence synthesis reveals restrictive tobacco retail laws based on proximity or mixed measures near home or very near school may not reduce smoking except in men who smoke heavily. Mechanisms to reduce retailer density should be thus considered part of tobacco control strategies., (© 2024 The Author(s). Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

Smoking during pregnancy is associated with negative pregnancy and perinatal health outcomes. Physiological and societal particularities can modify the smoking behavior of pregnant women. Pregnancy is a teachable moment for smoking cessation. Increased nicotine clearance may lead to exacerbated tobacco withdrawal symptoms and desire to smoke, which need to be taken into account when helping pregnant smokers to quit. Although most pregnant smokers try to quit on their own, 12% of pregnant women in France reported smoking in 2021 during the 3 rd trimester of pregnancy. Health care professionals should screen for tobacco consumption and assess the level of addiction. Management of smoking cessation can be multidisciplinary, including non-pharmacological support such as counselling, behavioral support, financial reward contingent on abstinence, and medication (nicotine replacement therapies). Assessment and limitation of secondhand smoke exposure (SHS) is needed because SHS can also have negative maternal and fetal consequences. Management of relapse during the postpartum period is also to be anticipated; in 2021, it concerned 22.4% of women who had stopped smoking during pregnancy. While electronic cigarette use is increasing overall and among pregnant women who smoke (5.4 before pregnancy, 1.3% during the 3rd trimester in 2021), well-conducted smoking cessation studies are necessary to assess its benefits and potential risks in this specific group of smokers., (Copyright © 2024 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Background: The purpose of this study was to evaluate the impact that obesity, smoking, and older age have on 30-day postoperative complications, reoperations, and readmissions of patients undergoing arthroscopic meniscectomy or meniscus repair., Materials and Methods: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was queried to identify meniscus surgeries and operative outcomes between 2008 and 2016. Controlled regression analysis was then performed to evaluate for an association between obesity, age, and smoking and these outcomes., Results: While obesity showed no influence on adverse postoperative complications or reoperations, class I obesity was associated with a lower rate of readmission. Older age, smoking, and comorbidity burden were significant predictors of postoperative complications, reoperations, and/or readmissions. Age 80 years or older was particularly predictive of 30-day complications (odds ratio, 3.5; P <.001) and readmissions (odds ratio, 2.5; P =.004)., Conclusion: Obesity is not a major risk factor for complications when undergoing meniscus surgery, while age older than 70 years predicts negative short-term postoperative outcomes. [ Orthopedics. 2024;47(6):332-336.].

Background: Risk factors including smoking, alcohol intake, physical activity (PA), and sleep patterns have been associated with cancer risk. Clonal hematopoiesis (CH), including mosaic chromosomal alterations and clonal hematopoiesis of indeterminate potential, is linked to increased hematopoietic cancer risk and could be used as common preclinical intermediates for the better understanding of associations of risk factors with rare hematologic malignancies., Methods: We analyzed cross-sectional data from 478,513 UK Biobank participants without hematologic malignancies using multivariable-adjusted analyses to assess the associations between lifestyle factors and CH types., Results: Smoking was reinforced as a potent modifiable risk factor for multiple CH types, with dose-dependent relationships persisting after cessation. Males in socially deprived areas of England had a lower risk of mosaic loss of chromosome Y (mLOY), females with moderate/high alcohol consumption (2-3 drinks/day) had increased mosaic loss of the X chromosome risk [OR = 1.17; 95% confidence interval (CI), 1.09-1.25; P = 8.31 × 10-6] compared with light drinkers, active males (moderate-high PA) had elevated risks of mLOY (PA category 3: OR = 1.06; 95% CI, 1.03-1.08; P = 7.57 × 10-6), and men with high body mass index (≥40) had reduced risk of mLOY (OR = 0.57; 95% CI, 0.51-0.65; P = 3.30 × 10-20). Sensitivity analyses with body mass index adjustment attenuated the effect in the mLOY-PA associations (IPAQ2: OR = 1.03; 95% CI, 1.00-1.06; P = 2.13 × 10-2 and IPAQ3: OR = 1.03; 95% CI, 1.01-1.06; P = 7.77 × 10-3)., Conclusions: Our study reveals associations between social deprivation, smoking, and alcohol consumption and CH risk, suggesting that these exposures could contribute to common types of CH and potentially rare hematologic cancers., Impact: This study underscores the impact of lifestyle factors on CH frequency, emphasizing social, behavioral, and clinical influences and the importance of sociobehavioral contexts when investigating CH risk factors., (©2024 American Association for Cancer Research.)

Objectives: The aim of this study was to examine the temporal dynamics of multiple health behaviours (physical activity, alcohol consumption, healthy eating, cigarette consumption, recreational drug use, vaping), and pandemic-related health behaviours (e.g., hand washing, physical distancing) using network psychometrics., Design: The International COVID-19 Awareness and Responses Evaluation (iCARE) study is an international multi-wave observational cohort study of public awareness, attitudes, and responses to public health policies implemented to reduce the spread of COVID-19 on people around the world. A sub-sample of longitudinal data from Canadians (n = 254) was analysed across four waves (February-July 2020)., Methods: We used temporal network models to fit temporal networks, contemporaneous networks, and between-subject networks from items within the iCARE survey., Results: Positive temporal associations were observed between physical activity and healthy eating, and a bidirectional relationship was evident between outdoor mask use and vaping. A contemporaneous network revealed positive associations between consumption behaviours (vaping, cigarette use, alcohol use, and recreational drug use), and negative associations between physical activity and drug use, and healthy eating and cigarette use., Conclusions: Health behaviours are interconnected and can be modelled as networks or behavioural systems. The application of temporal network analysis to the study of multiple health behaviours is well suited to address key research questions in the field such as 'how do multiple health behaviours co-vary with one another over time'. Future research using time series data and measuring affective and cognitive mediators of behaviour, in addition to health behaviours, has the potential to contribute valuable hypothesis-generating insights., (© 2024 The Author(s). British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Objective: Cigarette smoking prevalence has declined slower among women than men, and smoking-related pulmonary disease (PD) has risen among women. Given these trends, there is a critical need to understand and mitigate PD risk among women who smoke. The purpose of this narrative review and commentary is to highlight important evidence from the literature on smoking and PD among women., Methods: This review focuses broadly on examining cigarette smoking and PD among women within six topic areas: (1) demographic characteristics and prevalence of smoking, (2) smoking behavior, (3) lung cancer, (4) obstructive PD, (5) diagnostic and treatment disparities, and (6) gaps in the literature and potential directions for future research and treatment., Results: Growing evidence indicates that compared to men, women are at increased risk for developing smoking-related PD and poorer PD outcomes. Gender disparities in smoking-related PD may be largely accounted for by genetic differences and sex hormones contributing to PD pathogenesis and presentation, smoking behavior, nicotine dependence, and pathogen/carcinogen clearance. Moreover, gender disparities in smoking-related PD may be exacerbated by important social determinants (e.g., women with less formal education and those from minoritized groups may be at especially high risk for poor PD outcomes due to higher rates of smoking)., Conclusion: Rising rates of smoking-related PD among women risk widening diagnostic and treatment disparities. Ongoing research is needed to explore potentially complex relationships between sex, gender, and smoking-related PD processes and outcomes, and to improve smoking-cessation and PD treatment for women., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose. Dr. Coleman has research support from NHLBI. Dr. Menson has research support from the American Lung Association., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background and Aims: Risk factor modification may decrease the risk of cardiovascular disease (CVD). Whether risk factor modification can mitigate the effect of hyperuricemia on CVD is unclear. This study aimed to investigate the risk of CVD among individuals with hyperuricemia, according to risk factors on target, compared with controls without hyperuricemia., Methods and Results: This prospective study included 91,722 participants free of CVD at baseline (2006-2007) of the Kailuan study. Individuals with hyperuricemia were categorized according to the number of seven selected risk factors within the guideline-recommended target range (nonsmoking, physical activity, healthy diet, guideline-recommended levels of body mass index, blood pressure, fasting blood glucose, and total cholesterol). During a median follow-up of 13.00 years, 671 out of 6740 individuals (9.96%) with hyperuricemia and 6301 out of 84,982 control subjects (7.41%) had incident CVD. Compared with control subjects without hyperuricemia, individuals with hyperuricemia who had 4 or 5 to 7 risk factors on target had no significant excess CVD risk, the hazard ratio (HR) (95% confidence internal [CI]) was 0.93 (0.79-1.10) and 0.88 (0.71-1.10), respectively. Among individuals with hyperuricemia, excess CVD risk decreased stepwise for a higher number of risk factors on target, the HR of CVD associated with per additional risk factor within target range was 0.82 (95% CI, 0.77-0.87). Similar results were yielded for CVD subtypes., Conclusions: Among individuals with hyperuricemia, excess CVD risk decreased stepwise for a higher number of risk factors within target., (Copyright © 2024 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Objective: Study of the association between smoking and pain intensity has produced conflicting results; with less focus on pain interference. Different pain constructs could have varying associations with smoking behaviors. This study sought to investigate the association between smoking history and not only pain intensity, but also pain interference, symptom distribution and physical function., Methods: Smoking history (current, past, or none), pain interference (Pain, Enjoyment of Life, and General Activity scale), symptom distribution and physical function scores were extracted from medical records of patients seen in physical therapy for common sites of musculoskeletal pain (lumbar and cervical spine, knee, or hip). Generalized linear models assessed the relationship between smoking history and pain/function., Results: 833 patients from an integrated healthcare system were included (mean: 57.6 years, SD=16.3; 43 % male). After controlling for several variables, current smokers had significantly higher baseline pain interference scores compared to never and former smokers (beta [B]: 0.65, 95 %CI: 0.13 to 1.18, P=.02). Smoking was not a significant predictor of symptom distribution at baseline [B: 0.17, 95 %CI -0.06 to 0.42, P=.16] or physical function scores at discharge [B: -0.03, 95 %CI: -0.08 to 0.02, P=.25]., Conclusion: Smokers experienced a greater impact of pain at baseline. However, symptom distribution at intake and function upon discharge were similar between all smoking groups. These findings suggest smoking cessation and abstinence may be important recommendations to help curb pain interference., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: To analyse the 52,199 patients in the Swedish Knee Ligament Register (SKLR) preoperatively, and the patients reaching 5- and 10-year follow-ups who underwent anterior cruciate ligament reconstruction (ACLR), revision ACLR and ACLR on the contralateral side (CACLR). The main hypothesis was that patients undergoing revision ACLR would have worse patient-reported outcome measurements (PROMs) than the primary ACLR group at 10 years and that smoking and concomitant injuries would result in poorer outcomes for all groups., Methods: Data from 2005 to 2021 were extracted from the SKLR. Only patients whose ACLR surgery was registered in the SKLR were included for revision ACLR and CACLR. The PROMs consist of the Knee injury and Osteoarthritis Outcome Score (KOOS) and the knee-specific PROM (EQ-5D-3L). PROMs were analysed as a whole and in subgroups based on sex, smoking, graft choice and concomitant injuries., Results: Poorer KOOS were seen for revisions compared with primary ACLRs at both the 5- and 10-year follow-ups (p = 0.003). Smokers had significantly poorer KOOS than nonsmokers (p < 0.001) preoperatively in all groups, however only in the primary ACLR group at 5 and 10 years. At 10 years, patients who had undergone CACLR had lower KOOS than primary ACLRs (p = 0.03). Concomitant injuries resulted in statistically, significantly poorer KOOS for both primary ACLRs and CACLRs preoperatively and at the follow-ups., Conclusion: The PROMs for revision ACLRs have worse KOOS scores at 10 years compared with the primary ACLRs. The presence of concomitant meniscal or cartilage injuries at the time of ACLR or CACLR were associated with worse PROMs., Level of Evidence: Level III., (© 2024 The Author(s). Knee Surgery, Sports Traumatology, Arthroscopy published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)

Objectives: People with childhood-onset disabilities are living into adulthood, and the prevalence of smoking and illicit drug use among adults with disabilities is high. We evaluated the relationship between disability status and age of disability onset, current cigarette smoking status, and heavy alcohol drinking., Methods: We conducted a secondary data analysis of the National Health Interview Survey (NHIS), a US survey on illness and disability. Among 2020 NHIS participants aged 22-80 years (n = 28 225), we compared self-reported prevalence of current cigarette smoking and heavy alcohol drinking among those with and without disabilities and among those with childhood- versus adult-onset disabilities. We used adjusted logistic regression analysis to calculate the adjusted odds ratios (AORs) of current smoking and heavy alcohol drinking based on disability status and age of disability onset., Results: Compared with adults without disabilities, adults with disabilities were significantly more likely to report current smoking (23.5% vs 11.2%; P  < .001) and significantly less likely to report heavy alcohol drinking (5.3% vs 7.4%; P  = .001). The prevalence of these behaviors did not vary significantly by age of disability onset. In adjusted logistic regression models, adults with disabilities had significantly higher odds of current smoking (AOR = 1.76; 95% CI, 1.53-2.03) and similar odds of heavy alcohol drinking (AOR = 0.82; 95% CI, 0.65-1.04) compared with adults without disabilities. The odds of these health behaviors did not vary significantly by age of disability onset., Conclusions: Adults with disabilities overall may be at high risk for these unhealthy behaviors, particularly smoking, regardless of age of disability onset. Routine screening and cessation counseling related to smoking and unhealthy alcohol use are important for all people with disabilities., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background and Aims: The increasing incidence of metabolic dysfunction-associated steatotic liver disease (MASLD) has led to a gradual increase in MASLD-related hepatocellular carcinomas (HCC). In this context, we aimed to investigate the association between modifiable factors and the risk of incident HCC in patients with MASLD., Methods: Two authors independently searched electronic databases (PubMed, Embase, and the Cochrane Library) from their inception to April 1, 2023. Observational studies reporting an association between modifiable risk factors and MASLD-related HCC were eligible for inclusion. The effect size on the study outcomes was calculated using a random-effects model and was presented as a risk ratio with 95% confidence interval., Results: A total of 31 studies covering 1.02 million individuals were included. Regarding lifestyle factors, smoking and alcohol consumption were associated with 30% (1.30 [1.08-1.57]) and 140% (2.41 [1.03-5.65]) risk increase of MASLD-related HCC. Regarding metabolic risk factors, patients with MASLD who were overweight or obese (1.31 [1.13-1.52]), had diabetes (2.08 [1.71-2.53]) and hypertension (1.42 [1.12-1.80]) had a higher risk of developing HCC, while dyslipidemia was negatively associated with MASLD-HCC (0.78 [0.65-0.93]). The use of metformin, statin, and aspirin was associated with 18% (0.82 [0.68-0.98]), 55% (0.45 [0.36-0.56]), and 36% (0.64 [0.44-0.92]) risk reduction in incident HCC, respectively., Conclusions: This comprehensive systematic review and meta-analysis showed statistically significant increases in the risk of incident HCC inpatients with MASLD due to smoking, alcohol use, obesity, diabetes, and hypertension, whereas metformin, statin, and aspirin therapy might modify disease progression., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Health-risk behaviours tend to co-occur among the same sectors of the population. The aim of this study is to examine the association between an aggregate of multiple health-risk behaviours and tooth loss among American Adults., Methods: We used data from the Behavioural Risk Factor Surveillance System (BRFSS) 2022, a nationally representative survey of non-institutionalized American. We included participants aged 18 years and older. An aggregate variable of health-risk behaviours which included smoking, heavy alcohol consumption, lack of physical activities, overweight/obesity, infrequent dental visits and infrequent medical check-up was created. Tooth loss was indicated by losing one tooth or more. Logistic Regression analysis was conducted to test the association between the aggregate of behaviours and tooth loss adjusting for income, education, ethnicity and health insurance., Results: The analysis included 326,561 participants. The mean number of health-risk behaviours was 2.13 and 1.72 among participants with tooth loss and without tooth loss, respectively. The aggregate of health-risk behaviours was significantly associated with tooth loss with odds ratios 1.23 (95% CI, 1.21, 1.26) in a model adjusting for age, gender, education, income ethnicity and health insurance., Conclusion: This study demonstrated that an aggregate of health-risk behaviours, with some not directly linked to oral health, is associated with tooth loss among American adults. The study highlights the importance of considering different risk factors when planning health promotion policies to tackle oral health., (© 2024 The Authors. International Journal of Dental Hygiene published by John Wiley & Sons Ltd.)

On December 7, 2022, China switched from dynamic zeroing strategy against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to reopening. A nationwide SARS-CoV-2 epidemic emerged rapidly. The effect of smoking on SARS-CoV-2 infection remains unclear. We aimed to retrospectively investigate the relationship between smoking and coronavirus disease 2019 (COVID-19) using a community-based cohort of smokers and non-smokers. We included participants from a pre-pandemic cohort with a prolonged follow-up period. Data on smoking status, body mass index, and history of other diseases were collected from health examination and consultation clinic records. Cox regression analysis was used to identify the relationship between groups and SARS-CoV-2 infection over time. We analysed 218 male patients with varied smoking statuses (46.3% current or ex-smokers; average age 68.63 ± 9.81 years). Two peaks in the epidemic were observed following the December 2022 outbreak. At the end of the second peak, non-smokers, current smokers, and ex-smokers had primary infection rates increase to 88.0%, 65.1%, and 81.0%, respectively, with a significant difference between the groups. Current smoking significantly protected against SARS-CoV-2 infection (HR 0.625, 95% CI 0.402-0.970, p = 0.036). Further analyses showed that the prevalence of pneumonia in the unvaccinated, older, diabetic, and non-smoking groups was significantly higher than that in the other groups (p < 0.05). Our study suggests a potential association between smoking and a reduced risk of SARS-CoV-2 infection and pneumonia. This indicates that nicotine and ACE2 play important roles in preventing COVID-19 and its progression. We suggest smokers use nicotine replacement therapy during hospitalization for COVID-19., Competing Interests: Declarations. Conflict of interest: All the authors have no association that might pose a conflict of interest. Ethical approval: This study was approved by the Ethics Committee of Peking Union Medical College Hospital (I-23PJ234). Informed consent: Obtaining informed consent was waived by the Institutional Review Board of Peking Union Medical College Hospital because the data were anonymous and the study was retrospective. Human and animal rights: All procedures performed in the present study were in accordance with the principles outlined in the 1964 Helsinki Declaration and its later amendments. The study was approved by the Ethics Committee of Peking Union Medical College Hospital (I-23PJ234). Consent for publication: Obtaining informed consent was waived by the ethics/ IRB committee because the data were anonymous and this study was retrospective., (© 2024. The Author(s).)

Numerous reports in recent years have focused on the influence of environmental factors on rheumatoid arthritis. This article provides an overview of the current study situation on the influence of modifiable environmental factors on the development and course of rheumatoid arthritis. Lifestyle factors, such as cigarette smoking, diet, exercise and body weight can be individually influenced. Factors such as air pollution and socioeconomic status can be influenced by environmental and sociopolitical measures at a public level. Epidemiological studies have identified nicotine abuse, an unhealthy diet and obesity as well as a low level of education and social status as risk factors for the development of rheumatoid arthritis. Numerous factors are also associated with a poorer response to treatment and a worse prognosis. As randomized interventional studies on most environmental factors are hardly feasible, the causal relationship of the individual factors to the incidence and progression of rheumatoid arthritis is difficult to quantify. Nevertheless, the current evidence already enables the provision of appropriate counselling to patients with rheumatoid arthritis with respect to a healthy lifestyle including abstaining from cigarette smoking, maintaining a healthy diet, physical activity and avoiding obesity., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Rationale & Objective: Although smoking is a recognized risk factor for chronic kidney disease (CKD), the relationship between the time smoking is initiated after awakening each day and CKD remains largely unstudied. This study examined the association between this timing and the risk of CKD, and the potential interactions of smoking timing with other risk factors for the occurrence of CKD., Study Design: Observational cohort study., Setting & Participants: A total of 32,776 participants in the UK Biobank with complete data on the time from waking to the first cigarette and free of prevalent CKD were included., Exposure: Time from waking to the first cigarette., Outcome: Incident CKD cases., Analytical Approach: Cox proportional hazards regression was used to investigate the associations between the time smoking is initiated each day and the risk of CKD. The potential interactions of smoking timing with risk factors in relationship to CKD risk were assessed on both multiplicative and additive scales., Results: During a median follow-up period of 12 years, 940 incident CKD cases occurred. Shorter durations of time from waking to the first cigarette were associated with a higher risk of incident CKD (P trend=0.01). Compared with>120 minutes, the adjusted hazard ratio (HR) associated with smoking timing was 1.28 (95% CI, 0.92-1.80) for 61-120 minutes, 1.48 (95% CI, 1.11-1.96) for 30-60 minutes, 1.36 (95% CI, 1.01-1.88) for 5-15 minutes, and 1.70 (95% CI, 1.22-2.37) for<5 minutes, respectively. Furthermore, there was a significant additive interaction and multiplicative interactions between the timing of smoking and a healthy diet score (P for additive interaction=0.01; P for multiplicative interaction = 0.004)., Limitations: Generalizability, possible residual confounding, limiting causal inference., Conclusions: These findings reveal a significant association between the shorter time from waking to the first cigarette and a higher CKD risk. The magnitude of these associations was greater in the setting of an unhealthy diet., Plain-Language Summary: This study explored the association of the daily timing of first cigarette smoking and the occurrence of kidney disease. Further, we addressed whether this association was influenced by the quality of the diet. The study found that smoking very soon after waking, especially when combined with a poorer quality diet, was associated with a significantly increased risk of developing chronic kidney disease. This research emphasizes the value of healthier lifestyle choices for kidney health., (Copyright © 2024 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)