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Objective: In Japan, paper-based surveys are currently more effective than web-based surveys. This study compared the response rates and lifestyle behaviors between paper- and web-based surveys conducted among Japanese junior and senior high schools. Methods: In total, there were 42 and 64 junior and senior high schools, respectively, for the web-based surveys and 20 and 27 junior and senior high schools, respectively, for the paper-based surveys. The questionnaire covered lifestyle behaviors (e.g., alcohol consumption, smoking, exercise, eating, and sleep status), mental health, and plans to attend college. School- and student-level response rates by survey method were assessed, and so was the effect on the reporting of each lifestyle behavior using logistic regression models. Results: The school response rates were 16.0% and 38.3% for web- and paper-based surveys, respectively. The student response rates were 88.7% and 77.2%, respectively. The web-based group had significantly more female participants and lower response rates for higher grades in senior high schools. The odds of lifetime and current alcohol consumption and poor mental health were lower, whereas those of lifetime use of conventional cigarettes, shorter sleep duration, and plans to continue attending college were higher among web-based (vs. paper-based) participants. Conclusions: The school response rate was poor in the web-based survey. However, whether the differences in lifestyle behavior are attributed to selection bias or the survey method remains unclear.

Background: According to World Health Organization (WHO) estimates, there are currently 1.1 billion tobacco smokers worldwide. This study follows the need for change in the increasing trend of lifestyle-related diseases and the lack of extensive studies on the pattern of smoking. Methods: In the current study, an electronic database search was conducted to identify studies that examined the impact of smoking on internal diseases from the beginning of February 2018 to the end of December 2021. After eliminating numerous articles based on their titles and abstracts, 273 articles pertinent to the study's objectives were selected. Due to the inadequacy of the target audience and the inclusion and exclusion criteria, 239 of the remaining articles were eliminated. The 44 remaining articles were examined more closely. Results: Each cigarette produces more than 7,000 chemicals. Many of these substances are toxic, and about 69 of them can cause cancer. For every 15 cigarettes you smoke, a mutation occurs in the body. Mutations are the cause of cancer. Studies have shown a clear relationship between dose and response, with a sharp increase in the risk of arterial disease in heavy smokers. In countries where approximately 30% of the population smokes, 50% of arterial disease can be attributed to smoking. Conclusion: Smoking increases the risk of cardiovascular disease (CVD) and lung disease, and leads to an increased risk of lung, throat, stomach, and bladder cancer, and many other cancers. One of the most important organs in the body that can be disrupted by smoking is the heart.

Background: In recent years, electronic cigarettes (ECs) have been heavily advertised as an alternative smoking device as well as a possible cessation method. We aimed to review all published scientific literature pertaining to ECs and to present a simple conclusion about their effects for quitting smoking and respiratory health. Methods: This was a cross-sectional study with a search of PubMed, limited to English publications upto September 2014. The total number of papers which had ECs in its title and their conclusions positive or negative regarding ECs effects were computed. The number of negative papers was subtracted from the number of positive ones to make a score. Results: Of the 149 articles, 137 (91.9%) were accessible, of which 68 did not have inclusion criteria. In the 69 remaining articles, 24 studies supported ECs and 45 considered these to be harmful. Finally, based on this evidence, the score of ECs (computed result with positive minus negative) was −21. Conclusion: Evidence to suggest that ECs may be effective and advisable for quitting smoking or a safe alternative for smoking is lacking and may instead harm the respiratory system. However, further studies are needed.

Head and neck cancers are one of the most common cancers in the world which affects the mouth, throat, and tongue regions of the human body. Lifestyle factors such as smoking, and tobacco have been long associated with the generation of cancerous cells in the body. This paper is a novel approach towards extracting the correlation between these life factors and head and neck cancers, supported by crucial cancer attributes like the tumor-node-metastasis and human papilloma virus. Mortality prediction algorithms in cases of head and neck cancers will help doctors pre-determine the factors that are most crucial and help deliver specialized and targeted treatments. The paper used eight machine learning and four deep learning hyper-parameter tuned models to predict the mortality rate associated with head and neck cancer. The maximum accuracy of 98.8% was achieved by the gradient boosting algorithm in the paper. The feature importance of smoking and human papilloma virus positivity using the same classifier was approximately 4% and 2.5% respectively. The most influential factor in mortality prediction was the duration of follow-up from diagnosis to the last contact date, with 40.8% importance. Quantitative results from the area under the receiver operating characteristic curve substantiate the classifiers’ performance, with a maximum value of 0.99 for gradient boosting. This paper is bound to impact many medical professionals by helping them predict the mortality of cancer patients and aid appropriate treatments.

Background and Objectives: The widespread use of tobacco has evolved with the popularity of vapes, especially among young people, despite the lack of clarity in warnings about their risks. Studies indicate the need for more effective communication about the oral risks of vaping. In addition to systemic, respiratory, and cardiovascular effects, vaping is associated with an increased risk of gingivitis and periodontal disease as well as reduced antioxidant capacity of saliva. The objectives of this narrative review are to summarize the existing information in the literature on the effects of vaping at the oral level and to bring together knowledge about the mechanism of action of vaping in oral tissues. Materials and Methods: In the present study, articles were searched in PubMed, Elsevier Scopus, and Web of Science using the keywords “oral health”, “vaping”, and “vape”. Studies published in the last 6 years that addressed the effects of oral vaping were selected, including comparisons among vape users, smokers, and non-smokers. Repeated articles, prior to 2017 and in languages other than English, were excluded. Two review authors (A.M.I and M.F.E.M) independently selected the papers based on titles and abstracts and conducted a full review of the remaining papers. In cases of disagreement, a third reviewer was used. Results: A total of 113 results were obtained, distributed as 16 from PubMed, 35 from Web of Science, and 62 from Elsevier Scopus. After removing duplicates, 67 articles were filtered by reviewing titles and abstracts, and finally, 22 articles were selected for comprehensive reading. Subsequently, eight of these articles were chosen for qualitative synthesis and are presented in standardized tables. The sample size of all included studies was composed of 31,647 participants, (14,477 male and 17,170 female) with a mean of 35.016 ± 7.57 years of age. Conclusions: This review indicates that the use of vapes is associated with an increased risk of periodontitis and caries. Although users experience more oral problems than non-smokers, these are less severe than those of traditional smokers. The widespread prevalence, especially among young people, highlights the urgency of awareness campaigns to warn of risks and understand potential harm.

Smoking is the leading risk factor for noncommunicable diseases and mortality. This fact is becoming more widely known, and as a result, the growing demand for a healthier lifestyle is spreading. The rules aimed at reducing the harm caused by smoking and increasing opportunities to help people quit smoking have increased interest in quitting. The spread of novel nicotine and tobacco products, a lack of professional and public awareness about smoking, tobacco products, and coping mechanisms, and a smoking environment all impede the development of antismoking social attitudes and the decline in smoking prevalence. Among the measures aimed at reducing smoking, quit support should be emphasized much more than previously. Tobacco addiction is a chronic disease and the role of the healthcare professional/counselor in its treatment is critical. The aim of this paper is to supplement the above statements with the experiences of the reports of the National Methodology Center for Smoking Cessation Support, which has been operating at the National Korányi Institute of Pulmonology since 2012. The data and information provided are based on research in the international literature and the reports of the National Methodology Center for Smoking Cessation. Long-term behavioral change guided by specialists and pharmacotherapeutic support lead to long-term cessation.

Bruce Twinamasiko,1 Andrew Mutekanga,1 Olilanya Ogueri,2 Nakitto Irene Kisakye,3 Crystal M North,4,5 Conrad Muzoora,1 Daniel Muyanja1 1Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; 2Science Department, Phillips Academy, Andover, MA, USA; 3Department of Public Health, Kabale University, Kabale, Uganda; 4Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA; 5Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USACorrespondence: Bruce Twinamasiko, Tel +256772382195, Email bbrutwin@gmail.comPurpose: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. In this paper, we determined risk factors for COPD among patients presenting to pulmonology and medical outpatients’ clinics of Mbarara Regional Referral Hospital (MRRH).Methods: In this case–control study, cases were patients with COPD confirmed by spirometry and controls were those with normal spirometry. The two groups were matched by age and gender.Results: We enrolled 123 participants, of whom 41 were cases and 82 controls. A total of 51 women (41.5%) and 72 men (58.5%), of whom 25 were male cases (61%) and 47 were male controls (57%), were included. The results of our study suggest that the variables associated with the presence of COPD among participants attending MRRH were a history of having ever smoked and a prior history of atopy. This brings to our attention the fact that smoking remains a major risk factor for COPD in this setting, just as it is in developed countries.Conclusion: Our study has shown that the factors associated with COPD are smoking and a history of atopy. Patients with a history of asthma and tuberculosis are also probably more likely to develop COPD than those without similar disease conditions.Keywords: chronic bronchitis, emphysema, asthma, smoking

Abstract Background Smoking, alcohol consumption and weight gain outside recommendations during pregnancy are preventable health risk factors associated with poorer health outcomes for mother and infant. Clustering of these risk factors further increases the risk and severity of outcomes. Limited research has explored the characteristics of pregnant women that are associated with clustering of these risks and women’s preferences for receiving support. This paper aimed to determine: (i) the prevalence of clustered preventable risk factors; (ii) associations between maternal characteristics and presence of clustered risk factors; and (iii) women’s preferences for receiving care for clustered risk factors. Methods A cross-sectional survey was undertaken with women who had recently given birth in public maternity services in New South Wales, Australia. Descriptive statistics were used to assess prevalence of clustered risk factors and care preferences. Associations between the presence of clustered risk factors and maternal characteristics were assessed using multiple regression analyses. Results Of the 514 women who completed the survey, 52% reported one preventable health risk factor and 10% and 2% reported two or three. For women with two or more risk factors, the most common combination was alcohol consumption and gestational weight gain outside of recommendations (50%, n = 30). One characteristic had an association with the presence of clustered risk factors. Most women (77%, n = 46) with clustered risk factors indicated they wanted support for these health risks. Preferences for support addressing some or all risk factors, and whether the support was sequential or simultaneous, were not associated with particular risk factor combinations. Conclusions Around one in eight women reported clustered preventable risk factors during pregnancy, most of whom would like support to address these risks. There was only one association between maternal characteristics and clustered risk factors. This suggests a need for antenatal care that is women-centred and caters for a diverse profile of clustered risks and varied preferences for care.

Abstract Background Schizophrenia is a common mental disorder that seriously affects patients’ daily lives and brings heavy psychological and economic burdens to their families and society. The oral problems of patients with schizophrenia are gradually gaining attention, among which dental caries are among the most common oral diseases. Sex differences may be related not only to the various clinical symptoms of schizophrenia but also to different oral hygiene statuses; therefore, the main purpose of this paper is to investigate sex differences related to influencing factors for dental caries in patients with schizophrenia. Method Inpatients with schizophrenia over 18 years old were included in this study, and multidimensional indicators such as demographics, symptom and cognitive impairment assessments, medications, and the caries index of decayed, missing, and filled teeth (DMFT) were collected. An analysis of sex-based influential factors for dental caries in schizophrenia patients was performed. Results Four-hundred and ninety-six patients with schizophrenia were included, with a mean age of 46.73 ± 12.23 years, of which 142 were females and 354 were males. The mean DMFT was significantly higher in males (8.81 ± 8.50) than in females (5.63 ± 6.61, p

Abstract Background Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the world with nearly 90% of cases caused by tobacco smoking. Nearly 40% of people with COPD are diagnosed with depression which impacts quality of life and smoking cessation. The purpose of this study was to describe factors influencing smoking behaviors and readiness to change in people with comorbid COPD and depression. Methods A descriptive cross-sectional design was used. A convenience sample of 222 participants self-reported and/or had a documented diagnosis of COPD. Participants completed study measures which included the PHQ-9 for depressive symptoms, assessment of smoking behaviors using The Cigarette Dependence Scale, report of readiness to change using The Smoking Stage of Change Questionnaire, The Smoking Decisional Balance Questionnaire, and The Processes of Change Questionnaire. Electronic and paper questionnaires were used. Data was stored in RedCap and analyzed using SPSS version 26. Based on variable type, descriptive and comparative analyses were conducted using ANOVA, t-test, chi-square, Pearson correlation, linear regression, and multiple linear regression to determine the relationships between smoking behaviors, COPD, and depressive symptoms. Results Only 18 participants were classified as having no depressive symptoms. Participants who smoked had high nicotine dependence and wanted to quit smoking. Overall, participants saw more cons to smoking and were engaged in the processes of change. The majority of participants were in the maintenance or contemplation stage. Cigarette dependence could decrease by 9% if depressive symptoms are treated. Conclusions There is a need to assess COPD patients for depression and to assess COPD patients’ smoking behaviors and readiness to change. Adequate treatment of depression could promote an individual to move through the stages of change from chronic contemplation to action, thus improving smoking cessation efforts for individuals with COPD. Understanding patients’ smoking behaviors and readiness to change can aid in developing personalized interventions to achieve smoking cessation and improve long-term outcomes.

Presently, in the research processes involved in analysing the relationship between smoking and vital capacity, most researchers use statistical software to analyse, count the differences of vital capacity between different groups and carry out linear analysis or regression analysis. They cannot deeply analyse the relationship between the data, nor can they get the correlation of the data itself. Considering these limitations, this paper studies the influence of adolescent smoking on physical training vital capacity in eastern coastal areas. Based on the brief introduction of the research progress of data mining algorithm, and taking the teenagers in the eastern coastal area as the research object, the k-means algorithm and decision tree algorithm are applied to the data mining of vital capacity of physical training, after which we classify and reclassify the data, mine the rules between the data and put forward improvement strategies for the shortcomings of the algorithm itself. Finally, experiments are designed to analyse the accuracy, running time and reliability of the algorithm. The experimental results show that the improved k-means algorithm and decision tree algorithm shorten the running time and enhance the stability, and can realise the classification and mining of vital capacity data of physical training, so as to improve the reliability of experimental result analysis.

Abstract Background The prevalence of smoking among cervical cancer survivors is high and evidence-based smoking cessation interventions are critically needed. This paper describes the study design, methods, and data analysis plans for a randomized clinical trial (RCT) designed to evaluate the efficacy of a novel, personally tailored SMS-delivered text-based digital treatment adjuvant designed to enhance the long-term efficacy of a “Motivation And Problem-Solving” (MAPS) approach for smoking cessation among individuals with a history of cervical intraepithelial neoplasia (CIN) or cervical cancer. MAPS is a phone counseling approach designed to facilitate long-term abstinence that comprises 6 counseling calls over 12 months. The current trial is evaluating the efficacy of MAPS+, which comprises all MAPS components plus a 24-month digital treatment adjuvant. This trial represents a logical extension of our previous RCT, which compared the efficacy of MAPS to a quitline control condition and found that MAPS resulted in greater than a 2-fold increase in smoking abstinence at 12 months (i.e., 26.4% vs. 11.9%). This treatment effect was no longer significant at 18 months, suggesting that efficacy dissipated as time from the end of treatment increased. The primary aim of the current trial is to compare the efficacy of MAPS + and ST in facilitating long-term abstinence. Methods Individuals who smoke and have a history of cervical cancer or CIN (N = 340) are recruited throughout Florida and randomly assigned to Standard Treatment [ST] or MAPS+. ST participants are electronically connected with the Florida Quitline. MAPS + consists of 6 proactive MAPS-based counseling calls over 12 months plus the novel, personally tailored, text message-based treatment adjuvant delivered over 24 months. All participants receive 12 weeks of combination nicotine replacement therapy (patch and lozenge) and are followed for 24 months. Participant recruitment commenced in December 2022 and is ongoing. Discussion This study builds on promising results from our recent trial which found that MAPS was associated with substantially higher abstinence from smoking at the end of the 12-month treatment period. Finding that this low-burden, personally tailored digital treatment adjuvant improves the long-term efficacy of MAPS would have important clinical and public health implications. Trial registration Clinical Trials Registry NCT05645146; https://clinicaltrials.gov/ct2/show/NCT05645146 ; Registered on December 9, 2022.

Aim. Plasma values of nicotine and its metabolites are highly variable, and this variability has a strong genetic influence. In our study, we analysed the impact of common polymorphisms associated with smoking on the plasma values of nicotine, nicotine metabolites and their ratios and investigated the potential effect of these polymorphisms and nicotine metabolite ratios on the successful treatment of tobacco dependence. Methods. Five variants (rs16969968, rs6474412, rs578776, rs4105144 and rs3733829) were genotyped in a group of highly dependent adult smokers (n=103). All smokers underwent intensive treatment for tobacco dependence; 33 smokers were still abstinent at the 12-month follow-up. Results. The rs4105144 (CYP2A6, P

Abstract Background Smoking is a major risk factor for chronic diseases causing early death and disability. Smoking prevalence over the past 25 years has remained high in Switzerland. Evidence about the burden of disease and cost of illness attributable to smoking can support tobacco control. The aim of the present paper is to quantify from a societal perspective the mortality, disability-adjusted life years (DALYs), medical costs and productivity losses attributable to smoking in Switzerland in 2017. Methods Smoking attributable fractions (SAFs) were calculated based on the prevalence of current and former active smoking in the latest Swiss Health Survey from 2017 and relative risks from the literature. The SAFs were then multiplied with the number of deaths, DALYs, medical costs and productivity losses in the total population. Results In the Swiss population in 2017 smoking accounted for 14.4% of all deaths, for 29.2% of the deaths due to smoking-related diseases, 36.0% of the DALYs, 27.8% of the medical costs and 27.9% of productivity losses. Total costs amounted to CHF 5.0 billion which equals CHF 604 per capita per year. The highest disease burden in terms of mortality and DALYs attributable to smoking was observed for lung cancer and chronic obstructive pulmonary disease (COPD), whereas the highest cost of illness in terms of medical costs was observed for coronary heart diseases and lung cancer and in terms of productivity losses for COPD and coronary heart diseases. Sex and age group differences were found. Conclusions We provide an estimate of the burden of smoking on disease-specific mortality, DALYs, medical costs and productivity losses in Switzerland that could be prevented through evidence-based tobacco prevention and control policies as well as regular monitoring of tobacco consumption.

Introduction: Tobacco has been linked multiple times to many health implications. The relationship between periodontitis and tobacco was thoroughly investigated in this systemic review to evaluate if tobacco specifically smoking impacts the progression of periodontal through impairing vascular and immunity mediators processes. Materials and Methods: The manual and electronic literature searches up to 2020 in the databanks of the EMBASE, MEDLINE, PUBMED, and SCOPUS were conducted. The search terms were “periodontitis,” “periodontitis diseases,” “smoking,” “tobacco use,” “tobacco,” and “cigarette, pipe, and cigar.” The types of studies included were restricted to the original studies and human trials. Analyses of subgroups and meta-regression were used to calculate the heterogeneity. Results: 15 papers total were considered in the review, however only 14 of them provided information that could be used in the meta-analysis. Smoking raises the incidence of periodontitis by 85% according to pooled adjusted risk ratios (risk ratio 1.845, CI (95%) =1.5, 2.2). The results of a meta-regression analysis showed that age, follow-up intervals, periodontal disease, the severity of periodontitis, criteria used to determine periodontal status, and loss to follow-up accounted for 54.2%, 10.7%, 13.5%, and 2.1% of the variation in study results. Conclusion: Smoking has an undesirable impact on periodontal incidence and development. Therefore, when taking the history of the patients at the initial visits the information about the habit of smoking has to be thoroughly noted.

Abstract Background Internationally, there is an ‘evidence-practice gap’ in the rate healthcare professionals assess tobacco use and offer cessation support in clinical practice, including primary care. Evidence is needed for implementation strategies enacted in the ‘real-world’. Aim: To identify implementation strategies aiming to increase smoking cessation treatment provision in primary care, their effectiveness, cost-effectiveness and any perceived facilitators and barriers for effectiveness. Methods ‘Embase’, ‘Medline’, ‘PsycINFO’, ‘CINAHL’, ‘Global Health’, ‘Social Policy & Practice’, ‘ASSIA Applied Social Sciences Index and Abstracts’ databases, and grey literature sources were searched from inception to April 2021. Studies were included if they evaluated an implementation strategy implemented on a nation-/state-wide scale, targeting any type of healthcare professional within the primary care setting, aiming to increase smoking cessation treatment provision. Primary outcome measures: implementation strategy identification, and effectiveness (practitioner-/patient-level). Secondary outcome measures: perceived facilitators and barriers to effectiveness, and cost-effectiveness. Studies were assessed using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool. A narrative synthesis was conducted using the Expert Recommendations for Implementing Change (ERIC) compilation and the Consolidated Framework for Implementation Research (CFIR). Results Of 49 included papers, half were of moderate/low risk of bias. The implementation strategy domains identified involved utilizing financial strategies, changing infrastructure, training and educating stakeholders, and engaging consumers. The first three increased practitioner-level smoking status recording and cessation advice provision. Interventions in the utilizing financial strategies domain also appeared to increase smoking cessation (patient-level). Key facilitator: external policies/incentives (tobacco control measures and funding for public health and cessation clinics). Key barriers: time and financial constraints, lack of free cessation medications and follow-up, deprioritisation and unclear targets in primary care, lack of knowledge of healthcare professionals, and unclear messaging to patients about available cessation support options. No studies assessed cost-effectiveness. Conclusions Some implementation strategy categories increased the rate of smoking status recording and cessation advice provision in primary care. We found some evidence for interventions utilizing financial strategies having a beneficial impact on cessation. Identified barriers to effectiveness should be reduced. More pragmatic approaches are recommended, such as hybrid effectiveness-implementation designs and utilising Multiphase Optimization Strategy methodology. Protocol registration PROSPERO:CRD42021246683

Introduction: The Global Adult Tobacco Survey (GATS) India 2016–17 has shown that increased regulations over time impacted tobacco use culture, which opened the doors for further regulation, making it an iterative process. But do the ‘tobacco control policies’ reach till most deprived sections of society? This paper tries to answer this question. Methods: In this paper, the relative reduction in tobacco use prevalence is seen (from 2009 to 10 to 2016–17) across different levels of material deprivation and educational attainment. The relative reduction in prevalence/ use of various forms of smoking and smokeless tobacco products was also studied.Material Deprivation as a new index was computed, where the weightage was given to various variables related to household ownership of various material things as available in data sets of GATS Survey. The recoded variables were then added and further categorised into six levels of material deprivation where Level 1 corresponds to least deprived and Level 6 corresponds to most deprived.The relative reduction in the prevalence of tobacco use was calculated with the formula [(P1-P2)/P1]*100, where P1 is the prevalence of tobacco use (smoking or smokeless) during GATS1 (2009–10), and P2 is the prevalence of tobacco use (smoking or smokeless) during GATS2 (2016–17). Results: It has been shown that the higher the level of material deprivation, the lesser the relative reduction in the prevalence of tobacco use. The relative reduction in tobacco use was more for higher levels of educational attainment. It has been found that relative reduction is more for smoking products as compared to smokeless tobacco (SLT) products. Khaini and Bidis are emerging as popular products, which are least regulated by existing tobacco control policies. Conclusion: The reduction in the prevalence of tobacco use from GATS1 to GATS2 is inequitous across levels of material deprivation and levels of educational attainment by individuals. Also, there is a tendency for product substitution among tobacco users.

Background and Objectives: The negative effects of smoking on the musculoskeletal system were presented by many authors, although the relationship between smoking and osteoarthritis remains unclear. The aim of this paper was to investigate the negative effects of smoking on meniscal tissue in osteoarthritic knees by microscopic examination, by adapting the Bonar scoring system and its modifications. Materials and Methods: The study involved 34 patients with varus knees, from whom 65 samples of knee menisci were obtained. The mean age in the studied group was 65.385 years. The smoking status of the patients concluded that there were 13 smokers and 21 nonsmokers. Results: Among smokers, the mean classical Bonar score was 8.42 and the mean modified Bonar score was 6.65, while nonsmokers were characterized by scores of 8.51 and 7.35, respectively. There was a statistically significant negative correlation between the number of cigarettes and the collagen in the medial meniscus (p = 0.0197). Moreover, in the medial meniscus, the modified Bonar score correlated negatively with the number of cigarettes (p = 0.0180). Similarly, such a correlation was observed between the number of cigarettes and the modified Bonar score in the lateral meniscus (p = 0.04571). Furthermore, no correlation was identified between the number of cigarettes and the classical Bonar score in the lateral meniscus. There was a statistically significant difference in the collagen variable value between the smokers and nonsmokers groups (p = 0.04525). Conclusions: The microscopic investigation showed no differences in the menisci of smokers and nonsmokers, except for the collagen, which was more organized in smokers. Moreover, the modified Bonar score was correlated negatively with the number of cigarettes, which supports the role of neovascularization in meniscus pathology under the influence of tobacco smoking.

Long COVID is a recently described entity that is responsible for significant morbidity and that has consequences ranging from mild to life-threatening. The underlying mechanisms are not completely understood, and treatment options are currently limited, as existing data focus more on risk factors and predictors. Smoking has been reported as a risk factor for poor outcomes of acute SARS-CoV-2 infection and seems to also play a role in mediating post-COVID-19 symptoms. We aimed to review relevant work addressing the interaction between smoking and long COVID in order to characterize smoking’s role as a risk factor and possibly identify new research directions. Methods: The PubMed/MEDLINE database was searched using the keywords ‘smoking’, ‘long COVID’, and ‘post-acute COVID’ to identify relevant English-language articles published up to October 2023. Results and conclusions: From the 374 initial hits, a total of 36 papers were deemed relevant to the aim of the review. There was significant variability concerning the ways in which tobacco usage was quantified and reported; still, there is compelling evidence linking smoking to an increased risk of developing manifestations of post-acute-COVID disease. Some clinical conditions, such as dyspnea, cardiovascular symptoms, and cognitive or mental-health impairment, seem to be relatively strongly associated with smoking, while the connection between smoking and upper-airway involvement seems less certain. The available data support recommending smoking cessation as a clinical tool for the prevention of long COVID.

Both SARS-CoV-2 and smoking tobacco adversely impact the respiratory system, damaging the airways and impairing lung function. While some studies have identified a positive association between smoking and increased susceptibility to COVID-19 infections, a few papers have concluded that smokers may be protected against such infections. Given these contradictory findings, there is an ongoing debate in the scientific community about whether or not smokers have a stronger predisposition towards COVID-19 infections. Through this mini-review, we aimed to study the relationship between tobacco smoking and COVID-19 infections by conducting a comprehensive literature search of peer reviewed articles that reported on the effects of smoking on COVID-19 susceptibility and were published globally over the past two years (January 2020–April 2022). Our search identified 31 articles that demonstrated a positive or strong relationship between smoking and COVID-19, while 13 articles had contrasting results. Additionally, we evaluated mechanistic studies suggesting that, among smokers, angiotensin-converting enzyme-2 genes are upregulated, facilitating easier binding of SARS-CoV-2, thereby increasing the risk of COVID-19 infection. In conclusion, the majority of studies in this area to date provide evidence of a strong relationship between smoking and COVID-19 infection; however, the strength of this association may vary across the smoking behaviors of differing populations. Future work could involve a meta-analysis of studies focusing on susceptibility to COVID-19 infection for different types of tobacco product smokers, which would result in a more comprehensive understanding of the predisposition of smokers towards COVID-19 infections.

Tobacco kills more than 8 million people worldwide every year. Over 80% of the world’s 1.3 billion tobacco users live in low- and middle-income countries (LMICs), where the future burden is projected to grow. At the same time, progress in tobacco control has not advanced as far as in many LMICs. In particular, the implementation of tobacco-cessation programs and interventions remains limited. The bulk of the evidence for tobacco-cessation interventions comes from high-income countries and may not reflect the context in LMICs, particularly as resources and training for tobacco cessation are limited. This paper summarizes the current evidence for tobacco-cessation interventions in LMICs and highlights some key challenges and research gaps. Overall, there is a need to build capacity for locally relevant research and implementation science to support tailored cessation interventions and strategies for LMICs.

Background and Aim: Comorbid conditions and unhealthy lifestyles are risk factors for auditory dysfunction, including age-related hearing loss. With a focus on adults, this paper describes a new approach to hearing health care that aims to prevent or mitigate hearing loss and related disorders, like tinnitus. Accurate diagnosis and effective management of hearing loss is best achieved with a patient-specific test battery that includes sensitive measures of peripheral and central auditory function. Recent Findings: Within the past decade, peer reviewed research publications confirm the importance of comorbid conditions like diabetes, cardiovascular disease, and cognitive impairment as risk factors for hearing loss, tinnitus, and auditory processing disorders. Unhealthy lifestyles like poor diet, smoking, and chronic exposure to high intensity sound also contribute importantly to risk for hearing loss and tinnitus. In collaboration with physicians and other health care professionals, audiologists who recognize and address these risk factors for hearing loss have an opportunity to prevent or mitigate hearing loss in adult patients. Conclusion: The traditional model for hearing health care service delivery relies on a rather outdated and simplistic protocol for evaluating and describing hearing loss, and a technology-focused approach for management. This paper offers an evidence-based rationale for expanding the test battery for diagnosing hearing loss, and a multidisciplinary intervention approach.

Abstract Background Globally, substance use disorders are prevalent and remain an intractable public health problem for health care systems. This study aims to provide a global picture of substance use disorders research. Methods The Web of Science platform was used to perform a cross-sectional analysis of scientific articles on substance use disorders and treatment. Characteristics of publication volume, impact, growth, authors, institutions, countries, and journals were examined using descriptive analysis and network visualization graphs. Results Thirteen thousand six hundred eighty-five papers related to illicit drugs (5403), tobacco (4469), and alcohol (2137) use disorders and treatment were published between 1971 and 2017. The number of publications on Mindfulness and Digital medicine topics had the highest increase with more than 300% since 2003–2007 despite later presence than other methods. The number of papers on other non-pharmaceutical therapies (behavioral therapy, cognitive behavioral therapy, skills training or motivational interviewing) grew gradually, however, the growth rate was lower every 5-year period. The United States is the substance use disorder research hub of the world with the highest volume of publications (8232 or 60.2%) and total citations (252,935 or 65.2%), number of prolific authors (25 of top 30 or 83%) and institutions (24 of top 26 or 92%), formed the most international research partnerships (with 96 distinct countries). The international collaboration followed a pattern based on geographic proximity and cultural similarity. Conclusions This study offers a comprehensive picture of the global trend of publications of substance use disorder. Findings suggest a need for research policy that supports the examination of interventions that culturally adhere to different local contexts to address substance use disorder in communities.

Aim of the study: The aim of our review is to indicate and discuss the impact of cardiovascular risk factors, such as obesity, diabetes, lipid profile, hypertension and smoking on the course and mortality of COVID-19 infection. Background: The coronavirus disease 2019 (COVID-19) pandemic is spreading around the world and becoming a major public health crisis. All coronaviruses are known to affect the cardiovascular system. There is a strong correlation between cardiovascular risk factors and severe clinical complications, including death in COVID-19 patients. All the above-mentioned risk factors are widespread and constitute a significant worldwide health problem. Some of them are modifiable and the awareness of their connection with the COVID-19 progress may have a crucial impact on the current and possible upcoming infection. Data collection: We searched for research papers describing the impact of selected cardiovascular risk factors on the course, severity, complications and mortality of COVID-19 infection form PubMed and Google Scholar databases. Using terms, for example: “COVID-19 cardiovascular disease mortality”, “COVID-19 hypertension/diabetes mellitus/obesity/dyslipidemia”, “cardiovascular risk factors COVID-19 mortality” and other related terms listed in each subtitle. The publications were selected according to the time of their publications between January 2020 and December 2021. From the PubMed database we obtain 1552 results. Further studies were sought by manually searching reference lists of the relevant articles. Relevant articles were selected based on their title, abstract or full text. Articles were excluded if they were clearly related to another subject matter or were not published in English. The types of articles are mainly randomized controlled trial and systematic review. An additional criterion used by researchers was co-morbidities and age of patients in study groups. From a review of the publications, 105 of them were selected for this work with all subheadings included. Findings and Results: The intention of this review was to summarize current knowledge about comorbidities and development of COVID-19 infection. We tried to focus on the course and mortality of the abovementioned virus disease in patients with concomitant CV risk factors. Unfortunately, we were unable to assess the quality of data in screened papers and studies we choose because of the heterogenicity of the groups. The conducted studies had different endpoints and included different groups of patients in terms of nationality, age, race and clinical status. We decide to divide the main subjects of the research into separately described subtitles such as obesity, lipid profile, hypertension, diabetes, smoking. We believe that the studies we included and gathered are very interesting and show modern and present-day clinical data and approaches to COVID-19 infection in specific divisions of patients.

Background: Infertility in men has increased in recent years. Numerous physical, chemical, biological, and social factors are known to play a role in reducing semen quality, in between, there are high-risk behaviors that affect the quality of semen. In this paper, the effects of three factors: smoking, alcohol consumption, and drugs have been investigated. Methods: This case-control study was performed from June to September 2021 on 500 people, 250 people with normal semen quality and 250 people with defective semen quality. The data collection tool was a questionnaire made by researchers and semen test results. Finally, the collected data were analyzed by descriptive method with SPSS software. For quantitative variables, mean and standard deviation (SD) were used, while frequency and percentage reports were used for qualitative variables. Results: Drug use had a significant relationship with the shape and motility of sperm (B = -0.675, P = 0.005). The chance of natural semen decreases by 0.506 times with an increase of one drug use unit; moreover, the older the age of onset of drug use, the more the semen disorders (B = 0.514, P = 0.002).. Conclusion: Smoking and alcohol consumption were not identified as factors affecting semen quality, but there was a significant relationship between drug use and age of onset and semen disorders.

Introduction Although some research papers have suggested that smoking may increase mortality in patients with sepsis, no evidence has been produced in this regard. This systematic research evaluated the risk of death in patients with sepsis who were smokers to facilitate better clinical decision making. Material and Methods This is a systematic review registered in PROPERO (CRD42022296654). Searches were conducted to identify suitable studies from the databases of PubMed, Embase, Web of Science and the Cochrane Controlled Register of Trials from January 1980 to June 2021. Two independent reviewers screened the articles using keywords and extracted the data. The Newcastle–Ottawa Scale (NOS) was used to evaluate the quality of evidence. The primary endpoints included the mortality of patients with sepsis. Results Five studies involving 2694 participants were included in our study. Among the five included articles, three studies had an NOS score of 6, while the other two had an NOS score of 7. The results showed that a significantly higher risk of death was observed in smokers with sepsis compared with non-smokers with sepsis (hazard ratio, HR=1.62; 95% CI: 1.11–2.37, p=0.01). Among the patients followed for more than 2 months, the mortality rate of smokers was significantly higher (2.33 times) than that of non-smokers (HR=2.33; 95% CI: 1.83–2.96, p

ObjectiveBipolar disorder (BD) is a highly prevalent, chronic and recurrent mental illness. The smoking rates in patients with BD are much higher than those of the general population, and BD is associated with an increased risk of suicide. An association between smoking and suicidal behavior has been found in the general population, this systematic review examines whether there is evidence of an association between smoking and suicide behavior in patients with BD.MethodA database search was carried out in Medline, Embase, The Cochrane Library, Scopus, and Web of Science, updated until December 31st, 2021, according to the 2020 PRISMA guidelines. We identified prospective and retrospective studies that included patients diagnosed with BD types I, II, and not otherwise specified, and in which smoking and suicidal behavior were correlated. Articles that focused exclusively on other mental disorders were excluded. The Ottawa-Newcastle scale was used to assess the methodological quality of the included articles.ResultsFifteen articles (n = 7,395) met all the inclusion criteria. In nine of these articles, the authors found an association between smoking and suicidal behavior in BD, while in the remaining six articles, this association was not found. A great deal of variability was observed between articles, particularly in the measurement of suicidal behavior and tobacco consumption. The risk of bias, as assessed by the NOS, was high for most of the included articles, except for two papers, whose risk was low.ConclusionIt was not possible to establish a clear relationship between tobacco use and the risk of suicide in BD patients due to the heterogeneity of the articles included in this systematic review, which had different sample sizes and methodological issues. However, both conditions are highly prevalent and have a negative impact on the prognosis of BD. Therefore, a systematic approach is needed, based on accurate measurement of a patient’s smoking habits and their risk of suicidal behavior, in order to establish an appropriate therapeutic plan.Additional informationThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors and was registered on PROSPERO with the CRD42022301570 on January 21th 2022.

Periodontal disease is believed to be an opportunistic infection due to the interaction of bacterial plaque and the patient’s response that may be influenced by environmental, genetic, and other risk factors. In addition to the fact that smoking is considered a risk factor in many systemic diseases, it has also been associated with the initiation of periodontal disease. Smoking is one of the modifiable risk factors and has a significant influence on the development, progress, and results of the treatment of periodontal disease. The current state in the field of study suggests that smoking aids the colonization of periodontal microorganisms, accelerating the onset of periodontal disease. Biological modifications in pathogens, such as Porphyromonas gingivalis, along with poor immune response, influence the variations of subgingival flora in smoking patients. Only with an individual approach can the risk factors of each patient be identified and satisfactory results obtained. The aim of this paper is to present a comprehensive review of the influence of smoking on periodontal microbiome and the importance of adopting the appropriate treatment method according to the influence of this risk factor on healing.

Objective The aim of this paper was to examine smoking-specific norms and practices to understand the meaning of social context for young adolescent’s perception of tobacco use. The analysis of the social context was informed by the Collective Lifestyle framework and draws on concepts like place-based smoking, structure and agency. Methods This paper draws from an ethnographic study of smoking-specific norms and practices. We conducted eight focus group interviews with a total of 44 adolescents and 28 days of field observations among grade 8 students at two Danish schools. Results Our analysis suggests that adolescents’ smoking-related practices and hence meaning of smoking differs according to the social context they engage in. The social context contributes to the way adolescents smoking unfold in specific places by specific groups of adolescents. Herby suggesting that smoking becomes an object contributing to social exclusion. Conclusions Future interventions and tobacco control initiatives targeting young adolescents should consider the meaning of the social context for creating places to practice smoking.

Introduction: Till 2016, India was the second largest consumer of tobacco in the world, second only to China. However, in June 2017, the factsheet release of Global Adult Tobacco Survey-2 showed a 6% point decline in the prevalence of tobacco use among adults (>15 years) in the country. Materials and Methods: This is a form of ecological study where trends in aggregate prevalence of tobacco use at country level (using secondary data) were studied in relation to corresponding policy actions over a period of two decades. Results: The results have shown that initial policy actions since the cigarettes act of 1975 till prevention of food adulteration Amendment act of 1995 were largely targeting cigarettes, and so smoking prevalence among men was constantly declining. On the other hand, smokeless tobacco use was increasing among both men and women and reached a peak in 2009–2010. After that, the government took strict policy actions including Food Safety and Standards Authority of India Gutka ban in 2011. There were other persistent efforts, which are discussed in this paper. As a result, a transition has occurred in relation to tobacco epidemic in India. Conclusion: The paper has been concluded with a note that there is no room for complacence and we have a noncommunicable disease action goal to further decline the prevalence of tobacco use in the country to

Lung cancer screening trials using low-dose computed tomography (LDCT) show reduced late-stage diagnosis and mortality rates. These trials have identified high-risk groups that would benefit from screening. However, these sub-populations can be difficult to access and retain in trials. Implementation of national screening programmes further suggests that there is poor uptake in eligible populations. A new approach to participant selection may be more effective. Electronic medical records (EMRs) are a viable alternative to population-based or health registries, as they contain detailed clinical and demographic information. Trials have identified that e-screening using EMRs has improved trial retention and eligible subject identification. As such, this paper argues for greater use of EMRs in trial recruitment and screening programmes. Moreover, this opinion paper explores the current issues in and approaches to lung cancer screening, whether records can be used to identify eligible subjects for screening and the challenges that researchers face when using EMR data.

The present paper aims to illustrate the main particularities of tobacco product consumption in the city of Resita, in a period of time when smoking has proven to be a very largely extensive habit. Even though the law has become more restrictive during the last two years, the limitations of smoking in public did not determine people to give up this vice, at a larger scale. The first part of the paper presents general aspects regarding smoking, as well as an analysis of statistical data reffering to the spendings in this field, while the second part consists in a study conducted on respondents in the city of Resita, with the purpose of determining their preferences and attitude towards smoking in general and tobacco products in particular. Based on recent considerations, there is also a relatively modest percentage of people who forecast a decrease in the number of smokers in the future, namely a market constraint. Thus, the business in this field has a great potential of development, even if the health of consumers is at great risk. The number of smokers is increasing, especially in developing countries and the underdeveloped ones, partly due to less education on the negative effects of tobacco use.

Abstract Background Smoking inequalities in Turkey were previously demonstrated in an early stage of the smoking epidemic model. This paper aimed to assess the trends for socioeconomic inequalities in smoking in Turkey over the years in the context of the smoking epidemic model using data from the Global Adult Tobacco Survey (GATS) Turkey 2008–2012-2016. Methods Cross-sectional data were analyzed to calculate the association of smoking with, wealth, education, occupation and place of residence using age-standardized prevalence rates, odds ratios, relative index of inequality (RII) and slope index of inequality (SII). The analysis was performed separately for age groups (younger: 20–39 years/older: 40 and above years) and sex. Results Younger women with higher wealth and older women with higher wealth and education smoked more. For both age groups, smoking was increased for working class and urban women. Relative wealth inequalities in smoking narrowed and then showed a reversal for younger women (RII2008 = 3.37; 95% CI:1.64–3.40; RII2012 = 2.19; 95% CI:1.48–3.24; RII2016 = 0.80; 95% CI:0.58–1.10, p-for trend

Lifestyle factors are known to be influential determinants of health. According to the World Health Organization (WHO), approximately one third of deaths involve unhealthy lifestyle habits. Among lifestyle risk factors for head and neck cancers (HNC), alcohol consumption and smoking have an undeniable role in the multifactorial aetiology of the disease. In recent years, the promotion of healthy lifestyle choices has gained significant attention as contributory to improving health and disease prevention. Interventions to tackle these risk factors are vitally important in disease prevention and progression. However, in order to effectively prevent the disease and reduce the risk factors, it is crucial to identify what upstream reasons lead to the adoption of these lifestyle risk factors in the first place. Stress being a constant aspect of modern-day life is known to contribute to alcohol and smoking practices. In this review paper, relevant literature was searched in PubMed database for stress, lifestyle factors, HNC and cancer to explore the role of stress and its associated biological pathways as an upstream factor in the adoption of lifestyle risk factors that cause HNC. It highlights the importance of stress pathways and the Hypothalamus Pituitary Adrenal (HPA) axis as a locus of interaction between stress, alcohol, smoking and cancer. Despite their widely accepted harmful effects, alcohol and smoking remain deeply rooted in contemporary life. A greater understanding of the impact of stress on lifestyle choices and an exploration of the mechanisms resulting in stress, alcohol- and smoking- related cancer may highlight opportunities for improved prevention measures through the modification of unhealthy lifestyle choices.

Abstract Background It is of significance to look into the intergenerational transmission of risk behaviour to explain the disparity of health. Our paper contributes to the literature by providing evidence in the context of China, focusing on smoking behaviour. Methods This paper studies the intergenerational transmission of smoking in the context of China using a nationally representative dataset – the China Health and Nutrition Survey (CHNS). The two-part model, the Tobit model, and the fixed effects model are utilized for the empirical analysis, respectively. Results We found a strong intergenerational persistence of health behaviour. That is, parents’ smoking behaviour is positively correlated with their children’s smoking initiation. Conclusions Our study provides evidence of the intergenerational persistence of health behaviour in the case of smoking, in the world’s most populous country. This has policy implications for the issue of intergenerational mobility and health education, as well as for tobacco control in China.

This paper proposes a new quantile regression model to characterize the heterogeneity for distributional effects of maternal smoking during pregnancy on infant birth weight across different the mother's age. By imposing a parametric restriction on the quantile functions of the potential outcome distributions conditional on the mother's age, we estimate the quantile treatment effects of maternal smoking during pregnancy on her baby's birth weight across different age groups of mothers. The results show strongly that the quantile effects of maternal smoking on low infant birth weight are negative and substantially heterogenous across different ages.

The paper focuses on examining peculiarities of risk factors causing cardiac infarction at a young age. Although cardiac infarction primarily occurs among patients older than 45, its frequency at a young age has been growing recently. Risk factors that cause cardiac infarction at a young and old age are quite different. Examining risk factors profiles in different age groups provides wider opportunities for implementing primary and secondary prevention strategies aimed at reducing frequency and negative outcomes of ischemic heart disease. 108 patients aged from 18 to 45 and 35 patients aged from 60 to 75 took part in the research; they all had confirmed cardiac infarction with or without rise in ST segment and were treated in a regional center for cardiovascular pathology treatment in a period from January 01, 2017 to January 01, 2019. Basic risk factors of cardiac infarction were assessed when a patient was admitted to a clinic for treatment. The research results indicate high prevalence of risk factors that could cause ischemic heart disease among young patients. 92.2 % young patients have dyslipidemia, 70.2 % smoke, 68.5 have low physical activity, 68.2 % suffer from overweight and obesity, 58.8 % have arterial hypertension, 7.4 % suffer from type II pancreatic diabetes, and disorders in tolerance to carbohydrates was reveled in 15.7 % cases. Such factors as male sex (85.2 vs. 37.1 %, р=0,000), smoking (70.2 vs. 20.6 %, р=0.000) and burdened heredity as per early ischemic heart disease occurrence (54.6 vs. 16.0 %, р=0.001) were significantly more frequent among young patients than among older ones. Data obtained via the present research allowed creating risk factors profile for cardiac infarction associated with cardiac infarction occurrence at a young age; this profile included such factors as male sex, early ischemic heart disease occurrence in family history, and smoking.

Abstract Background Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) implementation framework, a National Institutes of Health-sponsored study compared the nurse-administered Tobacco Tactics intervention to usual care. A prior paper describes the effectiveness of the Tobacco Tactics intervention. This subsequent paper provides data describing the remaining constructs of the RE-AIM framework. Methods This pragmatic study used a mixed methods, quasi-experimental design in five Michigan community hospitals of which three received the nurse-administered Tobacco Tactics intervention and two received usual care. Nurses and patients were surveyed pre- and post-intervention. Measures included reach (patient participation rates, characteristics, and receipt of services), adoption (nurse participation rates and characteristics), implementation (pre-to post-training changes in nurses' attitudes, delivery of services, barriers to implementation, opinions about training, documentation of services, and numbers of volunteer follow-up phone calls), and maintenance (continuation of the intervention once the study ended). Results Reach: Patient participation rates were 71.5 %. Compared to no change in the control sites, there were significant pre- to post-intervention increases in self-reported receipt of print materials in the intervention hospitals (n = 1370, p

This paper explores the incidence and individual determinants of smoking and alcohol drinking with a high prevalence among young people in Moldova. It goes beyond epidemiological approach and descriptive analysis and provides a sociological explanation for these risk-taking behaviours by linking them to local social context in which young people inhabit. The study is based on secondary data analysis of National Youth Survey of Moldova among 14-29 aged population (1112 respondents) carried out in 2016, commissioned by the EU-OECD Youth inclusion project and Ministry of Education, Culture and Research of the Republic of Moldova. Data were processed in SPSS. Multivariate analysis, adjusting for demographic co-variates was performed using logistic regression. The results of this study show that rates of male smoking and alcohol drinking are high, while rates in women are far lower. According to multivariate data analysis, gender and age are strong individual determinants for both health-risk practices. As well, another important predictor for these behaviors is young people’s educational level – those with lower education level were particularly likely to smoke and drink alcohol. The study revealed also a strong interrelation between these health-risk practices. In paper is argued that high prevalence of smoking and drinking in male may reflect a normative structure for male socializing. Taking into consideration that strongest predictor variable overall is male gender, and strong relationship between heavy drinking and smoking, these behavioral factors might be responsible for the increasing in premature deaths among males in middle age.

Medical disorders can affect dental health directly or indirectly. As psychiatric disorders are one of the most frequent diseases in dental patients, such patients form a special needs group, which require modifications and adjustments to the standard treatment protocols. Schizophrenia is a complex, chronic mental disorder, which involves behavioural and cognitive changes, disturbances in perceptions, and impairment of certain conscious functions. In its active phase, the symptoms include delusions, hallucinations, disorganized speech, and abnormal motor function. If a schizophrenic patient presents to a dental office, psychiatric consultation may be necessary. Usually, it is suggested that any elective dental treatment should be deferred until the patient’s symptoms are under control or in a state of inactivity. Side effects of the medications may affect the patient in an adverse way; thus, a careful monitoring by a psychiatrist is essential and forms a part of the recommended treatment approach. This paper will address a literature review of various concepts and recommendations for defining a suitable dental treatment plan for the patients with schizophrenia.

Background& Aim: Given the high rate of smoking around the world and in our country and prevalence of smoking among people, the family groups and youth at fertility age and from other side due to toxic substances in cigarette smoke and its effect on smokers and their surroundings, one should take substantial action about this hygiene problem. Apart that damaging himself and society, the smoker mars his surrounding environment, and as expert believe, the smoker not only extirpate his own life but also contribute to blot out the families. Methods & Materials: In this review study, firstly the search of registered papers in electronic sites have been examined, and the keywords related to this title has been used and 9 papers are assessed. Results: Findings suggest the positive effect of counselling of family based on BASNEF model on smoking of smokers living with pregnant women. Conclusion: One of the models used for change of people behavior is BASNEF model that is a complete and comprehensive model for behavior study and change. BASNEFF model considers the factors like beliefs, attitudes, social norms and enablers as effective for change behavior.

Background Smoking habit is often picked up at early ages. Therefore, studying the pattern of smoking prevalence among the youth is critical for tobacco control. This paper explores how perception of smoking changes over time among the youth in Nepal. The paper also analyzes how youth’s perception of smoking and the surrounding environment influences youth’s initiation of smoking. Methods The 2001, 2007 and 2011 Nepal Global Youth Tobacco Survey (GYTS) is used in this study. Logistic regression models are performed to examine various factors that affect initiation of cigarette smoking among the youth in Nepal. Results The three Nepal GYTS surveys demonstrate increasing trends in percentages of youth who find boys and girls that smoke more attractive and have more friends. In the same group, belief that smoking helps people feel comfortable in social gatherings has also gone up. Although an increasing proportion of youth believes smoking is harmful for smokers’ health, a decreasing trend is observed regarding the harmful effects of second hand smoking. Results from logistic regression models reveal that any form of positive perception of smoking increases youth’s chance of smoking initiation. Conclusions Findings of this paper demonstrate that over the years the perception of smoking has become more positive among the youth in Nepal. This is extremely alarming as positive perception of smoking leads to smoking initiation and eventually they become regular smokers at early ages. Awareness programs on harmful effects of smoking need to be designed to target the youth in order to educate them.

Abstract Background This systematic review of prospective longitudinal primary studies sought to determine whether electronic cigarette (e-cigarette) use by teenagers who had never smoked conventional tobacco cigarettes (tobacco cigarettes) at baseline was associated with subsequently commencing tobacco cigarette smoking. Methods The review followed the principles of a systematic review and meta-analysis. A key word search identified peer-reviewed articles published between 1 January 2005 and 2 October 2019 from seven bibliographic databases and one search engine. Using pre-prepared inclusion/exclusion criteria two researchers independently screened abstracts, and subsequently, full text papers. Selected articles were quality assessed in duplicate. Data on study participants characteristics, exposure and outcome measures were recorded in an adapted Cochrane Data Extraction Form. Feasibility assessment was done to detect clinical heterogeneity and choose an approach to meta-analysis. Analysis comprised pairwise random effects meta-analyses, and sensitivity and subgroup analyses. Results From the 6619 studies identified, 14 one-off primary studies in 21 articles were suitable for inclusion. The participants ages ranged from 13 to 19 years and comprised teenagers based in Europe and North America. Nine of the 14 one-off studies, with follow-up periods between 4 and 24 months, met the criteria for inclusion in a meta-analysis of the association between ever use of e-cigarettes and subsequent initiation of tobacco cigarette use. Based on primary study adjusted odds ratios, our meta-analysis calculated a 4.06 (95% confidence interval (CI): 3.00–5.48, I2 68%, 9 primary studies) times higher odds of commencing tobacco cigarette smoking for teenagers who had ever used e-cigarettes at baseline, though the odds ratio were marginally lower (to 3.71 times odds, 95%CI: 2.83–4. 86, I2 35%, 4 primary studies) when only the four high-quality studies were analysed. Conclusion The systematic review found that e-cigarette use was associated with commencement of tobacco cigarette smoking among teenagers in Europe and North America, identifying an important health-related harm. Given the availability and usage of e-cigarettes, this study provides added support for urgent response by policymakers to stop their use by teenagers to decrease direct harms in this susceptible population group, as well as to conserve achievements in diminishing tobacco cigarette initiation.

Albert Prats-Uribe,1 Junqing Xie,1 Daniel Prieto-Alhambra,1 Irene Petersen2,3 1Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine - Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK; 2Department of Primary Care and Population Health, UCL, London, NW3 2PF, UK; 3Department of Clinical Epidemiology, Aarhus University, Aarhus N, 8200, DenmarkCorrespondence: Daniel Prieto-AlhambraPharmaco- and Device Epidemiology, Centre for Statistics in Medicine - Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Windmill Road, Oxford, OX3 7LD, UKEmail daniel.prietoalhambra@ndorms.ox.ac.ukBackground: Several papers have shown contradictory evidence about the relationship between smoking and COVID-19-related deaths. There is little evidence about smoking and risk of infection. We aim to examine association between smoking and COVID-19 infection and subsequent mortality.Methods: This was a prospective study with participants from the UK Biobank cohort. Participants who lived in England were followed up from 01/02/2020 to 28/06/2020 with data linked to hospital episode statistics, Office for National Statistics and Public Health England PCR tests. We compared current-smokers, previous-smokers with never-smokers and estimated risk ratio (RR) of COVID-19 infection and subsequent mortality using Poisson regression adjusting for age, sex, ethnicity, body mass index and socio-economic status. Interactions between smoking status and age and sex were tested for using multiplicative interactions, and analyses were stratified by median age (49– 68 years, 69– 86 years) and sex.Results: In total, 402,978 participants were included in the analyses. The majority were never smokers, 226,294 (56.2%), 140,090 (34.8%) were previous smokers, and 39,974 (9.9%) current smokers. COVID-19 infection was identified in 1591 (0.39%) people, and 372/1591 (23.4%) died. Amongst the younger participants, smokers were nearly twice as likely to become infected with COVID-19 than never smokers (RR 1.88 [1.49– 2.38]) whereas there was no difference for those aged 69+ (RR 1.05 [0.82– 1.34]). In contrast, amongst the older participants, smokers were twice as likely to die from COVID-19 compared to non-smokers (RR 2.15 [1.11– 4.16]) whereas there was no difference for those under the age of 69 (RR 1.22[0.83– 1.79]). Similar patterns were observed for previous smokers. The impact of smoking was similar in men and women.Conclusion: The association between smoking and COVID-19 infection and subsequent death is modified by age. Smokers and previous smokers aged under 69 were at higher risk of COVID-19 infection, suggesting the risk is associated with increased exposure to SARS-COV-2 virus. Once infected, older smokers were twice as likely to die from COVID-19 than never smokers, possibly mediated by increased risk of chronic conditions/illnesses.Keywords: smoking, COVID-19, UK Biobank

Abstract Background Graphic Health Warnings (GHWs) on cigarette packages were first introduced in Canada in 2001 and will become mandatory in the US as of January 2022. While previous studies have evaluated the impacts of GHWs, the data used in these studies have several shortcomings. The objective of this paper was to investigate the likely impact of such warnings in the US based upon the experience of Canada using hitherto unexplored monthly cigarette sales data, and to explore if alternative approaches involving risk-reduced products might be more successful in reducing smoking. Methods We used quasi-experimental segmented regression and difference-in-differences analyses. Data on monthly sales (i.e., shipments) of cigarettes from Canadian manufacturers to Canadian retailers during 1995–2005 were obtained from Statistics Canada. Results We found that GHWs did not have a significant impact on the sales of cigarettes in Canada. We propose an alternative type of graphical health messaging that actively combines information on how to quit with the legally required messaging. The novelty of the proposal is that it is incentive compatible for the supply side of the market and if adopted in several states, the measure could be tested by using a suitable treatment–control design. Conclusions Our findings imply that we should not expect any notable decline in sales or consumption as a result of implementation of GHWs in the US. The main impact of GHWs will be to add to the anti-smoking culture that has grown steadily over several decades, and this may impact smoking in the longer term.

Abstract Background Nicotine vaping products (NVPs) are increasingly popular worldwide. They may provide public health benefits if used as a substitute for smoking, but may create public health harms if used as a gateway to smoking or to discourage smoking cessation. This paper presents the Smoking and Vaping Model (SAVM), a user-friendly model which estimates the public health implications of NVPs in the USA. Methods SAVM adopts a cohort approach. We derive public health implications by comparing smoking- and NVP-attributable deaths and life-years lost under a No-NVP and an NVP Scenario. The No-NVP Scenario projects current, former, and never smoking rates via smoking initiation and cessation rates, with their respective mortality rates. The NVP Scenario allows for smoking- and NVP-specific mortality rates, switching from cigarette to NVP use, separate NVP and smoking initiation rates, and separate NVP and smoking cessation rates. After validating the model against recent US survey data, we present the base model with extensive sensitivity analyses. Results The SAVM projects that under current patterns of US NVP use and substitution, NVP use will translate into 1.8 million premature smoking- and vaping-attributable deaths avoided and 38.9 million life-years gained between 2013 and 2060. When the NVP relative risk is set to 5%, the results are sensitive to the level of switching and smoking cessation rates and to a lesser extent smoking initiation rates. When the NVP relative risk is raised to 40%, the public health gains in terms of averted deaths and LYL are reduced by 42% in the base case, and the results become much more sensitive to variations in the base case parameters. Discussion Policymakers, researchers, and other public health stakeholders can apply the SAVM to estimate the potential public health impact of NVPs in their country or region using their own data sources. In developing new simulation models involving NVPs, it will be important to conduct extensive sensitivity analysis and continually update and validate with new data. Conclusion The SAVM indicates the potential benefits of NVP use. However, given the uncertainty surrounding model parameters, extensive sensitivity analysis becomes particularly important.

Abstract Objective Although children from language backgrounds other than English (LBOTE) may be disadvantaged in English-reliant exams, they outperform children from an English language background (ELB) on many Australian National Assessment Program–Literacy and Numeracy (NAPLAN) assessments. Maternal alcohol and tobacco use during pregnancy and/or breastfeeding have been associated with poorer cognitive and academic performance. Using data from the Growing Up in Australia Study, this paper aimed to identify demographic, lifestyle, and prenatal and perinatal risk differences related to maternal tobacco and alcohol use between LBOTE and ELB groups, as a first step in trying to understand the academic performance differences. Results Only data from breastfed babies was included in the current analyses. Although LBOTE children were disadvantaged in several demographic areas, their NAPLAN performance was the same or superior to ELB children across all Grade 3 and 5 NAPLAN assessments. The LBOTE group were, however, breastfed for longer, and their mothers smoked fewer cigarettes and drank less alcohol on fewer occasions throughout their pregnancy. The LBOTE mothers also had lower or less risky patterns of alcohol consumption while breastfeeding. The longer breastfeeding duration of LBOTE children combined with lower maternal use of alcohol and cigarettes during pregnancy and/or breastfeeding may partially contribute to their exceptional NAPLAN performance.

Adolescents use cigarettes without considering the consequences and lack awareness about the dangers of using cigarettes. Peer group support potentially motivates to quit smoking in adolescents. It can empower group members by providing a role model to increase motivation. This paper analyzes the effect of peer group support on motivation to quit smoking among adolescents. It was quasi-experimental research with a post-test and pre-test one-group design. The population was smoking adolescents. In addition, there were 37 respondents with purposive sampling. The inclusion criteria were male teenagers aged 12-16 years and active smokers. The independent variable was peer group support, and the dependent variable was motivation to quit smoking. The instrument to assess motivation to quit smoking was the Richmond Test. Data analysis utilized paired t-test with α=0.05. There was an increase in the mean value of motivation to quit smoking before and after the intervention. In addition, paired t-tests obtained p=0.030 (p< 0.05), indicating a significant difference in pre-test and post-test. Thus, there was an effect of peer group support on adolescents' motivation to quit smoking. In conclusion, peer group support can increase adolescents' motivation to quit smoking. Nurses could enhance motivation for smoking cessation through peer support interventions so there is a change in smoking behavior in adolescents. Further study should use a control group and a larger sample size.

Objective:This meta-analysis aimed to identify the sleep quality between smokers and non-smokers within Turkish research published in the last 10 years. Turkish studies on the sleep quality and smoking published from 2010 to 2020 in the national thesis centre were systematically screened. The effect size was calculated according to the odds ratio and analysed with CMA V3 program. Cochrane Q statistics and I2 value for heterogeneity analysis and funnel plot, Egger’s Linear Regression test, Begg and Mazumdar rank correlations statistics, trim-and-fill method for publication bias were performed. Of 132 papers in ten years, 26 coding on smoking and good sleep quality were evaluated using a forest plot graph. By using the fixed effects model, a small effect in favour of good sleep quality (d=1.697, 95% confidence interval 1.501- 1.920, p=0.000) was found in non-smokers. Heterogeneity test and I2 value found a significant and moderate heterogeneity between studies (Q=59,672, p=0.000, I2=58,104). In the subgroup analysis, the mixedgender group (p=0.001 I2=55,807) and medicine field studies (p=0.001 I2=60,874) had a moderator role. No study had significantly found that non-smokers had poorer sleep than smokers (p>0.05). The results suggest that one of every four people is a smoker, and one of every two people had a poor sleep quality. Moreover, 69.7% of the non-smokers (approximately 1.7 times) had a better sleep quality than smokers. Promoting smoking cessation for good sleep has been proposed based on national research data.