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Mohammad A Jareebi Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi ArabiaCorrespondence: Mohammad A Jareebi, Email mjareebi@jazanu.edu.saBackground: Cigarette smoking is one of the world’s largest avoidable risk factors for morbidity and mortality. Numerous studies have investigated the association between smoking and hypertension (HTN). Although observational data and cross-sectional research often exhibit a link between smoking and HTN, establishing causation remains challenging owing to potential confounding variables. Mendelian randomization (MR), a genetic epidemiological technique that employs genetic variants as instrumental variables, offers a more robust approach for evaluating causal links. This review aimed to explore both the observational and causal relationships between smoking and the risk of HTN.Methodology: A comprehensive literature search across major electronic databases was conducted to identify relevant observational and Mendelian randomization (MR) studies on smoking and HTN risk. Various characteristics were included during study selection, such as study design, exposure assessment, and age range. Standardized processes were used for data retrieval and quality evaluation.Results: Analysis of observational data revealed a paradoxical association between smoking and the risk of HTN, where a lower risk was observed among current smokers when compared to non-smokers. However, observational analysis also presented a dose-response effect with greater smoking intensity showed a modest linear increase in HTN risk, and older smoking initiation was associated with a slight increase in HTN risk (compared with younger). In contrast, MR-based causal estimates provide inconsistent evidence regarding the causal relationship between smoking behavior and HTN. Some MR analyses indicated a potential causal link between smoking and HTN; but this was not consistent.Conclusion: Observational studies suggest a paradoxical association between smoking and HTN. However, MR studies do not provide sufficient evidence to establish a causal relationship. Regardless, lifestyle variables remain crucial for overall health. Healthcare professionals should regularly assess smoking status and provide counseling for quitting. Further research is needed to clarify the underlying processes, identify mediators, and evaluate the interventions.Keywords: smoking behavior, high blood pressure, hypertension, Mendelian randomization

PurposeThis study investigates the determinants of smoking behavior among young adults in Khuzestan province, southwest Iran, using two-level count regression models. Given the high prevalence of smoking-related diseases and the social impact of smoking, understanding the factors influencing smoking habits is crucial for effective public health interventions.MethodsWe conducted a cross-sectional analysis of 1,973 individuals aged 18–35 years, using data from the Daily Smoking Consumption Survey (DSCS) in Khuzestan province collected in 2022. A variety of count regression models, including Poisson, Negative Binomial, Conway–Maxwell Poisson, and their zero-inflated counterparts, were evaluated. The best-fitting model was selected based on goodness-of-fit indices.ResultsApproximately 90% of participants were non-smokers. Among smokers, the prevalence of light, moderate, and heavy smoking was 47.7, 19.0, and 33.3%, respectively. The two-level Zero-Inflated Conway–Maxwell Poisson (ZICMP) model provided the appropriate fit for the data. Key determinants of daily cigarette consumption included gender, age, education, and Body Mass Index (BMI). Men consumed 3.24 times more cigarettes per day than women. Higher education levels were inversely related to smoking intensity, with MSc/PhD holders having significantly lower smoking rates. Age and BMI also significantly influenced smoking behavior, with younger and obese individuals showing lower smoking rates.ConclusionThe use of advanced count models capable of handling numerous zeros and overdispersion is crucial for accurately analyzing trends in cigarette consumption across different population groups. The results indicate that factors such as older age, lower education levels, and gender differences influence smoking behavior. Therefore, prevention strategies aimed at delaying the onset of smoking, particularly among men, and promoting education among adolescents can effectively reduce smoking rates. However, further research should consider additional socioeconomic variables and encompass a broader age range to enhance the understanding of smoking behavior.

Introduction Perceptions, personal perspectives, and public awareness of e-cigarette information have a significant impact on e-cigarette smoking behavior, and provide comprehensive information that can help reduce interest in e-cigarette smoking and reduce the number of new smokers. This study aimed to investigate the perceptions towards e-cigarettes related to e-cigarette use and how that information related to people’s use of them. Methods The data for this cross-sectional study were collected via an online questionnaire. Thai nationals who were aged ≥18 years provided data between June 2021 and January 2022. Multivariable logistic regression and the chisquared test were used to analyze the data. Results There were 340 respondents, 76 e-cigarette users, and 264 non-e-cigarette users. Most of the perceptions of information that differed statistically significantly between e-cigarette users and non-e-cigarette users included information on regulations, products, health effects, and the effectiveness of smoking cessation. The association between factors and e-cigarette smoking behavior revealed that the perception of the product information and male gender were associated with e-cigarette smoking behavior (AOR=13.59; 95% CI: 2.35–78.60, and AOR=5.19; 95% CI: 2.87–9.40, respectively). Conclusions The perception of e-cigarette product information and male gender were associated with e-cigarette smoking behavior.

BackgroundImproper settings of outdoor smoking points in public places may increase the risk of secondhand smoke exposure among the population. Conducting research on air pollution in and around smoking spots and related influencing factors can provide valuable insights for optimizing the setting of outdoor smoking points. ObjectiveTo investigate the influence of the number of smokers at outdoor smoking points and the distance on the diffusion characteristics of surrounding air pollutants, in order to optimize the setting of outdoor smoking points. MethodsSurrounding the exhibition halls in the China International Import Expo (CIIE), two outdoor smoking points were randomly selected, one on the first floor (ground level) and the other on the second floor (16 m above ground), respectively. At 0, 3, 6, and 9 m from the smoking points in the same direction, validated portable air pollutant monitors were used to measure the real-time fine particulate matter (PM2.5) and carbon dioxide (CO2) concentrations for consecutive 5 d during the exhibition, as well as the environmental meteorological factors at 0 m with weather meters including wind speed, wind direction, and air pressure. An open outdoor atmospheric background sampling point was selected on each of the two floors to carry out parallel sampling. Simultaneously, the number of smokers at each smoking point were double recorded per minute. The relationships between the number of smokers, distance from the smoking points, and ambient PM2.5 and CO2 concentrations were evaluated by generalized additive regression models for time-series data after adjustment of confounders such as temperature, relative humidity, and wind speed. ResultsThe median numbers of smokers at smoking points on the first and second floors were 6 [interquartile range (IQR): 3, 9] and 9 (IQR: 6, 13), respectively. Windless (wind speed

Abstract Background Observational studies have preliminarily revealed an association between smoking and gastroesophageal reflux disease (GERD). However, little is known about the causal relationship and shared genetic architecture between the two. This study aims to explore their common genetic correlations by leveraging genome-wide association studies (GWAS) of smoking behavior—specifically, smoking initiation (SI), never smoking (NS), ever smoking (ES), cigarettes smoked per day (CPD), age of smoking initiation(ASI) and GERD. Methods Firstly, we conducted global cross-trait genetic correlation analysis and heritability estimation from summary statistics (HESS) to explore the genetic correlation between smoking behavior and GERD. Then, a joint cross-trait meta-analysis was performed to identify shared “pleiotropic SNPs” between smoking behavior and GERD, followed by co-localization analysis. Additionally, multi-marker analyses using annotation (MAGMA) were employed to explore the degree of enrichment of single nucleotide polymorphism (SNP) heritability in specific tissues, and summary data-based Mendelian randomization (SMR) was further utilized to investigate potential functional genes. Finally, Mendelian randomization (MR) analysis was conducted to explore the causal relationship between the smoking behavior and GERD. Results Consistent genetic correlations were observed through global and local genetic correlation analyses, wherein SI, ES, and CPD showed significantly positive genetic correlations with GERD, while NS and ASI showed significantly negative correlations. HESS analysis also identified multiple significantly associated loci between them. Furthermore, three novel “pleiotropic SNPs” (rs4382592, rs200968, rs1510719) were identified through cross-trait meta-analysis and co-localization analysis to exist between SI, NS, ES, ASI, and GERD, mapping the genes MED27, HIST1H2BO, MAML3 as new pleiotropic genes between SI, NS, ES, ASI, and GERD. Moreover, both smoking behavior and GERD were found to be co-enriched in multiple brain tissues, with GMPPB, RNF123, and RBM6 identified as potential functional genes co-enriched in Cerebellar Hemisphere, Cerebellum, Cortex/Nucleus accumbens in SI and GERD, and SUOX identified in Caudate nucleus, Cerebellum, Cortex in NS and GERD. Lastly, consistent causal relationships were found through MR analysis, indicating that SI, ES, and CPD increase the risk of GERD, while NS and higher ASI decrease the risk. Conclusion We identified genetic loci associated with smoking behavior and GERD, as well as brain tissue sites of shared enrichment, prioritizing three new pleiotropic genes and four new functional genes. Finally, the causal relationship between smoking behavior and GERD was demonstrated, providing insights for early prevention strategies for GERD.

Huina Gao,1,* Yijun Song,2,* Kun Liu,1,* Xinyuan Lu,3 Jiacheng Shen,2 Sulan Wei,2 Hongni Jiang,1,2 Nuo Xu2 1Department of Pulmonary Medicine, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, People’s Republic of China; 2Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China; 3School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Nuo Xu, Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People’s Republic of China, Email xu.nuo@zs-hospital.sh.cn; Hongni Jiang, Department of Pulmonary Medicine, Xiamen Branch, Zhongshan Hospital, Fudan University, 668 Jinhu Road, Xiamen, 361015, People’s Republic of China, Email jiang.hongni@zs-hospital.sh.cnPurpose: Cigarette smoking is the most recognized risk factor of chronic obstructive pulmonary disease (COPD) in China. However, there are no studies analyzing the impact of different smoking behaviors on pulmonary function and pulmonary hypertension (PH) among Chinese male patients with COPD.Patients and Methods: Chinese male smokers with COPD performed pulmonary function tests. Clinical characteristics, smoking behavior features, spirometry and echocardiographic results were compared between the two groups stratified by initial smoking age (18 years old) or complicated PH.Results: The early-smoking group had more respiratory symptoms, more severe smoking behavior, worse pulmonary function with lower FEV1%pre (38.5% vs 70.2%) and FEV1/FVC% (47.5% vs 63.8%), and higher systolic pulmonary artery pressure (sPAP: 38.6 vs 33.9 mmHg) than the late-smoking group. Initiating smoking before adulthood was an independently contributing factor of ventilatory dysfunction and Global Initiative for Obstructive Lung Disease (GOLD) stage escalation. It also had a significant interaction with long smoking duration (≥ 30 years), characterized by markedly decreased lung volumes (VC%pre: 64.0% vs 84.5%), impaired diffusing capacity (DLCO%pre: 58.0% vs 76.8%) and severe emphysema (RV/TLC%pre: 145.2% vs 130.2%). COPD patients complicated with PH exhibited worse ventilatory function (FEV1%pre: 43.2% vs 56.2%), impaired diffusion capacity (DLCO%pre: 56.7% vs 77.1%) and decreased lung volume (VC%pre: 67.67% vs 75.38%). Both severe smoking behaviors and impaired pulmonary function had close correlations with sPAP.Conclusion: The early-smoking group exhibited predominantly ventilation dysfunction and had complex interactions with long smoking duration to further affect lung volume and diffusion capacity. Different smoking behaviors influenced variations of pulmonary dysfunction and comorbid PH in patients with COPD.Keywords: chronic obstructive pulmonary disease, pulmonary function, smoking behavior, initial smoking age, pulmonary hypertension

The increasing aging population has drawn significant attention to the health behaviors of older men, specifically their smoking habits. In this study, we estimated the changes in smoking behavior among elderly men aged 65 years and over and identified the factors that influenced these changes. Using the Korean Longitudinal Study of Aging (KLoSA) data, conducted between 2006 and 2020, we analyzed the smoking behavior of 1741 elderly men who were 65 years-of-age in the first year. The mean smoking quantity showed a decreasing trend over time, from 4.47 cigarettes/day in 2006 to 0.30 cigarettes/day in 2020. The quadratic change model best explained these changes in smoking behavior. The factors that influenced the initial level of smoking behavior included education, residential area, marital status, age and household income. In conclusion, smoking behavior among elderly men in Korea has shown a significant decreasing trend over the past decade. Several sociodemographic factors played a role in influencing these changes and can provide insights for tailoring health promotion strategies for this population group in the future.

Background: Observational studies have preliminarily revealed an association between smoking and gastroesophageal reflux disease (GERD). However, little is known about the causal relationship and shared genetic architecture between the two. This study aims to explore their common genetic correlations by leveraging genome-wide association studies (GWAS) of smoking behavior—specifically, smoking initiation (SI), never smoking (NS), ever smoking (ES), cigarettes smoked per day (CPD), age of smoking initiation(ASI) and GERD. Methods: Firstly, we conducted global cross-trait genetic correlation analysis and heritability estimation from summary statistics (HESS) to explore the genetic correlation between smoking behavior and GERD. Then, a joint cross-trait meta-analysis was performed to identify shared "pleiotropic SNPs" between smoking behavior and GERD, followed by co-localization analysis. Additionally, multi-marker analyses using annotation (MAGMA) were employed to explore the degree of enrichment of single nucleotide polymorphism (SNP) heritability in specific tissues, and summary data-based Mendelian randomization (SMR) was further utilized to investigate potential functional genes. Finally, Mendelian randomization (MR) analysis was conducted to explore the causal relationship between the smoking behavior and GERD. Results: Consistent genetic correlations were observed through global and local genetic correlation analyses, wherein SI, ES, and CPD showed significantly positive genetic correlations with GERD, while NS and ASI showed significantly negative correlations. HESS analysis also identified multiple significantly associated loci between them. Furthermore, three novel "pleiotropic SNPs" (rs4382592, rs200968, rs1510719) were identified through cross-trait meta-analysis and co-localization analysis to exist between SI, NS, ES, ASI, and GERD, mapping the genes MED27, HIST1H2BO, MAML3 as new pleiotropic genes between SI, NS, ES, ASI, and GERD. Moreover, both smoking behavior and GERD were found to be co-enriched in multiple brain tissues, with GMPPB, RNF123, and RBM6 identified as potential functional genes co-enriched in Cerebellar Hemisphere, Cerebellum, Cortex/Nucleus accumbens in SI and GERD, and SUOX identified in Caudate nucleus, Cerebellum, Cortex in NS and GERD. Lastly, consistent causal relationships were found through MR analysis, indicating that SI, ES, and CPD increase the risk of GERD, while NS and higher ASI decrease the risk. Conclusion: We identified genetic loci associated with smoking behavior and GERD, as well as brain tissue sites of shared enrichment, prioritizing three new pleiotropic genes and four new functional genes. Finally, the causal relationship between smoking behavior and GERD was demonstrated, providing insights for early prevention strategies for GERD. [ABSTRACT FROM AUTHOR]

INTRODUCTION Since the beginning of the COVID-19 pandemic, a growing number of studies have documented more severe COVID-19 symptoms and worse outcomes among smokers compared to non-smokers. The aim of this research is to understand the views, risk perceptions, and behaviors of Lebanese adult smokers during the pandemic. METHODS We conducted 18 qualitative online structured interviews with adults who smoke cigarettes and waterpipe tobacco residing in Lebanon from November 2020 through April 2021. Participants were recruited predominantly via paid social media ads. Interviews were audio-recorded using Zoom software then transcribed verbatim. Data were analyzed thematically. RESULTS The findings showed three main themes: changes to smoking behaviors, concerns over the susceptibility and severity of COVID-19, and using coping methods to protect smokers from COVID-19. Although there was an increased risk perception of COVID-19 in relation to smoking, most participants reported an increase in smoking. Instead of being encouraged to quit, participants developed coping strategies against COVID-19 while smoking. CONCLUSIONS Smoking behavior did not seem to decrease during the COVID-19 pandemic. To support cessation initiatives and raise awareness, effective health messaging aimed at smokers is pivotal. Smoking cessation programs need to be better equipped at supporting people who smoke in finding healthier coping mechanisms during a pandemic. Moreover, policies to regulate the propagation of misinformation are required to prevent the development of a false sense of safety and protection from COVID-19. [ABSTRACT FROM AUTHOR]

The study aimed to explore prevalence, risk factors, and intervention approaches related to adolescent smoking in Pakistan. Databases included PubMed, Scopus, Embase, Google Scholar, and ProQuest. Studies were selected on Pakistani adolescents aged 10-21 years, original or secondary articles published in English, and the use of qualitative and quantitative methods. Out of 1300 articles, 300 duplicates were removed. After reviewing titles and abstracts, 980 records were excluded. The full text of the 18 remaining studies was reviewed based on inclusion criteria, with 13 eligible studies included. Data extraction included author, age, setting, design, sample, theory, prevalence, risk factors, findings, and appraisal. Ten eligible studies reported varying prevalence rates of adolescent smoking in Pakistan, ranging from 09% to 61.14%. Individual risk factors associated with smoking included disposition, mood, and substance abuse. Social risk factors included family and peer influences, including father's smoking status, family members' tobacco use, and peer pressure. Environmental risk factors, including attendance at a public school, school-related pressure, exposure to tobacco use on social media, and lower socioeconomic status, significantly increased the likelihood of smoking among adolescents. Three studies evaluating prevention and intervention approaches demonstrated positive outcomes, including increased awareness of smoking harms, attitude shifts, and increased intention to quit smoking. This scoping review identified the influence of individual, social, and environmental risk factors on adolescent smoking. Educational interventions showed positive results on knowledge and attitude; however, none specifically focused on smoking cessation. Future research should focus on addressing these risk factors and implementing theory-guided interventions. [ABSTRACT FROM AUTHOR]

Smoking is a prevalent global issue, with a significant risk factor for various non-communicable diseases necessitating prolonged, costly, and potentially devastating medical treatments. In addition, infectious diseases such as tuberculosis, COVID-19, and pneumonia in toddlers are often associated with active and passive smoking habits. The correlation is evident across diverse demographics, encompassing individuals of varying ages, professions, and genders. Therefore, this research aimed to explore and describe behavior of active smokers among campus members at various universities, focusing on the initiation, cessation, and influencing factors associated with smoking. A qualitative research design was used with a hermeneutic phenomenological approach, where information was provided by five active smoker informants. These individuals started smoking as teenagers, and the fluctuating patterns were influenced by health concerns or a perceived lack of significance attributed to smoking. However, the periods of abstinence were only temporary due to the pervasive influence of social and environmental factors. The initiation of smoking commonly started from the influence of close acquaintances, such as family members. Meanwhile, the process of quitting encountered numerous obstacles, primarily from potent social factors outweighing personal intentions. The implementation of smoking cessation strategies posed challenges due to the profound impacts of addiction, requiring unwavering determination, comprehensive plans, and diligent efforts.

The study aimed to explore prevalence, risk factors, and intervention approaches related to adolescent smoking in Pakistan. Databases included PubMed, Scopus, Embase, Google Scholar, and ProQuest. Studies were selected on Pakistani adolescents aged 10-21 years, original or secondary articles published in English, and the use of qualitative and quantitative methods. Out of 1300 articles, 300 duplicates were removed. After reviewing titles and abstracts, 980 records were excluded. The full text of the 18 remaining studies was reviewed based on inclusion criteria, with 13 eligible studies included. Data extraction included author, age, setting, design, sample, theory, prevalence, risk factors, findings, and appraisal. Ten eligible studies reported varying prevalence rates of adolescent smoking in Pakistan, ranging from 09% to 61.14%. Individual risk factors associated with smoking included disposition, mood, and substance abuse. Social risk factors included family and peer influences, including father's smoking status, family members' tobacco use, and peer pressure. Environmental risk factors, including attendance at a public school, school-related pressure, exposure to tobacco use on social media, and lower socioeconomic status, significantly increased the likelihood of smoking among adolescents. Three studies evaluating prevention and intervention approaches demonstrated positive outcomes, including increased awareness of smoking harms, attitude shifts, and increased intention to quit smoking. This scoping review identified the influence of individual, social, and environmental risk factors on adolescent smoking. Educational interventions showed positive results on knowledge and attitude; however, none specifically focused on smoking cessation. Future research should focus on addressing these risk factors and implementing theoryguided interventions.

The global tobacco epidemic, claiming over 8 million lives annually, constitutes a formidable public health threat. Fatalities arise from both direct tobacco use and exposure to second-hand smoke. Smoking prevalence, notably in Japan, varies across age groups with distinct patterns indicating higher rates among those aged 40 years and above. Persistent concerns surround the significance of smoking behavior in individuals aged 20 to 30 years, given the potential for early adulthood behavior to contribute to long-term health impacts. The emergence of heated tobacco products adds complexity with a substantial percentage of individuals aged 20 to 30 years using these alternatives. This study analyzed data from 15,333 individuals aged 20 to 39 years, collected through Japan's "Comprehensive Survey of Living Conditions 2017". Compliant with the Japan Statistics Act, a secondary analysis employed multivariate logistic analysis to examine concerns and stress sources by sex and smoking behavior, adjusting for various variables. As a result, no statistically significant associations were found between smoking in men and concerns or stress. However, in women who smoked, significant associations were observed between smoking and specific stressors, such as work-related concerns, financial stress, and stress from a lack of personal free time. This study emphasizes the necessity of considering gender differences and social backgrounds in designing targeted smoking-prevention programs, aiming to enhance overall health longevity and comprehensively reduce lifelong smoking rates in this demographic. [ABSTRACT FROM AUTHOR]

Nicotine, the main compound in cigarettes, leads to smoking addiction. Nicotine acts on the limbic dopamine reward loop in the midbrain by binding to nicotinic acetylcholine receptors, promoting the release of dopamine, and resulting in a rewarding effect or satisfaction. This satisfaction is essential for continued and compulsive tobacco use, and therefore dopamine plays a crucial role in nicotine dependence. Numerous studies have identified genetic polymorphisms of dopaminergic pathways which may influence susceptibility to nicotine addiction. Dopamine levels are greatly influenced by synthesis, storage, release, degradation, and reuptake-related genes, including genes encoding tyrosine hydroxylase, dopamine decarboxylase, dopamine transporter, dopamine receptor, dopamine 3-hydroxylase, catechol-O-methyltransferase, and monoamine oxidase. In this paper, we review research progress on the effects of polymorphisms in the above genes on downstream smoking behavior and nicotine dependence, to offer a theoretical basis for the elucidation of the genetic mechanism underlying nicotine dependence and future personalized treatment for smoking cessation.

Introduction Tobacco advertisement, promotion, and sponsorship (TAPS) in all forms influences youth smoking behaviors. TAPS exposure enhances their smoking frequency and vulnerability. A 2018 Indonesia Ministry of Health (MoH) Survey showed increased smoking prevalence among youth aged 10–18 years. Thus, our objective was to analyze the relationship between TAPS and the increased Indonesian youth smoking behavior. Methods We conducted a secondary analysis of the Indonesian 2019 Global Youth Tobacco Survey. The sample size differed in each variable: current smokers n=3386, ever smoker n=3666, and cigarette consumption per day n=1355. We adjusted for socioeconomic and demographic variables and used logistic regression with youth smoking prevalence as the outcome and TAPS variables as the primary exposures. Results The current male youth smoker prevalence was 38.3%, ever smoker was 67%, and high consumption per day smoker (≥2 cigarettes per day) was 39.1%. Youth respondents exposed to the promotion or sponsorship of cigarette products showed an increase in three smoking behaviors. In particular, when youth respondents were exposed to more than one type of cigarette promotion (AOR=1.67, 95% CI: 1.33–2.09) or noticed one type of cigarette sponsorship (AOR=2.06, 95% CI: 1.44–2.93), their odds of all three smoking behaviors (current smoker, ever smoker, and high consumption smoker) increased. Conclusions TAPS increase smoking behaviors among Indonesian youth. Therefore, to protect Indonesian youth health in the future, strategic action is needed to reduce youth smoking by banning all forms of TAPS in Indonesia. Tob.

Abstract Background Smoking is harmful, which has become a major public health burden. Physical activity may be related to smoking. Physical activity is one of the current methods for smoking control and smoking cessation. Different types of physical activity may have different effect on smoking behavior. Objective The purpose of this study was to identify the direction and extent of the impact of different types of physical activity above moderate intensity (including work physical activity, recreational physical activity, commuter physical activity and sedentary behavior) on smoking behavior. Materials and methods In this study, a total of 2,015 individuals (1,233 males and 782 females, mean age 54.02±17.31 years) was selected from the representative population aged 20 and above in the National Health and Nutrition Survey of the United States from 2017 to 2018. Physical activity was assessed using the Global Physical Activity Questionnaire (GPAQ) ; the tobacco use questionnaire (SMQ) was used to determine whether the sample had smoking behavior at this stage. Binary Logistic regression analysis was performed with various physical activities as independent variables and smoking behavior as dependent variables. All data were analyzed through Statistical Product and Service Solutions (SPSS) 26.0. Results After adjusted for all confounding variables, physical activity at work was close to significantly associated with smoking behavior (P=0.053), odds ratio (OR) =1.135 (95%Cl: 0.999-1.289). Recreational physical activity was significantly associated with smoking behavior (P < 0.001), OR=0.729 (95%Cl: 0.639-0.832). Commuting physical activity was significantly associated with smoking behavior (P < 0.001), OR=1.214 (95%Cl:1.048-1.405). Sedentary behavior was significantly associated with smoking behavior (P < 0.001), OR=1.363 (95%Cl: 1.154-1.611). Conclusions Given that different types of physical activity have different associations with smoking behavior. Therefore, when physical activity is used as a tobacco control measurement, it is necessary to pay attention to the type and environment of physical activity. Recreational physical activities should be appropriately increased, sedentary behavior should be reduced, and smoking prohibit environment should be expanded as far as possible to achieve better clinical intervention effects.

Abstract Introduction Tobacco use, in both smoking and smokeless forms, is highly prevalent among South Asian adults. The aims of the study were twofold: (1) describe patterns of SLT and combustible tobacco product use in four South Asian countries stratified by country and sex, and (2) assess the relationships between SLT and smoking intensity, smoking quit attempts, and smoking cessation among South Asian men. Methods Data were obtained from South Asia Biobank Study, collected between 2018 and 2022 from 148,944 men and women aged 18 years and above, living in Bangladesh, India, Pakistan, or Sri Lanka. Mixed effects multivariable logistic and linear regression were used to quantify the associations of SLT use with quit attempt, cessation, and intensity. Results Among the four South Asian countries, Bangladesh has the highest rates of current smoking (39.9% for male, 0.4% for female) and current SLT use (24.7% for male and 23.4% for female). Among male adults, ever SLT use was associated with a higher odds of smoking cessation in Bangladesh (OR, 2.88; 95% CI, 2.65, 3.13), India (OR, 2.02; 95% CI, 1.63, 2.50), and Sri Lanka (OR, 1.36; 95% CI, 1.14, 1.62). Ever SLT use and current SLT use was associated with lower smoking intensity in all countries. Conclusions In this large population-based study of South Asian adults, rates of smoking and SLT use vary widely by country and gender. Men who use SLT products are more likely to abstain from smoking compared with those who do not.

BackgroundPublic places are frequently polluted by cigarette smoking, and there is a lack of accurate, real-time, and intelligent monitoring technology to identify smoking behavior. It is necessary to develop a tool to identify cigarette smoking behavior in public places for more efficient control of cigarette smoking and better indoor air quality. ObjectiveTo construct a model for recognizing cigarette smoking behavior based on real-time indoor concentrations of PM2.5 in public places. MethodsReal-time indoor PM2.5 concentrations were measured for at least 7 continuous days in 10 arbitrarily selected places (6 public service providers and and 4 office or other places) from Oct. to Nov. 2022 in Pudong New Area, Shanghai. Indoor nicotine concentrations were monitored with passive samplers simultaneously. Outdoor PM2.5 concentration data were obtained from three municipal environmental monitoring stations which were nearest to each monitoring point during the same period. Mann-Whitney U test was used to compare indoor and outdoor means of PM2.5 concentrations, and Spearman rank correlation was used to analyze indoor PM2.5 and nicotine concentrations. An interactive plot and a random forest model was applied to examine the association between video observation validated indoor smoking behavior and real-time indoor PM2.5 concentrations in an Internet cafe. ResultsThe average indoor PM2.5 concentration in the places providing public services [(97.5±149.3) µg·m−3] was significantly higher than that in office and other places [(19.8±12.2) µg·m−3] (P=0.011). The indoor/outdoor ratio (I/O ratio) of PM2.5 concentration in the public service providers ranged from 1.1 to 19.0. Furthermore, the indoor PM2.5 concentrations in the 10 public places were significantly correlated with the nicotine concentrations (rs=0.969, P

Abstract Background COVID-19 pandemic emerged worldwide at the end of 2019, causing a severe global public health threat, and smoking is closely related to COVID-19. Previous studies have reported changes in smoking behavior and influencing factors during the COVID-19 period, but none of them explored the main influencing factor and high-risk populations for smoking behavior during this period. Methods We conducted a nationwide survey and obtained 21,916 valid data. Logistic regression was used to examine the relationships between each potential influencing factor (sociodemographic characteristics, perceived social support, depression, anxiety, and self-efficacy) and smoking outcomes. Then, variables related to smoking behavior were included based on the results of the multiple logistic regression, and the classification and regression tree (CART) method was used to determine the high-risk population for increased smoking behavior during COVID-19 and the most profound influencing factors on smoking increase. Finally, we used accuracy to evaluated the performance of the tree. Results The strongest predictor of smoking behavior during the COVID-19 period is acceptance degree of passive smoking. The subgroup with a high acceptation degree of passive smoking, have no smokers smoked around, and a length of smoking of ≥ 30 years is identified as the highest smoking risk (34%). The accuracy of classification and regression tree is 87%. Conclusion The main influencing factor is acceptance degree of passive smoking. More knowledge about the harm of secondhand smoke should be promoted. For high-risk population who smoke, the “mask protection” effect during the COVID-19 pandemic should be fully utilized to encourage smoking cessation.

Abstract Background The intrinsic damage and external hazards of smoking are major risk factors for poorer health and are recognized as a global health issue of concern in geriatric health. This study aims to assess the Dunning–Kruger effect through the influence of subjective health perceptions on smoking behavior in older adults. Methods This study used data from the 2018 Chinese Longitudinal Healthy Longevity Survey (N = 9,683) provided by the Center for Healthy Aging and Development Studies at Peking University. A binary logistic model was used to examine whether the Dunning–Kruger effect affects smoking behavior in older adults, and a linear probability model was used as a commentary baseline model for logistic regression to prevent measurement bias. In addition, a mediating analysis was used to examine the mechanisms through which the Dunning–Kruger effect occurs. Results Older adults often overestimated their current health status and underestimated the health risks of smoking, causing the Dunning–Kruger effect to arise from their inadequate self-perceived health (i.e., older adults are more likely to smoke when they have better self-rated health or when hypertension, cardiopathy, stroke, and diabetes have little or no impact on their daily lives). These observations can be explained by the older adults’ subjective health perceptions arising from their ingenuous understanding of their health, which indirectly influences their smoking behavior to some extent. Conclusion Older adults’ self-perceived health was associated with smoking behavior. Public health institutions should improve older adults’ health perceptions so that they objectively understand their own health status.

BackgroundThis study aimed to evaluate the causal impact of common modifiable lifestyles on obstructive sleep apnea (OSA), which is beneficial for recommendations to prevent and manage OSA.MethodPublished genome-wide association study (GWAS) summary statistics were used to perform two-sample Mendelian randomization (MR). Variants associated with each exposure of smoking, drinking, and leisure sedentary behaviors at the genetic level were used as instrumental variables (IVs). Then, inverse-variance weighting (IVW) was considered the primary result for causality. Moreover, several complimented approaches were also included to verify the observed associations. MR-PRESSO and MR-Egger intercept were applied to test the horizontal pleiotropy. To assess heterogeneity, Cochran's Q test by IVW and MR-Egger were applied.ResultsRegular smoking history increased OSA risk in all applied approaches [OR (95% CI)IVW = 1.28 (1.12, 1.45), p = 1.853 × 10−4], while the causality of lifetime smoking index [OR (95% CI)IVW = 1.39 (1.00, 1.91), p = 0.048], alcohol intake frequency [outliers removed OR (95% CI)IVW = 1.26 (1.08, 1.45), p = 0.002], and coffee intake behavior [OR (95% CI)IVW = 1.66 (1.03, 2.68), p = 0.039] on OSA risk were not always consistent in other approaches. In addition, no robust causal associations were observed for the effect of sedentary leisure behaviors on OSA risk. In sensitivity analysis, we observed no sign of horizontal pleiotropy or heterogeneity.ConclusionEver regularly smoking has a robust causal role in increasing OSA risk, which should be discouraged as precautions from developing OSA.

Background: Smoking is harmful, which has become a major public health burden. Physical activity may be related to smoking. Physical activity is one of the current methods for smoking control and smoking cessation. Different types of physical activity may have different effect on smoking behavior. Objective: The purpose of this study was to identify the direction and extent of the impact of different types of physical activity above moderate intensity (including work physical activity, recreational physical activity, commuter physical activity and sedentary behavior) on smoking behavior. Materials and methods: In this study, a total of 2,015 individuals (1,233 males and 782 females, mean age 54.02±17.31 years) was selected from the representative population aged 20 and above in the National Health and Nutrition Survey of the United States from 2017 to 2018. Physical activity was assessed using the Global Physical Activity Questionnaire (GPAQ) ; the tobacco use questionnaire (SMQ) was used to determine whether the sample had smoking behavior at this stage. Binary Logistic regression analysis was performed with various physical activities as independent variables and smoking behavior as dependent variables. All data were analyzed through Statistical Product and Service Solutions (SPSS) 26.0. Results: After adjusted for all confounding variables, physical activity at work was close to significantly associated with smoking behavior (P=0.053), odds ratio (OR) =1.135 (95%Cl: 0.999-1.289). Recreational physical activity was significantly associated with smoking behavior (P < 0.001), OR=0.729 (95%Cl: 0.639-0.832). Commuting physical activity was significantly associated with smoking behavior (P < 0.001), OR=1.214 (95%Cl:1.048-1.405). Sedentary behavior was significantly associated with smoking behavior (P < 0.001), OR=1.363 (95%Cl: 1.154-1.611). Conclusions: Given that different types of physical activity have different associations with smoking behavior. Therefore, when physical activity is used as a tobacco control measurement, it is necessary to pay attention to the type and environment of physical activity. Recreational physical activities should be appropriately increased, sedentary behavior should be reduced, and smoking prohibit environment should be expanded as far as possible to achieve better clinical intervention effects. [ABSTRACT FROM AUTHOR]

Introduction: Tobacco use, in both smoking and smokeless forms, is highly prevalent among South Asian adults. The aims of the study were twofold: (1) describe patterns of SLT and combustible tobacco product use in four South Asian countries stratified by country and sex, and (2) assess the relationships between SLT and smoking intensity, smoking quit attempts, and smoking cessation among South Asian men. Methods: Data were obtained from South Asia Biobank Study, collected between 2018 and 2022 from 148,944 men and women aged 18 years and above, living in Bangladesh, India, Pakistan, or Sri Lanka. Mixed effects multivariable logistic and linear regression were used to quantify the associations of SLT use with quit attempt, cessation, and intensity. Results: Among the four South Asian countries, Bangladesh has the highest rates of current smoking (39.9% for male, 0.4% for female) and current SLT use (24.7% for male and 23.4% for female). Among male adults, ever SLT use was associated with a higher odds of smoking cessation in Bangladesh (OR, 2.88; 95% CI, 2.65, 3.13), India (OR, 2.02; 95% CI, 1.63, 2.50), and Sri Lanka (OR, 1.36; 95% CI, 1.14, 1.62). Ever SLT use and current SLT use was associated with lower smoking intensity in all countries. Conclusions: In this large population-based study of South Asian adults, rates of smoking and SLT use vary widely by country and gender. Men who use SLT products are more likely to abstain from smoking compared with those who do not. What this paper adds?: • Tobacco use remains a leading risk factor of chronic disease in South Asia. Smokeless tobacco use is particularly popular in this region, even among adult women. Evidence on smokeless tobacco use and smoking cessation are inconclusive and may be dependent on specific cultural and historical factors. • Contemporaneous data on smokeless and combustible tobacco use patterns in South Asia are limited. Little is known whether SLT use is associated with smoking cessation in South Asia where the vast majority of the world's SLT users reside. • This study provided information on patterns of SLT use and smoking in four South Asia countries using a large population-based sample of 148,944 adults collected between 2018 and 2022. We observed that SLT use was associated with higher smoking cessation and lower smoking intensity among men. Strengthening SLT product regulation may have important population health implications with the changing tobacco use landscape in South Asia. [ABSTRACT FROM AUTHOR]

INTRODUCTION Tobacco advertisement, promotion, and sponsorship (TAPS) in all forms influences youth smoking behaviors. TAPS exposure enhances their smoking frequency and vulnerability. A 2018 Indonesia Ministry of Health (MoH) Survey showed increased smoking prevalence among youth aged 10--18 years. Thus, our objective was to analyze the relationship between TAPS and the increased Indonesian youth smoking behavior. METHODS We conducted a secondary analysis of the Indonesian 2019 Global Youth Tobacco Survey. The sample size differed in each variable: current smokers n=3386, ever smoker n=3666, and cigarette consumption per day n=1355. We adjusted for socioeconomic and demographic variables and used logistic regression with youth smoking prevalence as the outcome and TAPS variables as the primary exposures. RESULTS The current male youth smoker prevalence was 38.3%, ever smoker was 67%, and high consumption per day smoker (≥2 cigarettes per day) was 39.1%. Youth respondents exposed to the promotion or sponsorship of cigarette products showed an increase in three smoking behaviors. In particular, when youth respondents were exposed to more than one type of cigarette promotion (AOR=1.67, 95% CI: 1.33-2.09) or noticed one type of cigarette sponsorship (AOR=2.06, 95% CI: 1.44-2.93), their odds of all three smoking behaviors (current smoker, ever smoker, and high consumption smoker) increased. CONCLUSIONS TAPS increase smoking behaviors among Indonesian youth. Therefore, to protect Indonesian youth health in the future, strategic action is needed to reduce youth smoking by banning all forms of TAPS in Indonesia. [ABSTRACT FROM AUTHOR]

Background: COVID-19 pandemic emerged worldwide at the end of 2019, causing a severe global public health threat, and smoking is closely related to COVID-19. Previous studies have reported changes in smoking behavior and influencing factors during the COVID-19 period, but none of them explored the main influencing factor and high-risk populations for smoking behavior during this period. Methods: We conducted a nationwide survey and obtained 21,916 valid data. Logistic regression was used to examine the relationships between each potential influencing factor (sociodemographic characteristics, perceived social support, depression, anxiety, and self-efficacy) and smoking outcomes. Then, variables related to smoking behavior were included based on the results of the multiple logistic regression, and the classification and regression tree (CART) method was used to determine the high-risk population for increased smoking behavior during COVID-19 and the most profound influencing factors on smoking increase. Finally, we used accuracy to evaluated the performance of the tree. Results: The strongest predictor of smoking behavior during the COVID-19 period is acceptance degree of passive smoking. The subgroup with a high acceptation degree of passive smoking, have no smokers smoked around, and a length of smoking of ≥ 30 years is identified as the highest smoking risk (34%). The accuracy of classification and regression tree is 87%. Conclusion: The main influencing factor is acceptance degree of passive smoking. More knowledge about the harm of secondhand smoke should be promoted. For high-risk population who smoke, the "mask protection" effect during the COVID-19 pandemic should be fully utilized to encourage smoking cessation. [ABSTRACT FROM AUTHOR]

Introduction: On April 1, 2017, California Proposition 56 (Prop 56) was implemented, increasing the excise tax on cigarettes by $2/pack. This study compares the association of Prop 56 with smoking prevalence and smoking intensity across racial/ethnic groups, further examining distinctions across income subgroups within each racial/ethnic group.Methods: The study used pooled cross-sectional data from the 2012-2018 California Behavioral Risk Factor Surveillance System. We examined two outcomes: current smoking prevalence and smoking intensity conditional on current smoking. A two-part econometric model was used to estimate the association of Prop 56 with smoking prevalence and intensity using multiple logistic regression and multiple linear regression, respectively. The two-part model was run separately for all adults (full sample) and each racial/ethnic group. Within each racial/ethnic group, we ran stratified analyses by income subgroups.Results: The results indicated that Prop 56 was negatively associated with smoking prevalence among full-sample, Hispanic, White, and African American adults; and negatively associated with smoking intensity among full-sample and White smokers. Stratified analyses by race/ethnicity and income showed that Prop 56 was negatively associated with smoking prevalence among low-income full-sample and White adults and among middle-income smokers in the full, Hispanic, White, African American, and Asian samples. Prop 56 was negatively associated with smoking intensity among middle-income Hispanic and high-income White smokers. The association between Prop 56 and smoking intensity was positive among high-income African American smokers.Conclusion: Prop 56 was associated with a reduction in smoking prevalence across multiple racial/ethnic groups, particularly within the low- and middle-income subgroups.Policy implications: Our findings indicate that the reduction in smoking prevalence immediately following the implementation of California Proposition 56 tobacco tax increase was significant across a variety racial/ethnic groups, particularly low- and middle-income subgroups. We found differential responses in smoking prevalence across income groups among Whites but not among racial/ethnic minorities. We found no evidence of any significance association between Proposition 56 and smoking intensity among minorities and economically vulnerable populations, except for middle-income Hispanics. Researchers, policymakers, and advocates should consider additional merits of targeted, community-based, non-economic tobacco control interventions in reaching low- and middle-income groups within racial/ethnic minorities.

ObjectiveTo examine the impact of indoor workplace smoking ban regulation on smoking behavior among various occupation groups in different regions of China, and to provide a reference for evaluating and promoting smoke-free indoor workplaces. MethodsThe data on 5 795 persons working in indoor places were collected from the National Adult Tobacco Survey conducted in 2018 across China. Unconditional multivariate logistic regression analysis was adopted to analyze the effect of indoor workplace smoking ban regulation on smoking behavior among occupational groups. ResultsNon-comprehensive and comprehensive smoking prohibition in indoor workplace were reported by 3 153 (54.4%) and 2 642 (45.6%) of all the employed persons. Of the 3 153 employed persons working in indoor places without comprehensive smoking prohibition, 2 324 reported ever having seen someone (including themselves) smoking in workplace, with a weighted ratio of 75.9%; while of the 2 642 employed person working in indoor places with comprehensive smoking prohibition, 743 reported ever having seen someone smoking in workplace, with the weighted ratio of 27.3%. After adjusting for gender, age, occupation, living area (urban/rural), residence region (eastern/western), current smoking, attitude towards smoking prohibition in workplace, and awareness of health hazards associated with second-hand smoke, the results of logistic regression analysis showed that the employed persons working in indoor places without comprehensive smoking prohibition were less likely to have seen someone smoking in indoor workplace (odds ratio = 0.14, 95% confidence interval: 0.12 – 0.17). ConclusionComprehensive indoor workplace smoking prohibition could reduce indoor smoking among occupational persons.

Abstract Background The COVID-19 pandemic as a public health crisis has led to a significant increase in mental health difficulties. Smoking is strongly associated with mental health conditions, which is why the pandemic might have influenced the otherwise decline in smoking rates. Persons belonging to socioeconomically disadvantaged groups may be particularly affected, both because the pandemic has exacerbated existing social inequalities and because this group was more likely to smoke before the pandemic. We examined smoking prevalence in a French cohort study, focusing on differences between educational attainment. In addition, we examined the association between interpersonal changes in tobacco consumption and educational level from 2018 to 2021. Methods Using four assessments of smoking status available from 2009 to 2021, we estimated smoking prevalence over time, stratified by highest educational level in the TEMPO cohort and the difference was tested using chi2 test. We studied the association between interpersonal change in smoking status between 2018 and 2021 and educational attainment among 148 smokers, using multinomial logistic regression. Results Smoking prevalence was higher among those with low education. The difference between the two groups increased from 2020 to 2021 (4.8–9.4%, p

Background: Smoking is a behavior that does not occur spontaneously but rather evolves through a series of processes influenced by various internal and external factors. Smoking leads to a decline in health, impacting the quality of life for children in the new generation. Objective: This study aimed to analyze the relationship between the social environment, media/advertising exposure, the role of parents, and the role of teachers in adolescent smoking behavior in the coastal area of Kendari, Indonesia Methods: The study utilized a cross-sectional study approach. The population comprised all adolescents in the coastal area of Kendari, with a sample size of 526 students, including both male and female students. The study was conducted in April 2023. Data were collected through a questionnaire, and were analyzed using Chi-square test. Results: The study found that a percentage of students engaged in smoking behavior. Additionally, 100% (221 individuals) of students reported being influenced by cigarette advertising, leading to smoking. Furthermore, 92.4% of students with parents in a deficient role exhibited smoking behavior, and 83.2% of students with teachers in a lacking role ended up smoking. The chi-square test yielded a ρ-value of 0.000, indicating a significant relationship between the social environment, media/advertising exposure, the role of parents, the role of teachers, and smoking behavior. Conclusion: The study results demonstrate a significant influence of the social environment, media/advertising exposure, the role of parents, and the role of teachers on the smoking behavior of senior high school students.

Objective To explore the chaotic dynamic mechanism of the formation and change of smoking behavior. Methods Based on the chaos theory, the chaotic characteristics of smoking-quitting behavior, the dynamic mechanism of chaotic process and chaos control strategy were analyzed by using typical analysis and comparative analysis. Results The formation and change of smoking habit accorded with the typical characteristics of chaos. The individual smoking behavior belief, which is composed of psychological cognition, behavioral motivation, and external environment/situation/occasion, is the aattractorn to induce and control the development, evolution, and disappearance of smoking behavior. The a scenario-motivationn coupling mechanism is the power source of smoking behavior, and multiple scenario-motivation, coupling mechanisms cooperate to dominate the behavior, which gradually increases the frequency of behavior and enters a chaotic state. The stability of chaotic system makes it difficult to quit the habit for a long time. Quitting smoking needs to fundamentally break the chaotic state of behavior and deconstruct multiple a scenario-motivation0 coupling mechanisms in chaotic attractors. Conclusion This study puts fonvard the chaotic dynamic mechanism of the formation and change of smoking habits, which provides a new perspective and train of thought for deeply understanding, explaining, and intervening other health-related behaviors and habits. It provides theoretical support for individual smoking cessation and smoking control policy-making. [ABSTRACT FROM AUTHOR]

INTRODUCTION Smoking is one of the risk factors for noncommunicable diseases and is harmful to both active and passive smokers. This study aimed to identify the influence of socioeconomic and environmental issues on smoking in Thailand. METHODS The study is a secondary dataset analysis of cross-sectional data using data from the 2017 Smoking and Drinking Behaviors Survey of the National Statistical Office of Thailand. The survey collected the data among 88689 participants using a structured questionnaire. The multi-level analysis was used to identify the association between socioeconomics, environmental factors, social marketing, and smoking while controlling for the effects of covariates and presenting the adjusted odds ratio (AOR) and its 95% confidence interval (CI). RESULTS Among 88689 respondents, the prevalence of smoking was 18.2% (95% CI: 18.00-18.51). Factors that were associated with smoking were: exposure to secondhand smoke in residential settings (AOR=15.31; 95% CI: 14.47-16.20) and alcohol regular drinking (AOR=4.44; 95% CI: 4.14-4.76). In addition, social marketing factors include: disagreeing or being unsure of the opinions that cigarettes should be categorized as harmful goods (AOR=3.15; 95% CI: 2.94-3.37); not having been exposed to the disadvantages of smoking in social media (AOR=1.51; 95% CI: 1.43-1.61); not having been exposed to the disadvantages of smoking in newspapers, television, radio, advertisements, or other sources (AOR=1.46; 95% CI: 1.37-1.62); having never seen the warning cautions or having seen them but ignored the hazardous effect (AOR=4.81; 95% CI: 4.5-4.9); and having ever seen the warning cautions/ever seen but ignore the hazardous effect (AOR=4.81; 95% CI: 4.54-5.09), and ever seen advertisements or billboards which motivate smoking in various places (AOR=1.33; 95% CI: 1.24-1.42). CONCLUSIONS Smoking and secondhand smoke are crucial problems that affect health. In addition, related sectors should help to develop a policy recommendation to reduce the smoking rate through social marketing. Strict and comprehensive policies and laws on non-smoking in work places, public spaces, and homes, will help to reduce secondhand smoke exposure among non-smokers. [ABSTRACT FROM AUTHOR]

Smoking is a major public health problem in most countries and usually occurs in marginalized groups. Analyzing the smoking behavior of migrant workers, a marginalized group in China, is of practical significance. Using panel data from the China Health and Retirement Longitudinal Study (CHARLS) database from 2013 to 2018, this study examined influence factors of smoking behavior (whether to smoke and smoking frequency) among migrant workers in China through the Heckman two-stage model. The results showed that the smoking rates of migrant workers were positively associated with social activity and a sense of loneliness, while smoking frequency was negatively associated with work stress and life satisfaction. Meanwhile, smoking behavior was associated with the demographic variables such as gender, age, and education level. Gender differences in smoking behavior were particularly notable among Chinese migrant workers. Furthermore, there was regional heterogeneity in smoking behavior among migrant workers. Smoking behavior in the eastern region was mainly influenced by psychological factors of wellbeing, such as social activity and life satisfaction, while it was affected by material conditions such as income in the central-western region. Effective strategies to control tobacco use among migrant workers are proposed in order to promote social integration between urban and rural residents, increase vocational education and training, and strengthen anti-smoking propaganda among migrant workers. [ABSTRACT FROM AUTHOR]

Abstract Background There is an increase in the use of cigarettes and e-cigarettes worldwide, and the similar trends may be observed in young adults. Since 2014, e-cigarettes have become the most commonly used nicotine products among young adults (Sun et al., JAMA Netw Open 4:e2118788, 2021). With the increase in e-cigarette use and the decrease in use of cigarettes and other tobacco products, however, there is limited information about Chinese smokers, e-cigarettes users and trends in cigarettes and e-cigarettes use among university students. Therefore, our objective was to investigate the using status of cigarettes, e-cigarettes and smoking behavior among the students from 7 universities in Guangzhou, China. Methods Students at 7 different universities in Guangzhou were investigated online in 2021 through a cross-sectional survey. A total of 10,008 students were recruited and after screening, 9361 participants were adopted in our statistics. Descriptive analysis, Chi-square analysis, and multiple logistic regression analysis were used to explore the smoking status and influencing factors. Results The average age of the 9361 university students was 22.4 years (SD = 3.6). 58.3% of participants were male. 29.8% of the participants smoked or used e-cigarettes. Among the smokers and users of e-cigarettes, 16.7% were e-cigarettes only users, 35.0% were cigarettes only users, and 48.3% were dual users. Males were more likely to smoke or use e-cigarettes. Medical students, students from prestigious Chinese universities, and students with higher levels of education were less likely. Students with unhealthy lifestyles (e.g., drinking alcohol frequently, playing video games excessively, staying up late frequently) were more likely to smoke or use e-cigarettes. Emotion can have significant impacts on both cigarettes and e-cigarettes dual users when choosing cigarettes or e-cigarettes to use. More than half of dual users said they would choose cigarettes when they were depressed and e-cigarettes when they were happy. Conclusion We identified factors influencing the use of cigarettes and e-cigarettes among university students in Guangzhou, China. Gender, education level background, specialization, lifestyle habits and emotion all influenced the use of cigarettes and e-cigarettes among university students in Guangzhou, China. Male, low education level, from non-prestigious Chinese universities or vocational schools, non-medical specialization, and presence of unhealthy lifestyles were influencing factors for the use of cigarettes and e-cigarettes among university students in Guangzhou and students with these factors were more likely to smoke or use e-cigarettes. Besides, emotions can influence dual users' choice of products. This study provides more information to better understand young people's preferences for cigarettes and e-cigarettes by elucidating the characteristics of cigarettes and e-cigarettes use, as well as related influencing factors, among university students in Guangzhou. Further research involving more variables connected to the use of cigarettes and e-cigarettes will be required in our future study.

Abstract Background Lung cancer screening may provide a “teachable moment” for the smoking cessation and relapse prevention. However, the impact of lung cancer screening on smoking initiation in non‐smokers has not been reported. Methods A baseline smoking behavior survey was conducted in 2000 participants who were screened by low‐dose computed tomography (LDCT) from 2014 to 2018. All participants were re‐surveyed on their smoking behavior in 2019. Of these, 312 participants were excluded, leaving 1688 participants in the final analysis. The smoking initiation rate in baseline non‐smokers, the relapse rate in baseline former smokers, and the abstinence rate in baseline current smokers were calculated, respectively. The associations between screening results, demographic characteristics, and smoking behavior change were analyzed using multivariable logistic regression. Results From 2014 to 2019, smoking prevalence significantly decreased from 52.6% to 49.1%. The prevalence of smoking initiation, relapse, and abstinence in baseline non‐smokers, former, and current smokers was 16.8%, 22.9%, and 23.7%, respectively. The risk of smoking initiation in baseline non‐smokers was significantly higher in those with negative screening result (adjusted OR = 2.97, 95% CI: 1.27–6.94). Compared to smokers who only received baseline screening, the chance of smoking abstinence in baseline current smokers was reduced by over 80% in those who attended 5 rounds of screening (adjusted OR = 0.15, 95% CI:0.08–0.27). No significant associations were found between smoking relapse and prior screening frequency, with at least one positive screening result. Age, gender, occupational exposure, income, and smoking pack years were also associated with smoking behavior changes. Conclusions The overall decreased smoking prevalence indicated an overwhelming effect of “teachable moment” on “license to smoke.” A tailored smoking cessation strategy should be integrated into lung cancer screening.

Introduction: Several scientific evidence showed that smoking can increase the severity and mortality rate of coronavirus disease 2019 (COVID-19). This indicates that the pandemic is the best time to reduce its frequency or stop the habit, but misinformation that smoking prevents infection has an effect on smokers' behavior. Therefore, this study aims to assess the beliefs about the effects of smoking on COVID-19 as well as to determine their relationship with smoking habits among university student smokers in Jakarta, Indonesia. Methods: This study was carried out in three Universities in Jakarta with a total of 198 respondents, who were selected conveniently. Furthermore, independent variables were derived from the Health Belief Model theory, while the dependent variables include quit intention and smoking frequency. Chi-square and ordinal regression analyses were carried out to determine the association between the variables. Results: The belief that smoking increases the severity of COVID-19 as well as having the determination to stop the habit, had an effect on the respondents' quit intention. Moreover, perceived barriers, such as feeling anxious (adjusted odds ratio [AOR]: 0.34, 95% confidence interval [CI]: 0.19–0.60) and being exposed to information that the habit prevents COVID-19 severity (AOR: 0.45, 95% CI: 0.01–0.71) were protective factors against the decrease in the number of cigarettes smoked daily. Conclusion: Improving digital health literacy, campaigns to clarify the risk of cigarettes, and self-efficacy related to cessation are important efforts to prevent smoking behavior during a pandemic.

Introduction According to the World Health Organization, tobacco use is a global pandemic and the leading preventable cause of illness and death. Most smokers start to smoke during adolescence. Therefore, it is crucial to develop and implement evidence-based measures to improve the effectiveness of smoking prevention. The Azores have the highest prevalence of smokers among the Portuguese regions and studies on Azorean adolescents are scarce. This study’s objectives were to determine the prevalence of smoking behavior in Azorean adolescents and to explore associations among smoking behavior and demographic and psychosocial variables. Methods Participants in this study were 209 young Azoreans (mean age=15.4 ± 1.9; 68% females) who answered a questionnaire available online between November 2020 and February 2021. Access to the questionnaire was provided through a link disseminated at school by teachers. Variables such as age, sex, smoking attitude, social influence, selfefficacy, intention to smoke and smoking behavior, were included in the questionnaire. The statistical analyses performed include descriptive statistics, comparisons tests between never smokers and already smokers, correlations, and a logistic regression to determine effects on smoking behavior. Results Most participants (68.9%) reported never having smoked, not even a puff, and 5.7% answered that they smoked regularly. Beliefs about the advantages of smoking, reduced self-efficacy to refuse smoking in social situations, and having a best friend who smokes, are the variables associated with smoking behavior. The model explains 44% of the variance. Conclusions Smoking prevention interventions with Azorean adolescents should address and correct beliefs about the pros of smoking, reinforce self-efficacy to refuse cigarettes in social situations, and provide strategies to deal with pressure to smoke from friends who smoke.

Background: The COVID-19 pandemic as a public health crisis has led to a significant increase in mental health difficulties. Smoking is strongly associated with mental health conditions, which is why the pandemic might have influenced the otherwise decline in smoking rates. Persons belonging to socioeconomically disadvantaged groups may be particularly affected, both because the pandemic has exacerbated existing social inequalities and because this group was more likely to smoke before the pandemic. We examined smoking prevalence in a French cohort study, focusing on differences between educational attainment. In addition, we examined the association between interpersonal changes in tobacco consumption and educational level from 2018 to 2021. Methods: Using four assessments of smoking status available from 2009 to 2021, we estimated smoking prevalence over time, stratified by highest educational level in the TEMPO cohort and the difference was tested using chi2 test. We studied the association between interpersonal change in smoking status between 2018 and 2021 and educational attainment among 148 smokers, using multinomial logistic regression. Results: Smoking prevalence was higher among those with low education. The difference between the two groups increased from 2020 to 2021 (4.8–9.4%, p < 0.001). Smokers with high educational level were more likely to decrease their tobacco consumption from 2018 to 2021 compared to low educated smokers (aOR = 2.72 [1.26;5.89]). Conclusion: Current findings showed a widening of the social inequality gap in relation to smoking rates, underscoring the increased vulnerability of persons with low educational level to smoking and the likely inadequate focus on social inequalities in relation to tobacco control policies during the pandemic. [ABSTRACT FROM AUTHOR]

Background. The Global Adult Tobacco Survey is an official agency that systematically monitors adult tobacco use and tracks key tobacco contro indicators. This survey collects data on people aged 15 years and over. The purpose of this study was to analyze the socio-cultural, personality, and environmental relatiionship with smoking behavior. Methods. This research uses a cross-sectional method. The population is all students of classes X and XI at Public Senior High School 1 Peulimbang, as many as 125 people, and the entire population is used as a sample. Data analysis consisted of univariate, multivariate, and bivariate analysis using Chi-square bivariate test and multivariate analysis using Poisson regression at =0.05. Results. The result variable bivariate associated with smoking is a social-cultural behavior with P<0.001; RP=7.819; CI 95%=4.358-14.028, personalized with P<0.001; RP=57.759; CI 95%=8.234-405.158, environment with P<0.001; RP=5.750; CI 95%=3.069-10.772. Conclusion. The most dominant variable associated with smoking behavior in Public Senior High School 1 Peulimbang was statistically significant, (personal approach 0.05). The prevalence of smoking behavior with personal is RP=42.630; CI 95%=5.376-338.064; P=0,000. [ABSTRACT FROM AUTHOR]

The global tobacco epidemic, claiming over 8 million lives annually, constitutes a formidable public health threat. Fatalities arise from both direct tobacco use and exposure to second-hand smoke. Smoking prevalence, notably in Japan, varies across age groups with distinct patterns indicating higher rates among those aged 40 years and above. Persistent concerns surround the significance of smoking behavior in individuals aged 20 to 30 years, given the potential for early adulthood behavior to contribute to long-term health impacts. The emergence of heated tobacco products adds complexity with a substantial percentage of individuals aged 20 to 30 years using these alternatives. This study analyzed data from 15,333 individuals aged 20 to 39 years, collected through Japan’s “Comprehensive Survey of Living Conditions 2017”. Compliant with the Japan Statistics Act, a secondary analysis employed multivariate logistic analysis to examine concerns and stress sources by sex and smoking behavior, adjusting for various variables. As a result, no statistically significant associations were found between smoking in men and concerns or stress. However, in women who smoked, significant associations were observed between smoking and specific stressors, such as work-related concerns, financial stress, and stress from a lack of personal free time. This study emphasizes the necessity of considering gender differences and social backgrounds in designing targeted smoking-prevention programs, aiming to enhance overall health longevity and comprehensively reduce lifelong smoking rates in this demographic.

Introduction The study focused on the influence of tar concentrations, smoking regimen, and smoking behavior, on benzo[a]pyrene (B[a]P) emission from cigarette mainstream smoke and related health hazards to determine the key factors influencing B[a]P reduction and protection of the smoker’s health. Methods A locally popular brand of cigarettes in Beijing was selected with tar concentrations of 1, 3, 5, 8, 10, and 11 mg/cigarette. Two different machine smoking regimens, the Canada Intense (HCI) regimen and the International Organization for Standardization (ISO) regimen, were adopted to collect the cigarette mainstream smoke. The B[a]P emission concentrations were then measured by gas chromatography and mass spectrum. Results The average B[a]P emission was 8.14–17.6 ng/cigarette for the HCI regimen and 0.92–3.46 ng/cigarette for the ISO regimen. As expected, the tar concentrations and B[a]P emissions exhibited a positive relation in both the HCI and ISO regimens, the cancer risk and non-cancer risk increased with an increase in tar concentrations for both the ISO and HCI regimens, and the smoking behavior also affected the B[a]P emissions with a tendency of VB (ventilation blocking) > HVB (half ventilation blocking) > DP (deep puff), under the same smoking regimen. Under the same conditions, the cancer risk and non-cancer risk in men were 1.19 and 1.11 times, respectively, higher than in women. Conclusions The smoking regimen influences the B[a]P emission relatively more than the cigarette tar concentration and smoking behavior. The cancer risk and non-cancer risk are higher in men than in women that possibly due to longer smoking duration and greater smoking intensity.

Background: There is an increase in the use of cigarettes and e-cigarettes worldwide, and the similar trends may be observed in young adults. Since 2014, e-cigarettes have become the most commonly used nicotine products among young adults (Sun et al., JAMA Netw Open 4:e2118788, 2021). With the increase in e-cigarette use and the decrease in use of cigarettes and other tobacco products, however, there is limited information about Chinese smokers, e-cigarettes users and trends in cigarettes and e-cigarettes use among university students. Therefore, our objective was to investigate the using status of cigarettes, e-cigarettes and smoking behavior among the students from 7 universities in Guangzhou, China. Methods: Students at 7 different universities in Guangzhou were investigated online in 2021 through a cross-sectional survey. A total of 10,008 students were recruited and after screening, 9361 participants were adopted in our statistics. Descriptive analysis, Chi-square analysis, and multiple logistic regression analysis were used to explore the smoking status and influencing factors. Results: The average age of the 9361 university students was 22.4 years (SD = 3.6). 58.3% of participants were male. 29.8% of the participants smoked or used e-cigarettes. Among the smokers and users of e-cigarettes, 16.7% were e-cigarettes only users, 35.0% were cigarettes only users, and 48.3% were dual users. Males were more likely to smoke or use e-cigarettes. Medical students, students from prestigious Chinese universities, and students with higher levels of education were less likely. Students with unhealthy lifestyles (e.g., drinking alcohol frequently, playing video games excessively, staying up late frequently) were more likely to smoke or use e-cigarettes. Emotion can have significant impacts on both cigarettes and e-cigarettes dual users when choosing cigarettes or e-cigarettes to use. More than half of dual users said they would choose cigarettes when they were depressed and e-cigarettes when they were happy. Conclusion: We identified factors influencing the use of cigarettes and e-cigarettes among university students in Guangzhou, China. Gender, education level background, specialization, lifestyle habits and emotion all influenced the use of cigarettes and e-cigarettes among university students in Guangzhou, China. Male, low education level, from non-prestigious Chinese universities or vocational schools, non-medical specialization, and presence of unhealthy lifestyles were influencing factors for the use of cigarettes and e-cigarettes among university students in Guangzhou and students with these factors were more likely to smoke or use e-cigarettes. Besides, emotions can influence dual users' choice of products. This study provides more information to better understand young people's preferences for cigarettes and e-cigarettes by elucidating the characteristics of cigarettes and e-cigarettes use, as well as related influencing factors, among university students in Guangzhou. Further research involving more variables connected to the use of cigarettes and e-cigarettes will be required in our future study. [ABSTRACT FROM AUTHOR]

Understanding students' attitudes toward smoking and tobacco products is essential for effective smoking prevention interventions. This questionnaire-based cross-sectional survey aims to determine the prevalence of use and knowledge about cigarettes, heated tobacco products, and electronic cigarettes and their harmful effects among university students. The survey was conducted using a self-administered online questionnaire among 1184 students. Questions were related to the respondents' demographic characteristics, tobacco use patterns, and opinions about exposure to health warnings and tobacco product advertising messages. Data were analyzed using descriptive statistics and generalized linear regression analysis. The results showed that 30.2% of the students use tobacco products (74.5% smoked conventional cigarettes; 7.9% used electronic cigarettes; and 17.6% used heated tobacco products). The median (interquartile range) score of the students' knowledge (maximum = 27) was 16 (12–22). The results showed that students from technical, social, humanities, natural, and biotechnology scientific programs had lower levels of knowledge about tobacco products and their harmful effects than biomedical students (p ≤ 0.001). In addition, past and current use of tobacco products was significantly associated with higher overall knowledge of tobacco products and their harmful effects (adjusted odds ratio (OR) 1.90, % confidence interval (CI) 1.09–3.31, p = 0.023; OR 1.41, CI 1.08–1.84, p = 0.011). The research findings confirm the lack of knowledge and misconceptions about the harmful effects associated with tobacco product use. They also emphasize the need for better prevention and awareness of the harmful effects of smoking on human health. [ABSTRACT FROM AUTHOR]

Background: Lung cancer screening may provide a "teachable moment" for the smoking cessation and relapse prevention. However, the impact of lung cancer screening on smoking initiation in non‐smokers has not been reported. Methods: A baseline smoking behavior survey was conducted in 2000 participants who were screened by low‐dose computed tomography (LDCT) from 2014 to 2018. All participants were re‐surveyed on their smoking behavior in 2019. Of these, 312 participants were excluded, leaving 1688 participants in the final analysis. The smoking initiation rate in baseline non‐smokers, the relapse rate in baseline former smokers, and the abstinence rate in baseline current smokers were calculated, respectively. The associations between screening results, demographic characteristics, and smoking behavior change were analyzed using multivariable logistic regression. Results: From 2014 to 2019, smoking prevalence significantly decreased from 52.6% to 49.1%. The prevalence of smoking initiation, relapse, and abstinence in baseline non‐smokers, former, and current smokers was 16.8%, 22.9%, and 23.7%, respectively. The risk of smoking initiation in baseline non‐smokers was significantly higher in those with negative screening result (adjusted OR = 2.97, 95% CI: 1.27–6.94). Compared to smokers who only received baseline screening, the chance of smoking abstinence in baseline current smokers was reduced by over 80% in those who attended 5 rounds of screening (adjusted OR = 0.15, 95% CI:0.08–0.27). No significant associations were found between smoking relapse and prior screening frequency, with at least one positive screening result. Age, gender, occupational exposure, income, and smoking pack years were also associated with smoking behavior changes. Conclusions: The overall decreased smoking prevalence indicated an overwhelming effect of "teachable moment" on "license to smoke." A tailored smoking cessation strategy should be integrated into lung cancer screening. [ABSTRACT FROM AUTHOR]

Introduction: Several scientific evidence showed that smoking can increase the severity and mortality rate of coronavirus disease 2019 (COVID-19). This indicates that the pandemic is the best time to reduce its frequency or stop the habit, but misinformation that smoking prevents infection has an effect on smokers' behavior. Therefore, this study aims to assess the beliefs about the effects of smoking on COVID-19 as well as to determine their relationship with smoking habits among university student smokers in Jakarta, Indonesia. Methods: This study was carried out in three Universities in Jakarta with a total of 198 respondents, who were selected conveniently. Furthermore, independent variables were derived from the Health Belief Model theory, while the dependent variables include quit intention and smoking frequency. Chi-square and ordinal regression analyses were carried out to determine the association between the variables. Results: The belief that smoking increases the severity of COVID-19 as well as having the determination to stop the habit, had an effect on the respondents' quit intention. Moreover, perceived barriers, such as feeling anxious (adjusted odds ratio [AOR]: 0.34, 95% confidence interval [CI]: 0.19–0.60) and being exposed to information that the habit prevents COVID-19 severity (AOR: 0.45, 95% CI: 0.01–0.71) were protective factors against the decrease in the number of cigarettes smoked daily. Conclusion: Improving digital health literacy, campaigns to clarify the risk of cigarettes, and self-efficacy related to cessation are important efforts to prevent smoking behavior during a pandemic. [ABSTRACT FROM AUTHOR]

INTRODUCTION According to the World Health Organization, tobacco use is a global pandemic and the leading preventable cause of illness and death. Most smokers start to smoke during adolescence. Therefore, it is crucial to develop and implement evidence-based measures to improve the effectiveness of smoking prevention. The Azores have the highest prevalence of smokers among the Portuguese regions and studies on Azorean adolescents are scarce. This study's objectives were to determine the prevalence of smoking behavior in Azorean adolescents and to explore associations among smoking behavior and demographic and psychosocial variables. METHODS Participants in this study were 209 young Azoreans (mean age=15.4 ± 1.9; 68% females) who answered a questionnaire available online between November 2020 and February 2021. Access to the questionnaire was provided through a link disseminated at school by teachers. Variables such as age, sex, smoking attitude, social influence, selfefficacy, intention to smoke and smoking behavior, were included in the questionnaire. The statistical analyses performed include descriptive statistics, comparisons tests between never smokers and already smokers, correlations, and a logistic regression to determine effects on smoking behavior. RESULTS Most participants (68.9%) reported never having smoked, not even a puff, and 5.7% answered that they smoked regularly. Beliefs about the advantages of smoking, reduced self-efficacy to refuse smoking in social situations, and having a best friend who smokes, are the variables associated with smoking behavior. The model explains 44% of the variance. CONCLUSIONS Smoking prevention interventions with Azorean adolescents should address and correct beliefs about the pros of smoking, reinforce self-efficacy to refuse cigarettes in social situations, and provide strategies to deal with pressure to smoke from friends who smoke. [ABSTRACT FROM AUTHOR]

Abstract Objectives Smokers or never smokers exposed to environmental tobacco use are usually associated with various diseases and cancers. In order to better help college students prevent the tobacco use and thus lower the incidence of avoidable diseases, this study explored the predictive power of different variables including demographic and psychological variables in relation to smoking behaviors. Methods Maslach Burnout Inventory-Student Survey and Kessler Psychological Distress Scale (K10) were used in this study. Results There were 1449 college students participating in the study with 1340 pieces of valid data left, the effective ratio was 92.48%. The valid data included 37.1% male and 62.9% female aged 18.83 on average with 1.55 standard deviation. The multivariate logistic regression indicated that college students who were male (versus female, OR = 9.55), majoring in medicine and sports (versus nursing, ORmedicine = 2.19, ORsports = 2.81), born in the non-singleton family (versus singleton family, OR = 0.63) with higher family income (versus lower family income, OR = 0.45), surrounded with smoking friends (versus without smoking friends, OR = 0.18), were more vulnerable to smoke. In addition, combined with the theory of planned behavior, the dimensions of learning burnout had full mediation effects between psychological distress and smoking behavior. Conclusions Psychological distress can only indirectly affect smoking behavior via learning efficacy, cynicism and emotional exhaustion. Adjustments from different dimensions of learning burnout such as avoiding cynicism about learning, enhancing learning efficacy and emotion exhaustion will help college students better prevent the tobacco use.

BackgroundSmoking is well known to be associated with a higher prevalence and incidence of liver diseases such as advanced fibrosis. However, the impact of smoking on developing nonalcoholic fatty liver disease remains controversial, and clinical data on this is limited. Therefore, this study aimed to investigate the association between smoking history and nonalcoholic fatty liver disease (NAFLD).MethodsData from the Korea National Health and Nutrition Examination Survey 2019-2020 were used for the analysis. NAFLD was diagnosed according to an NAFLD liver fat score of >-0.640. Smoking status was classified as into nonsmokers, ex-smokers, and current smokers. Multiple logistic regression analysis was conducted to examine the association between smoking history and NAFLD in the South Korean population.ResultsIn total, 9,603 participants were enrolled in this study. The odds ratio (OR) for having NAFLD in ex-smokers and current smokers in males was 1.12 (95% confidence interval [CI]: 0.90–1.41) and 1.38 (95% CI: 1.08–1.76) compared to that in nonsmokers, respectively. The OR increased in magnitude with smoking status. Ex-smokers who ceased smoking for

Abstract Objective: This study aims to develop a generalizable architecture for enhancing an enterprise data warehouse for research (EDW4R) with results from a natural language processing (NLP) model, which allows discrete data derived from clinical notes to be made broadly available for research use without need for NLP expertise. The study also quantifies the additional value that information extracted from clinical narratives brings to EDW4R. Materials and methods: Clinical notes written during one month at an academic health center were used to evaluate the performance of an existing NLP model and to quantify its value added to the structured data. Manual review was utilized for performance analysis. The architecture for enhancing the EDW4R is described in detail to enable reproducibility. Results: Two weeks were needed to enhance EDW4R with data from 250 million clinical notes. NLP generated 16 and 39% increase in data availability for two variables. Discussion: Our architecture is highly generalizable to a new NLP model. The positive predictive value obtained by an independent team showed only slightly lower NLP performance than the values reported by the NLP developers. The NLP showed significant value added to data already available in structured format. Conclusion: Given the value added by data extracted using NLP, it is important to enhance EDW4R with these data to enable research teams without NLP expertise to benefit from value added by NLP models.