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Background: Determine the impact of tobacco smoking status on patients hospitalized with COVID-19 pneumonia in the need for ICU care, mechanical ventilation and mortality. Methods: We performed a retrospective cohort study, that involved chart review. All adults 18 years or older with a diagnosis of COVID-19 pneumonia hospitalized from March 15th, 2020 to May 06th, 2020 with a positive reverse transcription polymerase chain reaction (RT-PCR) nasopharyngeal swab for COVID-19. We used chi-squared test for categorical variables and student t-tests or Wilcoxon rank sum tests for continuous variables. We further used adjusted and unadjusted logistic regression to assess risk factors for mortality and intubation.Results: Among 577 patients hospitalized with COVID-19 pneumonia, 268 (46.4%) had a history of smoking including 187 former and 81 active smokers. The former smokers when compared with non-smokers were predominantly older with more comorbidities. Also, when compared with never smokers D Dimer levels were elevated in active (p=0.05) and former smokers (pConclusions: In our cohort of hospitalized patients with COVID-19 pneumonia, former smokers had higher need for non-invasive respiratory support on admission, ICU care, and mortality compared to non-smokers. Also, active smokers versus non-smokers needed more mechanical ventilation.

Background Chronic opioid users pose a unique challenge for orthopedic surgeons, as they often report suboptimal outcomes following total knee arthroplasty (TKA). We aim at identifying risk factors associated with patients who were preoperative chronic opioid users and continued to use 6 months following TKA. Methods All preoperative chronic opioid users among 338 consecutive TKA cases performed at our institution between February and June 2016 were identified and divided into 2 cohorts: patients who (1) persistently used opioids and (2) discontinued use by the 6-month time point following surgery. Baseline characteristics were compared between cohorts in order to determine risk factors for persistent opioid use following TKA. Results Of the 338 patients, 53 (15.7%) were identified as preoperative chronic opioid users. Of these, 23 (43.4%) continued chronic opioid use 6 months following surgery, whereas 14 (4.9%) previously nonchronic users were identified as new chronic users at 6 months. Characteristics that were predictive of persistent opioid use included male gender, prior injury or surgery to the ipsilateral knee, current tobacco smoking status, and a history of psychiatric disorder. Opioid dose consumption of ≥12 mg/d morphine-equivalents over the 3 months leading up to surgery had an increased risk of persistent chronic opioid use by a factor of 6. Conclusion TKA candidates who have complicated medical, social, and surgical histories are at an increased risk of chronic opioid abuse postoperatively. By better understanding the risk factors associated with persistent chronic opioid use, targeted opioid reduction programs may be appropriately implemented to manage this high-risk population.

BACKGROUND: Article 11 of WHO-FCTC strategies emphasize the need for countries to include health warnings on packages of tobacco products. This study aims to assess Jordanian people, aged 13 years and above knowledge and beliefs about the inclusion of health warning labels on waterpipe tobacco packages. METHODS: A descriptive cross-sectional approach was conducted among youth and adults aged 13 years and above. The sample was recruited from public schools, universities, and a governmental public service agency. Data collection was done through an electronic survey using Tablets. RESULTS: A total of 1067 participated in the study, with ages ranging between 13– 63 years old with a mean (20.9, SD= ± 6.1). Study participants mainly consisted of students making (86.7%) of the total sample. These students were in secondary education school (19.3%) or attending university (67.4%). Findings indicated that participants tobacco smoking status were non-smokers, single type smoker, dual smoker, and triple smokers (67.8%, 21.6%, 6.8%, and 3.7% respectively). In comparison the prevalence of smoking single tobacco type, dual smoking, and triple smokers tobacco products was statistically higher among males than females (11.1%-10.6%, 5.1%-1.8%, and 3.1%-0.7% respectively). Eighty-seven percent knew that waterpipe smoking is harmful and would support the inclusion of health warnings on the tobacco packet. Thirty percent indicated that the inclusion of health warnings will greatly improve their knowledge of the harmful effects of tobacco smoking. CONCLUSION: The current study shows that participants believe including health warnings on waterpipe tobacco package would help smokers to think about quitting.

BACKGROUND: Waterpipes (WP) have a long tradition in certain regions of the world, and their use has been increasing worldwide. Current data on the use of WP in different subgroups of the German population are missing.; OBJECTIVE: To estimate the current prevalence of WP use and associated socio-demographic characteristics, tobacco smoking status and e-cigarette usage behaviour in the German population aged ≥14years; to describe the frequency of use and starting age in current WP users.; METHODS: We analysed data from waves 13-18 (June/July 2018-April/May 2019; N=12,220) of the German Study on Tobacco Use (DEBRA) - a representative, computer-assisted national household survey. Associations of socio-demographic characteristics, tobacco smoking status and e-cigarette usage behaviour were assessed with multivariable logistic regression models.; RESULTS: A total of 1.8% (n=217) (95% confidence interval (CI)=1.5%-2.0%) of the population were current WP users, 13% (n=1618) (95% CI=12.3%-13.5%) were ever users. Adjusted multivariable logistic models showed that people with migration background, male sex, younger age, and those who were smokers or used e-cigarettes, were more likely to use a WP. Among current WP users, 15.2% (n=33) (95% CI=10.7%-20.7%) had started to use WP at the age of 26 or older, and 23.0% (n=50) (95%CI=17.6%-29.2%) had used WP at least once a week or almost daily in the last month.; CONCLUSIONS: In Germany, the use of WP is popular and most strongly associated with migration background and use of tobacco and e-cigarettes. These aspects should be considered when designing future target group-specific prevention strategies. Copyright © 2020 Elsevier Ltd. All rights reserved.

Background: Tuberculosis is among the major causes of illness and death worldwide especially in Asia. Smoking is associated with recurrent tuberculosis and its related mortality. Also, it could affect clinical manifestations, bacteriological conversion and outcome of treatment. This study aimed to evaluate the pattern of tobacco smoking, history of previous quit attempts and attitude towards quitting in tuberculosis patients. Materials and Methods: It was a cross-sectional study done amongst tuberculosis patients presented to DOTS corner of Rajshahi Medical College Hospital. 315 patients entered the study as "First Come First Serve". Selfreported questionnaires were designed according to the standard questionnaires of smoking pattern. Results: Sixty one percent (61%) patients (n=192) were smoker before the diagnosis of tuberculosis. 51.1% were current smokers at the time of interview and were continuing smoking after the diagnosis of tuberculosis. Only 10.2% discontinued smoking after diagnosis. 68.2% smokes less than 10 cigarettes per day. 53.1% was between 31-50 age group. 21-30 is the commonest age group (62%) to start smoking is and 66.1% smoked less than 10 years before diagnosis. To reduce stress was the most common cause to continue smoking (48.9%). 71.9% smokers showed keen interest to stop smoking. Conclusion: Considering the prevalence of smoking in tuberculosis patients, evaluation of tobacco smoking status in such patients and motivating them to quit smoking could be considered as important steps in their treatment process. Chatt Shi Hosp Med Coll J; Vol.15 (1); Jan 2016; Page 22-25

Background: The authenticity and true status of tobacco use, especially in the form of smoking among the patient clientele is always a matter of concern for their physicians. Objectives: The purpose of this study was to assess the authenticity of self-reported habit of tobacco smoking among a population sample of male respondents in rural India. Methods: Respondents were asked to complete oral questionnaires that assessed their status of tobacco smoking (if any) as well as duration of tobacco smoking, type of tobacco smoking, and frequency of tobacco smoking. Subsequently, exhaled breath carbon monoxide analysis was performed to detect their amounts of exhaled carbon monoxide. Results: In 175 respondents, the Smoke Check color indicators were significantly different (P < 0.0001) in the respondents who were diagnosed smokers per oral questionnaires (n = 92) versus diagnosed nonsmokers per oral questionnaires (n = 83). The probability statistics of authenticity of oral questionnaires for assessing smoking status showed that self-reporting was only 75% sensitive and 76% specific with 80% positive predictive value and 70% negative predictive value. Conclusion: True status of tobacco smoking with exhaled breath carbon monoxide analysis can be an easy clinical maneuver with community health screening and health promotion implications among patient populations in rural India.

AE is one of the most significant prognosis determinants in patients (pts) with COPD. Searching for specific biomarker, which could predict the risk of AE is still in progress. SP-D is a lung derived protein that suggests being specific marker for respiratory system injury. Aim: to evaluate influence of plasma SPD concentration in stable COPD pts on the AE rate. Study population: 44 stable pts with COPD (GOLD I-IV) made the study sample. Methods: AE history during past year, post-bronchodilator spirometry (by Masterlab, Viasis), plasma SPD (by ELISA, HycultBiotech) were evaluated in all pts. Results: Among 44 COPD pts, 12 (27.27%) had no any AE during past year (Group I), 32 (72.73%) had at least one AE during last 12 month (Group II). Both groups were similar regarding to age, sex, tobacco smoking status and the pulmomary function tests data. At the same time SPD concentration was significantly (p=0.007) higher in group II (919,66 [443,61-1216,61] ng/dl) in comparison with group I (466,97 [332,17-541,85] ng/dl). Statistically significant (p=0.002) positive correlation (R=0.460) was found between plasma SPD and AE rate. Conclusion: Measuring of plasma SPD concentration in COPD pts could be useful for prediction of AE.

Aim: This study examined alcohol and tobacco consumption trends among a national sample of Australian health care workers between 1989 and 2005.Method: Alcohol and tobacco smoking data specific for physicians and nurses was obtained during four national health surveys. Data were analysed by alcohol consumption level, tobacco smoking status, job category and year of study. The relative risk of substance use between physicians, nurses and the general Australian population was also evaluated.Results: The proportion of Australian physicians and nurses with risky alcohol consumption habits appears to have fluctuated over time, particularly among nurses. Although tobacco smoking among Australian nurses has declined in recent years, the relatively low proportion of physician smokers remained fairly stable over the same time period. Both professional groups were considerably less likely to use tobacco when compared with the general population.Conclusion: This study provides one of the first clear insights into lo...

Introduction There is strong interest in the use of electronic cigarettes (e-cigarettes) globally. This paper is the first to report population-based data on ever-use and current use of e-cigarettes among New Zealand adults. The paper also extends previous international studies by exploring the reasons for trying e-cigarettes, ever users' recall of brand(s) they have ever tried, and current users' recall of their current brand. Methods The Health and Lifestyles Survey (HLS) is a biennial face-to-face in-house survey of New Zealand adults aged 15 years or over. In 2014, 2594 participants completed the survey. Results Ever-use and current use of e-cigarettes were 13.1% and 0.8% respectively. Tobacco smoking status predicted the use of e-cigarettes, with current smokers reporting the highest rate of use (50% ever-use and 4% current use). Among current smokers who had tried an e-cigarette, curiosity (49%) and desire to quit smoking (37%) were the most common reasons for trying. About half of the ever-users could not name any of the brand(s) they had ever tried, and one-fifth of current users could not name their current brand. Conclusions Compared with other countries, New Zealand has a high rate of ever-use. Among current smokers, one in two had tried an e-cigarette. However, progression to regular use appears to be rare. The finding that 18% of current e-cigarette users could not name their current brand highlights the importance of investigating users' knowledge of e-cigarettes in general and assessing the factors that influence brand choice such as advertising, price, and accessibility.

Limited data are available from Jordan examining patterns of tobacco use among adolescents, or how use is related to health perceptions. This study aims to estimate the prevalence of tobacco use and to assess the relationship between use and health-related perceptions. A cross-sectional survey was conducted among a sample of 11–18 year old school students from a major governorate in Jordan. Using a multistage random sampling 1050 students were selected. Students were categorized as non-smokers, cigarette-only smokers, waterpipe-only smokers, or dual smokers. Rates of waterpipe-only and cigarette-only smoking were 7% and 3%, respectively, and were similar for boys and girls. In contrast, the rate of dual use was much higher than for single product use and was double in girls compared to boys (34% vs. 17%). Dual-smokers were significantly more likely to think that it is safe to smoke as long as the person intends to quit within two years compared to non-smokers, and had lower self-rated health status than other groups. This is the first study among Arab adolescents to document high rates of dual tobacco use, especially pronounced among girls. The study findings have significant implications for designing tobacco smoking prevention programs for school health settings.

This study aimed to explore factors associated, specifically belief factors, with self-reported tobacco smoking status. A sample of 300 students was recruited from a private university in Malaysia. Data was collected using a pre-tested self-administrated questionnaire that investigated various factors including socio-demographics, socio-economic status, smoking behavior and beliefs on tobacco smoking. The main tobacco use in this study sample was cigarettes and the estimated prevalence of self-reported cigarette smoking was 10.3%. In bivariate analysis, self-reported cigarette smoking was significantly associated with socio-demographic, behavioral factors and faculty of study (P

Depressiveness and tobacco use in adolescents are linked, however, there is limited evidence about the cognitive mediators involved and how the role of mediators may differ by gender and racial/ethnic subgroups.We used a racially/ethnically diverse population-based cross-sectional sample of middle and high school students (n=24,350). Logistic regression models measured the associations of depressiveness with tobacco smoking status, and whether smoking-related knowledge and attitudes (KA) and smoking refusal self-efficacy (SE) attenuated the associations indicating preliminary evidence of mediation.Depressiveness was associated with intention to smoke (OR=2.41; 95% CI=2.22, 2.61), experimental smoking (OR=1.93; 95% CI=1.72, 2.17) and established smoking (OR=1.85; 95% CI=1.57, 2.18). The percent attenuation of these associations due to the inclusion of smoking-related KA and smoking refusal SE was 58% for intention to smoke (p0.001), 68% for experimental smoking (p0.001) and 86% for established smoking (p0.001). The association of depressiveness with established smoking did not remain statistically significant (OR=1.16; CI=0.97, 1.40) after including smoking-related KA and smoking refusal SE. Attenuation was more pronounced in males and white students.The results suggest that smoking-related KA and smoking refusal SE attenuated the relation between depressiveness and smoking, indicating that they may serve as mediators of the link between depressiveness and smoking. Tobacco use prevention programs targeting teens with the aim of increasing anti-smoking KA and smoking refusal SE may benefit from addressing depressiveness, particularly by using gender and racially/ethnically tailored strategies. The cross-sectional nature of the data precludes causal inferences.

SETTING: Waterpipe smoking is becoming a global health crisis among youth. OBJECTIVE: To identify the prevalence of waterpipe use among Iranian university students and to explore perceived reasons for use. METHODS: A random sample of 1024 university students at two major universities in South Iran was enrolled in the study. A three-part questionnaire (baseline data, tobacco smoking status and perceived reasons for waterpipe use) was used. Students filled out the self-administered questionnaire in their classrooms. RESULTS: The prevalence of waterpipe smoking in the respondents' lifetime and in the last 30 days was 42.5% and 18.7%, respectively. The mean age at initiation of waterpipe smoking was 16.3 ± 3.2 years. Ever smoking was positively associated with age and male sex, whereas no association was found regarding marital status. The highest odds of lifetime waterpipe smoking were observed in students with close friends who smoked the waterpipe (5.94, 95%CI 4.26-8.30). The most important perceived reason for waterpipe smoking as stated by students was enjoyment (55.8%). CONCLUSION: Given the alarming prevalence of waterpipe smoking, preventive measures should be adopted among university students taking into account the influence of peers, siblings and parents in the lessening social tolerance of waterpipe smoking.

Objectives: The objective of the study was to compare prevalence rates of smoking in schoolgoing adolescents among urban, peri-urban, and rural districts. Design: Secondary analysis of the Zambia Global Youth Tobacco Survey (GTYS) data of 2007. Main outcome measure: Tobacco smoking status. Results: Totals of 2378 adolescents in Lusaka urban, 1756 in Kafue per-urban, and 1386 in Chongwe/Luangwa rural districts were enrolled into the study. Smoking rates were 10.5% in urban, 11.1% in peri-urban, and 13.5% in rural districts. After adjusting for age, sex, grade, parental and best friend smoking status, and knowing that smoking is harmful to health, compared to adolescents in Lusaka urban district, adolescents in Chongwe/Luangwa rural districts were 17% (AOR=1.17, 95%CI [1.10, 1.23]) more likely to smoke cigarettes. No significant difference in smoking rates was observed between adolescents in urban and peri-urban districts. Conclusions: The prevalence rate of smoking among adolescents was higher in rural than urban district. Antismoking interventions should be more targeted to adolescents in rural than urban areas.

Imprint culture and a mouthwash method were used to determine if quantitative differences exist between isolates of Candida albicans from individuals with healthy oral mucosa and from patients with erythematous candidosis (EC). The C. albicans isolated were differentiated by morphotyping. No quantitative difference in yeast isolations was observed with either technique irrespective of tobacco smoking status, the presence of a prosthesis, or EC. Multiple morphotypes were isolated from smokers with upper dentures and from smokers and non-smokers with EC, whilst a single morphotype was isolated from non-smokers with a healthy oral mucosa.

Objective. To determine what factors are associated with the smoking status among some of the spectators and participants of the 2002 North American Indigenous Games. Study Design. Cross-sectional. Methods. A survey inquiring about tobacco use and lifestyle behaviours was implemented at the North American Indigenous Games in Winnipeg, Canada. This survey, entitled the 2002 Aboriginal Youth Lifestyle Survey, included Aboriginal youth between the ages 12 to 22 years old. Results. There were 570 survey participants (53.5% female) that met the inclusion criteria. It was determined that smoking initiation began earlier than what is reported in the literature and did not occur beyond age 18. The logistic regression analysis revealed that the variables age,peer smokings, self-rated health, and participation status at the NAIG, were associated with smoking status in this sample. Conclusion. These findings demonstrate that Aboriginal youth require different tobacco control strategies compared to non-Aboriginal youth. While these youth experience similar risk factors associated with smoking status, based on the earlier initiation age, tobacco prevention needs to commence much earlier. This study also showcases the positive role that involvement in physical activity plays in building resiliency among Aboriginal youth. Keywords: Aboriginal youth, tobacco status, physical activity

A review of the periodontal literature offers little information concerning trends in referral patterns of patients for periodontal therapy. Over the last 2 decades, there has been a significant increase in the knowledge base concerning inflammatory periodontal disease. It might be assumed that the collective advances in knowledge have impacted periodontal referral patterns. Thus, the purpose of this study was to examine the differences in periodontal referral patterns in the same offices separated by a 20-year interval (i.e., 1980 and 2000).A retrospective chart analysis was conducted on a total of 782 patient charts from three conveniently selected periodontal practices. Charts were randomly selected from two time periods: 1980-1981 and 2000-2001. The following information was obtained from each patient record: gender, age at time of initial examination, tobacco smoking status at time of initial examination, periodontal case type, number of missing teeth at initial examination (not including third molars), and number of teeth scheduled for extraction per periodontal treatment plan. Descriptive data were analyzed using frequency distributions, measures of central tendency, and measures of dispersion. Non-parametric statistics were used to examine the relationship of disease severity as a function of site, time period, and patient age.The following trends were noted: 1) an increase in the average age of patients at the time of the initial examination; 2) a decrease in the percentage of patients using tobacco at the time of the initial interview; 3) an increase in the percentage of periodontal Case Type IV patients with a concomitant decrease in the number of periodontal Case Type II patients; 4) an increase in the average number of missing teeth per patient at the initial examination; and 5) an increase in the average number of teeth scheduled for extraction per periodontal treatment plan.Characteristics of patients referred in 1980 compared to those referred in the year 2000 indicate that, although fewer patients used tobacco, there were several noteworthy trends. At referral, patients exhibited a greater loss of teeth, had more severe disease, and required extraction of a greater number of teeth in 2000 compared to 1980. Possible reasons for these trends are discussed.

Serum and salivary cotinine levels were measured in 327 smoking and nonsmoking participants in a study of the health effects of marijuana with and without tobacco. These individuals had no reason to misrepresent their current tobacco-smoking status. The sensitivity, specificity, and predictive values positive and negative of the cotinine levels in distinguishing self-reported current tobacco smokers from nonsmokers was high (88-100%) and essentially the same for both fluids. Agreement between self-report and cotinine levels was not influenced by the presence or absence of marijuana smoking. A good correlation was found between serum and salivary cotinine levels in self-reported tobacco smokers (r = 0.84, p less than 0.001). Mean average levels were 279 +/- 144 ( +/- standard deviation) ng/ml for serum and 360 +/- 195 ng/ml for saliva. In a separate group of seven tobacco smokers, cotinine levels in saliva were found to be essentially independent of salivary flow rate. An analogous relationship has been observed by others for various compounds that are filtered to saliva from the blood. This may explain the close relationship observed between serum and salivary cotinine levels, and the observation made by others that the half-life of salivary cotinine is similar to that of serum cotinine.