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This article, published in the National Journal of Physiology, Pharmacy & Pharmacology, discusses the impact of tobacco smoking on pulmonary function. The study found that smokers had lower spirometric variables, such as forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and peak expiratory flow rate (PEFR), compared to non-smokers. The reduction in lung function was also proportional to the number of years the person had been smoking. The article emphasizes the importance of early detection and support for asymptomatic smokers, as early cessation is linked to improved survival. [Extracted from the article]

Background: Psychiatric patients are at high risk of readmission, and a high body mass index has previously been shown as a risk factor. We sought to replicate this finding and 1) to prospectively assess the association of metabolic syndrome and its five components with readmission in psychiatric hospitals and 2) to identify other clinical and sociodemographic predictors of readmission. Methods: Between 2007 and 2019, data on 16727 admissions of 7786 adult and elderly patients admitted to the Department of Psychiatry of the Lausanne University Hospital, were collected. Metabolic syndrome was defined according to the International Diabetes Federation definition. Cox frailty models were used to investigate the associations between readmission and metabolic disturbances. Results: A total of 2697 (35%) patients were readmitted to our psychiatric hospital. Novel risk factors for readmission in non-smokers were identified, including being overweight (HR=1.26; 95%CI=[1.05; 1.51]) or obese (HR=1.33; 95%CI=[1.08; 1.62]), displaying hypertriglyceridemia (HR=1.21; 95%CI=[1.04; 1.40]) and metabolic syndrome (HR=1.26; 95%CI=[1.02; 1.55]). Central obesity and hyperglycemia increased the risk of readmission when considering the Health of the Nation Outcome Scales variable. In first-episode psychosis patients, obesity (HR=2.23; 95%CI=[1.14; 4.30]) and high-density lipoprotein hypocholesterolemia (HR=1.90; 95%CI=[1.14; 3.20]) doubled the risk of readmission. Conclusion: The observed interaction between smoking and metabolic variables are compatible with a ceiling effect; metabolic variables increase the risk of readmission in non-smokers but not in smokers who are already at higher risk. Future studies should determine whether better metabolic monitoring and treatment can reduce readmission risk. [ABSTRACT FROM AUTHOR]

Background: Esophageal squamous cell carcinoma (ESCC) is sometimes detected in non‐drinker and non‐smoker females who are considered to have very low risk of ESCC development in daily practice. This study examined the clinicopathological and genomic characteristics of ESCCs in females with no history of drinking and smoking. Methods: The sample comprised 118 ESCC lesions occurring in 95 female patients who underwent endoscopic submucosal dissection at our department between January 2008 and December 2019. The patients were categorized into two groups: 51 lesions in 49 patients with no history of drinking and smoking (nondrinker/nonsmoker [NDNS] group) and 69 lesions in 45 patients with a history of drinking or smoking (drinker/smoker [DS] group). We analyzed the differences in clinicopathological and cancerous genomic characteristics between the groups. Significant genomic alterations were validated using immunohistochemistry. Results: Multiple logistic regression revealed that older age, fewer multiple Lugol‐voiding lesions (LVLs), and reflux esophagitis (RE) were independently associated with the occurrence of ESCCs in the NDNS group. ESCC lesions in the NDNS group were predominantly located in the mid‐thoracic esophagus, posterior wall side, with 0‐IIa, the aspect ratio of the lesion >2 (vertical/horizontal), and endoscopic keratinization. Genetic analysis showed that CDKN2A driver alterations were significantly more frequent and KMT2D alterations were significantly less frequent in the NDNS group than in the DS group. KMT2D alterations were strongly correlated with immunostaining. Conclusion: Older nondrinker, nonsmoker females with RE and fewer multiple LVLs may develop longitudinal 0‐IIa ESCC with keratinization of the posterior wall of the mid‐thoracic esophagus. ESCCs in nondrinker, nonsmoker females had fewer KMT2D alterations and more CDKN2A alterations, which may be a biomarker for treatment. [ABSTRACT FROM AUTHOR]

In healthy adults, airway-to-lung (i.e., dysanapsis) ratio is lower and dyspnoea during exercise at a given minute ventilation (V̇E) is higher in females than in males. We investigated the relationship between dysanapsis and sex on exertional dyspnoea in healthy adults. We hypothesized that females would have a smaller airway-to-lung ratio than males and that exertional dyspnoea would be associated with airway-to-lung ratio in males and females. We analyzed data from n = 100 healthy never-smokers aged ≥40 years enrolled in the Canadian Cohort Obstructive Lung Disease (CanCOLD) study who underwent pulmonary function testing, a chest computed tomography scan, and cardiopulmonary exercise testing. The luminal area of the trachea, right main bronchus, left main bronchus, right upper lobe, bronchus intermedius, left upper lobe, and left lower lobe were 22%–37% smaller (all p < 0.001) and the airway-to-lung ratio (i.e., average large conducting airway diameter relative to total lung capacity) was lower in females than in males (0.609 ± 0.070 vs. 0.674 ± 0.082; p < 0.001). During exercise, there was a significant effect of V̇E, sex, and their interaction on dyspnoea (all p < 0.05), indicating that dyspnoea increased as a function of V̇E to a greater extent in females than in males. However, after adjusting for age and total lung capacity, there were no significant associations between airway-to-lung ratio and measures of exertional dyspnoea, regardless of sex (all r < 0.34; all p > 0.05). Our findings suggest that sex differences in airway size do not contribute to sex differences in exertional dyspnoea. [ABSTRACT FROM AUTHOR]

Background:The two main environmental determinants that provide a risk of chronic obstructive pulmonary disease are exposure to biomass smoke and occupational exposures. The present study was conducted to assess etiological factors of chronic obstructive pulmonary disease in non-smokers. Materials & Methods:74 cases of chronic obstructive pulmonary disease (COPD) of both genderswere classified into 2 groups. Group I was smokers and group II was non-smokers. Results: Out of 74 patients, males were 50 and females were 24. Out of 74 COPD patients, 54 were smokers and 20 were non-smokers. The etiology was exposure to biomass smoke in 1 and 8, asthma in 3 and 6, treated pulmonary tuberculosis in 16 and 4, occupational exposure in 21 and 1, outdoor air pollution in 8 and 1, low SES in 2 and 0 and LRTI in 3 and 0 patients in group I and II respectively. Conclusion: Common risk factors of COPD in smokers were exposure to biomass smoke, asthma, treated pulmonary tuberculosis. [ABSTRACT FROM AUTHOR]

Smoking is recognized as one of the most important preventable causes of premature death in the world and personality traits as one of the influential factors in people's tendency to smoke. Therefore, we conducted the present research to compare the sensation seeking and core self-evaluations in the smoking and nonsmoking population. 867 people from the general population of Hormozgan Province participated in this cross-sectional study. We collected the data online using questionnaires of demographic information, smoking, Zuckerman sensation seeking and core self-evaluations. 38.2% of the participants in the study were smokers and 61.8% were nonsmokers. The mean scores of awareness of the harms of smoking in non-smokers and smokers were 7.43 (SD = 2.43) and 6.51 (1.72), respectively (p < 0.001). The mean scores of sensation seeking in the non-smokers and smokers were 15.10 (SD = 5.64) and 23.09 (SD = 4.18), respectively (p < 0.001). The mean scores of core self-evaluations in the non-smokers and smokers were 43.46 (SD = 6.79) and 37.9 (SD = 4.82), respectively (p < 0.001). According to the findings, smokers have lower core self-evaluations and high sensation seeking compared to non-smokers. Therefore, paying attention to these personality factors is necessary in the design and implementation of preventive therapeutic and psychological interventions in smokers. [ABSTRACT FROM AUTHOR]

Tobacco heating systems (THS) are new products on the market, advertised as a less harmful alternative for smokers, in which tobacco is heated and not burned like in conventional cigarettes. This research explored the effect on periodontal tissues in contact with heating and burning tobacco residual products (smoke and tobacco). Methods: The sample included 66 subjects, patients of the Clinic of Dentistry in Rijeka, Croatia, aged 26–56 (median 38), 64% females. Three age- and gender-matched groups were formed (each N = 22): non-smokers, classic cigarettes smokers and THS smokers. Probing depth (PD) and clinical attachment loss (CAL) were primary research parameters. Results: Three groups differed in average PD and CAL (p ≤ 0.002), with cigarette smokers having the highest and non-smokers the lowest values (p ≤ 0.002). THS consumers generally had lower values of periodontal indices than smokers, but only CAL differed significantly (p = 0.011). Periodontal indices CAL and PD were worse in THS consumers than non-smokers, but they did not reach a level of statistical significance. Cigarette smoking was the only predictor of periodontitis (average CAL ≥ 4 mm) in logistic regression models, with an odds ratio of 4.7 (95% confidence interval 1.2–18.3; p = 0.027). Conclusions: Exposure to nicotine-containing aerosol of THS in adults has a less harmful effect on periodontal tissues, measurable through periodontal indices (PD and CAL), compared to burning tobacco of conventional cigarettes. THS, presented as an alternative product to classic cigarettes, also has a detrimental effect on the periodontium. [ABSTRACT FROM AUTHOR]

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Background: Smoking is a major preventable risk factor for cardiovascular morbidity and mortality. Tobacco smoking induces atherosclerosis, ischemic heart diseases, and arrhythmias. The impact of electronic cigarettes on cardiovascular health is still controversial. This study aimed to evaluate the electrocardiographic parameters in chronic electronic cigarette users compared to chronic conventional cigarette smokers and a non-smoker control group of matched age and gender. Results: The study involved 105 volunteers with no history of chronic or cardiovascular diseases or cardioactive drug use. Participants were assigned into three study groups, chronic e-cigarette users, conventional cigarette smokers, and non-smokers, each consisting of 35 participants. Demographic data, smoking history, vital signs, and 12-lead electrocardiogram (ECG) were evaluated. Demographic data were insignificantly different among all study groups. The mean heart rate was significantly higher in chronic electronic cigarette users and conventional cigarette smokers compared to non-smokers (p < 0.001).QRS complex duration was significantly shorter in e-cigarette users and conventional smokers compared to non-smokers (p < 0.001). Prolonged QT and QTc intervals duration were recorded in e-cigarette users and conventional smokers compared to non-smokers (p < 0.001). All the ventricular repolarization indices (T wave—peak to T-end (Tpe) interval, TPe/QT ratio, and TPe/QTc ratio were significantly prolonged in chronic e-cigarette users, and conventional smokers compared to non-smokers (p < 0.001). Mean systolic, diastolic blood pressure, P wave amplitude and duration, and PR interval were insignificantly different between all groups (P > 0.05). Conclusions: Chronic e-cigarette use is associated with higher heart rates, shorter QRS complex, prolonged QT, QTc duration, and prolonged ventricular repolarization indices compared to non-smokers of matched age and gender. Conclusively, e-cigarette use is associated with negative cardiovascular effects like conventional cigarette smoking. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to investigate differences between non-smokers, ex-smokers and current smokers in hospital length of stay (LOS), readmission (seven and 28 days) and cost of readmission for patients admitted for elective surgery. Methods: A retrospective cohort study of administrative inpatient data from 24, 818 patients admitted to seven metropolitan hospitals in Western Australia between 1 July 2016 and 30 June 2019 for multiday elective surgery was conducted. Data included smoking status, LOS, procedure type, age, sex and Indigenous status. LOS for smoking status was compared using multivariable negative binomial regression. Odds of readmission were compared for non-smokers and both ex-smokers and current smokers using separate multivariable logistic regression models. Results: Mean LOS for non-smokers (4.7 days, SD=5.7) was significantly lower than both ex-smokers (6.2 days SD 7.9) and current smokers (6.1 days, SD=8.2). Compared to non-smokers, current smokers and ex-smokers had significantly higher odds of readmission within seven (OR=1.29; 95% CI: 1.13, 1.47, and OR=1.37; 95% CI: 1.19, 1.59, respectively) and 28 days (OR=1.35; 95% CI: 1.23, 1.49, and OR=1.53; 95% CI: 1.39, 1.69, respectively) of discharge. The cost of readmission for seven and 28-day readmission was significantly higher for current smokers compared to non-smokers (RR=1.52; 95% CI: 1.1.6, 2.0; RR=1.39; 95% CI: 1.18, 1.65, respectively). Conclusion: Among patients admitted for elective surgery, hospital LOS, readmission risk and readmission costs were all higher for smokers compared with non-smokers. The findings indicate that provision of smoking cessation treatment for adults undergoing elective surgery is likely to produce multiple benefits. [ABSTRACT FROM AUTHOR]

INTRODUCTION Some elderly people in China prefer sun-cured tobacco to cigarettes, and the composition of sun-cured tobacco and cigarettes is inconsistent. The influence of cigarettes on the cognitive function of COPD patients has been widely reported, but the research on sun-cured tobacco is relatively rare. Our study explored the association of sun-cured tobacco and cigarette use with cognitive decline in COPD patients. METHODS This was a cross-sectional study. A total of 401 COPD patients were included, and 190, 103, and 108 participants were included in non-smoking, cigarette-smoking, and sun-cured tobacco groups, respectively. We evaluated the global cognitive function using the Beijing version of the Montreal Cognitive Assessment, verbal fluency function using an animal fluency test, and memory function using ten unrelated words. RESULTS The participants of both cigarette-smoking (AOR=11.18; 95% CI: 1.28-- 97.5) and sun-cured tobacco (AOR=10.46; 95% CI: 1.14--96.4) groups were more likely to develop mild cognitive impairment compared to the non-smoking group. The mean z scores of global cognitive function, verbal fluency, and memory were lower in cigarette-smoking and sun-cured tobacco groups than those in a non-smoking group; Multivariable linear regression showed that global cognitive function (β= -0.61; 95% CI: -1.04 -- -0.18; and β= -0.48; 95% CI: -0.91 -- -0.05) and verbal fluency (β= -0.79; 95% CI: -1.33 -- -0.26; and β= -0.69; 95% CI: -1.23 -- -0.16) of the sun-cured tobacco group and the cigarette-smoking group were significantly lower than those of the non-smoking group when adjusting for demographic and disease-related characteristics. However, there was no significant difference between the cigarette-smoking and sun-cured tobacco groups in global cognitive function, verbal fluency, and memory. CONCLUSIONS Compared with non-smokers, the use of cigarettes and sun-cured tobacco may damage the cognitive function of COPD patients, especially in global cognitive function and verbal fluency. [ABSTRACT FROM AUTHOR]

INTRODUCTION Certain foods and beverages are associated with smoking craving. However, only few studies have explored the relationship between food or beverage-related and taste-associated smoking craving. In this study, we aimed to identify the types of foods related to smoking craving in Japanese individuals who smoke cigarettes or heated tobacco products (HTPs). METHODS A total of 657 individuals (HTP and cigarette smokers and never smokers) participated in this cross-sectional study. Participants were asked what foods/ beverages, tastes, seasonings, cooking methods, and cuisine categories, made them want to smoke and what foods they consumed. RESULTS Alcoholic beverages such as beer, coffee, and fat-rich foods were associated with a higher likelihood of smoking craving. Fruits, dairy products such as milk, and sweet and sour tastes, were associated with a lower likelihood of smoking craving. The daily intake of fruit and dairy products was significantly lower in cigarette and HTP smokers than in non-smokers (median fruit intake: nonsmokers, 46.4 g/1000 kcal/day; cigarette smokers, 22.2 g/1000 kcal/day; HTP smokers, 31.4 g/1000 kcal/day; p<0.001; median dairy product intake: nonsmokers, 76.3 g/day; cigarette smokers, 48.2 g/day; HTP smokers, 57.6 g/day; p<0.001) as assessed using a food frequency questionnaire (BDHQ). CONCLUSIONS Specific foods and beverages such as alcohol, fruits, and dairy products are related to smoking craving, and their intake differs according to smoking status. [ABSTRACT FROM AUTHOR]

Introduction Children of people who smoke are more likely to take up smoking themselves. In Aotearoa New Zealand (NZ), adolescent smoking declined dramatically between 2000 and 2016 despite limited change in parental smoking, demonstrating that the cycle can be broken. Aims and Methods This study aimed to identify modifiable factors associated with never smoking in Year 10 students (14–15 years) who had at least one caregiver who smoked. We used data from the Youth Insights Survey (2016 and 2018, pooled, N  = 5,422) and identified students with at least one caregiver (mother, father, grandparent, other caregiver) who smoked (N  = 2,205). To investigate modifiable factors potentially associated with nonsmoking we used logistic regression with marginally adjusted prevalence estimates. Results Overall, 41% of students had at least one caregiver who smoked. In this group, the majority (65%) had never smoked themselves. After adjustment, never-smoking was more prevalent among students attending low-deprivation (more affluent) schools (73% had never smoked) compared to high-deprivation schools (44%); students not exposed to others' smoking inside the home (72%) or in cars (70%) in the past week compared to those exposed (59% and 51%, respectively); and students whose parents would be upset if they were caught smoking (68% vs 49% for those whose parents would not be upset), or who had high self-esteem (69% vs 55% for those with low self-esteem). Conclusions Modifiable factors independently associated with non-smoking in adolescents with caregiver(s) who smoked were: nonexposure to smoking inside the home and in cars, parental expectations of nonsmoking, and high self-esteem. Implications Even in countries like NZ with relatively low adult smoking rates, children's exposure to caregiver smoking may be prevalent, particularly in structurally disadvantaged populations. This study suggests that action to promote smokefree homes and cars, build high self-esteem in young people, and communicate expectations of non-smoking are likely to help children of people who smoke to remain nonsmokers. A comprehensive approach that also addresses "upstream" factors (eg, socioeconomic deprivation) and underlying causes of structural inequity (eg, institutional racism) is needed. Such policy and community action may help to break intergenerational cycles of tobacco use and health inequity. [ABSTRACT FROM AUTHOR]

Introduction: This study examined the association between smoking and heart disease in workers with a medical history of hypertension. Methods: Data were obtained from the 2018 Indonesian Basic Health Research database. Information was collected from 80,602 respondents who met the inclusion criteria: workers between the ages of 15 and 64 years who were exposed to cigarettes and had a medical history of hypertension. Multivariate logistic regression analysis assessed the association between smoking behavior and heart disease in workers with hypertension. Results: A strong association was observed between passive smoking and heart disease. The odds of developing heart disease were significantly higher in passive smokers who were former cigarette smokers than passive smokers who never smoked a cigarette (adjusted odds ratio [aOR] = 2.11, 95% confidence interval [CI]: 1.85-2.41). However, the odds were lower in current smokers than in passive smokers without a history of cigarette smoking (aOR = 0.71, 95% CI: 0.63-0.79). In addition, the present study found that the odds of developing heart disease increased in respondents from urban areas (aOR = 1.27, 95% CI: 1.14-1.40), aged 46-64 years (aOR = 2.12, 95% CI: 1.90-2.36), and from high-level economic status (aOR = 1.41, 95% CI: 1.27-1.58). Conclusion: Implementing health advocacy initiatives, expanding smoking-free zones, and enhancing workplace anti-smoking policies are important for preventing and reducing the harmful effects of cigarette smoking among workers, particularly those with conditions that make them more susceptible, such as hypertension. [ABSTRACT FROM AUTHOR]

Large epidemiologic studies suggest that diets rich in total or specific carotenoids are associated with a reduced risk of many chronic diseases. However, there are few studies characterizing trends in dietary carotenoid sources and intake among subgroups of the US adult population in the previous decade. This study aimed to assess these trends using data from 22,339 adults who participated in NHANES 2009–2018 cycles. Carotenoid intake and major food sources were calculated by linking food consumption data from the 24 h diet recall to an FNDDS 2009–2018 and the USDA's National Nutrient Database for Standard Reference (Release 28). Among US adults, mean (SE) dietary carotenoid intake was 9687.1 (158.0) mcg/day, and total intake was highest in men, non-smokers, moderate alcohol consumers, supplement users, and those with normal BMI, a PIR ≥ 1.85, and whose physical activity level was considered vigorous (p < 0.05). Carotenoid intake has gradually decreased over the past decade (p-trend: 0.097), especially among White adults (p-trend < 0.05), males (p-trend: 0.062), and those with a PIR of 1.0–1.3 (p-trend: 0.051), as have estimated rates of vitamin A adequacy. Tomatoes, carrots, and spinach were major food sources of carotenoids, and consumption of carrots and tomatoes decreased, while the consumption of lettuce, spinach, and salsa increased from 2009 to 2018. Our results warrant further studies investigating the consequences of the decreased tendencies of carotenoid intake on chronic disease risk, especially focusing on population subgroups exhibiting low or decreasing trends of carotenoid intake status. [ABSTRACT FROM AUTHOR]

Context: Carbon monoxide (CO) concentrations in exhaled air may impart a quick, non-invasive method to determine smoking status. Haras is a nutraceutical medication, which is slowly gaining recognition for its antioxidant and anti-inflammatory activities. Aims: The effectiveness of the Haras therapy in smokers and non-smokers will be assessed by evaluating breath CO levels. Methods and Materials: The study included 101 test subjects with 76 subjects of smokers and 25 subjects of non-smokers. Both the test groups were given 10 mL of Haras juice in divided doses per day for 30 days. The CO levels were evaluated using a breath analyser before drug trial and then on the 8th, 15th, 22nd and after the conclusion of the drug trial. Statistical Analysis Used: The Wilcoxon signed-rank test was used to compare the CO and carboxyhemoglobin levels among smokers and non-smokers. Results: Smokers had higher mean percent carboxyhemoglobin and mean parts per million CO values than non-smokers, and the difference between the two was shown to be statistically significant (P < 0.001). It was also found to be statistically significant from the first day to the eighth day, the first day to the 15th day, the first day to the 20th second day, first day to the 30th day (P < 0.001). Conclusions: Haras can be used effectively as an alternative supportive treatment for the diminution of CO levels in smokers and non-smokers. [ABSTRACT FROM AUTHOR]

INTRODUCTION The aim of this study is to identify profiles of never smokers, ex-smokers, occasional smokers, and daily smokers, through their individual, lifestyle, and health characteristics. This analysis allows provides profiles of individuals with a greater or less propensity to use tobacco, which contributes to the design of effective prevention policies. METHODS Econometric models are used with data from the Spanish National Health Survey. Specifically, a multinomial logit model is estimated to evaluate the probabilities of tobacco use. Additionally, discrete changes, odds ratios, and predicted probabilities for prone individuals, are calculated. RESULTS Differences are found between the profiles of each alternative of tobacco use. The individual attributes with the most striking effect are being aged 26-45 years, which reduces the probability of being a non-smoker by 21 percentage points compared to the younger group, and regular exposure to secondhand smoke, which is 30% more likely to be a regular smoker. The characteristics that define an individual with higher probability of smoking daily are: belonging to a certain region of Spain, male, aged 26-45 years, born in Spain, unemployed, with primary studies, separated, no physical activity, consumes alcohol, and is exposed to smoke regularly, not chronically ill, and have very poor health. CONCLUSIONS Identification of the profiles most likely to choose each of the tobacco consumption alternatives can contribute to the design of more effective prevention strategies. The results confirm that the accumulation of bad habits results in a high risk of smoking. The quantification of the differences in the effects of each trait is an interesting contribution that is useful to orient the policies to specific segments of the population more prone to consume tobacco. [ABSTRACT FROM AUTHOR]

INTRODUCTION Smoking tobacco results in the death of more than 8 million people every year. Our study aims to explore a new approach for smoking cessation by analyzing body composition differences between smokers and non-smokers, focusing on potential variations in biological and chronological ages. METHODS A cross-sectional study was conducted in 2019 at the Special Hospital for Medical Rehabilitation in Croatia. It included 164 subjects, 81 smokers and 83 non-smokers, aged 40-65 years. This study was part of a two-year investigation on locomotor parameter changes as early COPD predictors. Measurements encompassed body parameters, spirometry tests, and body composition. Spirometry was done using the Flowscreen Pro device, and the FEV1/FVC ratio determined lung function. The GAIA 359 PLUS device assessed body composition and estimated biological age. Exclusion criteria applied to specific medical conditions and recent surgeries. RESULTS Smokers had a slightly higher percentage of fat tissue than non-smokers (median=27%, IQR: 24-31) compared to non-smokers (median=25%, IQR: 22-28, p<0.001). The difference in the Gaia estimated age and the actual age of the subjects was significantly higher in the group of smokers (median=2, IQR: 0-3) compared to non-smokers (median=0 IQR: -2-2, p=0.003), but they did not differ in muscle tissue, weight or the proportion of trunk adipose tissue. CONCLUSIONS Our study revealed that smokers exhibit higher fat tissue percentages and a higher estimated biological age relative to non-smokers. These findings underscore the established health hazards of smoking and the imperative for smoking cessation in mitigating these adverse effects. [ABSTRACT FROM AUTHOR]

The SCREEN study investigated screening eligibility and survival outcomes between heavy smokers and light-or-never-smokers with lung cancer to determine whether expanded risk factor analysis is needed to refine screening criteria. SCREEN is a retrospective study of 917 lung cancer patients diagnosed between 2005 and 2018 in Nova Scotia, Canada. Screening eligibility was determined using the National Lung Screening Trial (NSLT) criteria. Mortality risk between heavy smokers and light-or-never-smokers was compared using proportional-hazards models. The median follow-up was 2.9 years. The cohort was comprised of 179 (46.1%) female heavy smokers and 306 (57.8%) female light-or-never-smokers. Light-or-never-smokers were more likely to have a diagnosis of adenocarcinoma [n=378 (71.6%)] compared to heavy smokers [n=234 (60.5%); P < 0.001]. Heavy smokers were more frequently diagnosed with squamous cell carcinoma [n=111 (28.7%)] compared to light-or-never-smokers, [n=100 (18.9%); P < 0.001]. Overall, 36.9% (338) of patients met NLST screening criteria. There was no difference in 5-year survival between light-or-never-smokers and heavy smokers [55.2% (338) vs 58.5% (529); P = 0.408; HR 1.06, 95% CI 0.80-1.40; P = 0.704]. Multivariate analysis showed that males had an increased mortality risk [HR 2.00 (95% CI 1.57-2.54); P < 0.001]. Half of lung cancer patients were missed with the conventional screening criteria. There were more curable, stage 1 tumors among light-or-never-smokers. Smoking status and age alone may be insufficient predictors of lung cancer risk and prognosis. Expanded risk factor analysis is needed to refine lung cancer screening criteria. [Display omitted] [ABSTRACT FROM AUTHOR]

Background The use of e-cigarettes has been rising in the UK, particularly by young people. This study investigated behaviours, attitudes and beliefs about e-cigarettes amongst 15–30-year-olds in the UK. Methods An online survey was administered to a sample of 1009 15–30-year-olds in the UK. Results About one in five participants currently used e-cigarettes at least monthly, with 1 in 10 using them daily. Amongst those using e-cigarettes at least monthly, 90% had used e-cigarettes containing nicotine. E-cigarettes were mainly obtained from vape shops and used at home. Having friends who used e-cigarettes and using them to help quit/reduce smoking were the most common reasons for vaping. About half of participants had been exposed to e-cigarette advertising, especially online, and warning labels on e-cigarettes. Most participants agreed that e-cigarettes are addictive (75%), help people quitting smoking (64%) and are bad for health (63%). Previous or current tobacco smokers were 9 and 22 times more likely to use e-cigarettes than never smokers, respectively. Perceiving e-cigarettes as harmful was associated with a 40% lower likelihood of use. Conclusion Raising awareness on the uncertain long-term consequences of vaping and regulation of marketing and sales are crucial to protect young people in the UK. [ABSTRACT FROM AUTHOR]

Objective: This study aims to evaluate the gingival crevicular fluid (GCF) levels of tumor necrosis factor‐α (TNF‐α), zonula occludens‐1 (ZO‐1), occludin (Occ), and tricellulin (Tric) in periodontitis, as well as their alterations due to smoking. Background: Tight junctions (TJ), which consist of transmembrane and cytoplasmic scaffolding proteins, connect the epithelial cells of the periodontium. Occ, claudins, junctional adhesion molecules, and Tric are transmembrane TJ proteins found at the cell membrane. The transmembrane TJ proteins and the intracellular cytoskeleton are directly linked by cytoplasmic scaffolding proteins such as ZO‐1. Although the functions and locations of these molecules have been defined, their behavior in periodontal inflammation is unknown. Methods: The study included four groups: individuals with periodontal health without smoking (C; n = 31), individuals with generalized Stage III periodontitis without smoking (P; n = 28), individuals with periodontal health while smoking (CS; n = 22), and individuals with generalized Stage III periodontitis while smoking (PS; n = 18). Clinical periodontal parameters were recorded, and enzyme‐linked immunosorbent assay (ELISA) was used to examine ZO‐1, Occ, Tric, and TNF‐α levels in GCF. Results: In the periodontitis groups, clinical parameters were significantly higher (p <.001). The site‐specific levels of TNF‐α, ZO‐1, Tric, and Occ in the P group were statistically higher than those in the other groups (p <.05). TNF‐α, probing pocket depth (PPD), and bleeding on probing (BOP) exhibited positive correlations with all TJ proteins (p <.005). Conclusions: Smoking could potentially affect the levels of epithelial TJ proteins in the GCF, thereby potentially playing a significant role in the pathogenesis of the periodontal disease. [ABSTRACT FROM AUTHOR]

People failing to give a specimen of breath at a police station are assumed to be deliberately obstructive and are charged with Failure to Provide under the Road Traffic Act 1988. However, spirometry records of 281,210 healthy individuals from UK BioBank showed that a significant minority cannot use existing evidential breath analysis machines. Women were three times more likely to be unable to use them than men (1.64% vs 0.54%) with the risk rising with age six-fold from those in their 40s (0.43%) to 2.7% in their 70s, with women more affected (0.65% to 3.8%). Short stature was a further risk factor: 2.6% of men and 3.8% of women below the 2nd percentile of height could not use the current machines, with almost one in ten elderly, short women unable to do so, while smokers aged 50+ were twice as likely as non-smokers of the same age to be unable to provide breath specimens. [ABSTRACT FROM AUTHOR]

We evaluated and compared the biomechanical properties of Leukocyte-and Platelet Rich Fibrin L-PRF clots and membranes derived from smoker and nonsmoker donors. Twenty venous-blood donors (aged 18 to 50 years) were included after signing informed consent forms. L-PRF clots were analyzed and then compressed to obtain L-PRF membranes. L-PRF clot and membrane samples were tested in quasi-static uniaxial tension and the stress–stretch response was registered and characterized. Furthermore, scanning electron microscope representative images were taken to see the fibrin structure from both groups. The analysis of stress–stretch curves allowed us to evaluate the statistical significance in differences between smoker and nonsmoker groups. L-PRF membranes showed a stiffer response and higher tensile strength when compared to L-PRF clots. However, no statistically significant differences were found between samples from smokers and nonsmokers. With the limitations of our in vitro study, we can suggest that the tensile properties of L-PRF clots and membranes from the blood of smokers and nonsmokers are similar. More studies are necessary to fully characterize the effect of smoking on the biomechanical behavior of this platelet concentrate, to further encourage its use as an alternative to promote wound healing in smokers. [ABSTRACT FROM AUTHOR]

To assess the effect of chronic cigarette smoking on corneal and lens densitometry measurements using Pentacam HR and to compare the results obtained with those in non-smokers. This cross-sectional comparative study included 40 chronic-smokers and 40 age-matched healthy non-smokers between 18–40 years. After general ophthalmic examination, the Pentacam HR imaging system was used to evaluate corneal and lens densitometry measurements of smokers and non-smokers. The mean corneal densitometry values were not statistically significantly different in all the concentric zones and layers in the eyes of the smokers and non-smokers (p > 0.05, for all). However, the mean values of zone 1, zone 2, zone 3 and average lens densitometry measurements of the smokers were statistically significantly higher compared to non-smokers (p < 0.05, for all). Additionally, significant positive correlations were detected between the number of pack-years smoked and lens densitometry measurements. Lens densitometry measurements of smokers were significantly increased while corneal densitometry measurements were not significantly altered compared to non-smokers. Smoking may contribute to cataractogenesis and smoking and age-related changes may act synergistically to cataract development among smokers. [ABSTRACT FROM AUTHOR]

The exposure to smoking related products has been evaluated through urine illness risk marker determination through the analysis of urine samples of smokers and vapers. Biomarkers and their metabolites such as N-acetyl-S-(2-cyanoethyl)-L-cysteine (CEMA), N-acetyl-S-(3,4-dihydroxybutyl)-L-cysteine (DHBMA), N-acetyl-S-[1-(hydroxymethyl)-2-propen-1-yl)-L-cysteine (MHBMA), N-acetyl-S-(3-hydroxypropyl)-L-cysteine (3HPMA), 2R-N-acetyl-S-(4-hydroxybutan-2-yl)-L-cysteine (HMPMA), and N-acetyl-S-(3-carboxy-2-propyl)-L-cysteine (CMEMA) together with nicotine and cotinine were identified and quantified by LC-HRMS and LC-MS/MS, and data found normalized to the creatinine level. One hundred two urine samples were collected from smokers, non-smokers, and vapers, spanning an age range from 16 to 79 years. Results obtained showed that CEMA was only detected in urine samples from smokers and MHBMA was in the same order of magnitude in all the urine samples analyzed. HMPMA was found in the urine of vapers at the same order of concentration as in non-smokers. 3HPMA in vapers was lower than in the urine of smokers, presenting an intermediate situation between smokers and non-smokers. On the other hand, DHBMA in vapers can reach similar values to those found for smokers, while CMEMA shows concentrations in the urine of vapers higher than in the case of non-smokers and traditional smokers, requiring new research to link this metabolite to the use of electronic cigarettes and possible alternative metabolomic routes. In general, this study seems to verify that traditional smoking practice constitutes a major source of carcinogenic chemicals compared with substitutive practices, although those practices are not free of potential harm. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to examine the relationship between secondhand smoke (SHS) exposure and severe headaches or migraine in never‐smoking adults verified by serum cotinine. Background: Current evidence about the association between self‐reported SHS exposure and headaches or migraine is limited and contradictory. An important issue lies in the lack of actual SHS exposure assessment through biomarkers. Methods: We conducted a cross‐sectional study on 4560 never‐smoking adults from the National Health and Nutrition Examination Survey (NHANES), 1999–2004. The SHS exposure was evaluated by measuring serum cotinine concentrations. The information regarding severe headaches or migraine was based on self‐reporting. Results: The overall prevalence rate of severe headaches or migraine was 20% (919/4560). After adjusting for relevant covariates, we found that heavy SHS exposure (serum cotinine at 1 to 10 ng/mL) was positively associated with severe headaches or migraine (OR: 2.02, 95% CI [1.19, 3.43]); however, no significant association was found between low SHS exposure (serum cotinine at 0.05 to 0.99 ng/mL) and severe headaches or migraine (OR: 1.15, 95% CI [0.91, 1.47]). Restricted cubic spline analysis showed that the natural logarithm of serum cotinine had a linear relationship with severe headaches or migraine (p = 0.335 for nonlinearity). Stratified analysis indicated that individuals with a BMI of <25 (p < 0.001 for interaction) and sedentary activity (p = 0.016 for interaction) modified the relationship between SHS exposure and severe headaches and migraine. Even after altering the definition of SHS exposure, excluding drugs that might affect the metabolism of serum cotinine, and multiple imputation, our sensitivity analysis results remained stable. Conclusions: The study demonstrated that heavy SHS exposure (serum cotinine at 1 to 10 ng/mL) had a significant positive association with severe headaches or migraine in never‐smoking adults. Prospective studies are necessary to verify this relationship in the future. [ABSTRACT FROM AUTHOR]

Exposure to radon can impact human health. This is a nonsystematic review of articles written in English, Spanish, French, or Portuguese published in the last decade (2013-2023), using databases such as PubMed, Google Scholar, EMBASE, and SciELO. Search terms selected were radon, human health, respiratory diseases, children, and adults. After analyzing the titles and abstracts, the researchers initially identified 47 studies, which were subsequently reduced to 40 after excluding reviews, dissertations, theses, and case-control studies. The studies have shown that enclosed environments such as residences and workplaces have higher levels of radon than those outdoors. Moreover, radon is one of the leading causes of lung cancer, especially in nonsmokers. An association between exposure to radon and development of other lung diseases, such as asthma and COPD, was also observed. It is crucial to increase public awareness and implement governmental control measures to reduce radon exposure. It is essential to quantify radon levels in all types of buildings and train professionals to conduct such measurements according to proven efficacy standards. Health care professionals should also be informed about this threat and receive adequate training to deal with the effects of radon on human health. [ABSTRACT FROM AUTHOR]

Introduction: Immune checkpoint inhibitor (ICI) pneumonitis causes substantial morbidity and mortality. Estimates of real-world incidence and reported risk factors vary substantially. Methods: We conducted a retrospective review of 419 patients with advanced non-small cell lung cancer (NSCLC) who were treated with anti-PD-(L)1 with or without anti-CTLA-4 therapy. Clinical, imaging, and microbiological data were evaluated by multidisciplinary adjudication teams. The primary outcome of interest was grade ≥2 (CTCAEv5) pneumonitis. Clinicopathologic variables, tobacco use, cancer therapies, and preexisting lung disease were assessed for univariate effects using Cox proportional hazards models. We created multivariate Cox proportional hazards models to assess risk factors for pneumonitis and mortality. Pneumonitis, pneumonia, and progression were modeled as time-dependent variables in mortality models. Results: We evaluated 419 patients between 2013 and 2021. The cumulative incidence of pneumonitis was 9.5% (40/419). In a multivariate model, pneumonitis increased the risk for mortality (HR 1.6, 95% CI, 1.0-2.5), after adjustment for disease progression (HR 1.6, 95% CI, 1.4-1.8) and baseline shortness of breath (HR 1.5, 95% CI, 1.2-2.0). Incomplete resolution was more common with more severe pneumonitis. Interstitial lung disease was associated with higher risk for pneumonitis (HR 5.4, 95% CI, 1.1-26.6), particularly in never smokers (HR 26.9, 95% CI, 2.8-259.0). Conclusion: Pneumonitis occurred at a high rate and significantly increased mortality. Interstitial lung disease, particularly in never smokers, increased the risk for pneumonitis. This article examines the predisposing risk factors and incidence of pneumonitis in patients with non-small cell lung cancer undergoing immune checkpoint inhibitor therapy and explores the potential modifying effects of smoking history and preexisting lung disease. [ABSTRACT FROM AUTHOR]

Background: Electronic cigarettes or e-cigarettes have gained significant popularity as an alternative to traditional combustible tobacco smoking particularly among the youth. Although there is a growing prevalence of e-cigarette usage, the effects on cardiovascular function and physical capacity have not been adequately studied. The toxic products in combustible tobacco cigarettes negatively impact functional exercise capacity. However, the available data regarding the effect of e-cigarette use on functional exercise capacity are scarce. Thus, in the current study, we aimed to evaluate the functional aerobic exercise capacity among chronic e-cigarette users compared to combustible cigarette smokers and non-smokers. Results: This comparative, cross-sectional study was conducted on 105 healthy volunteers. Participants were assigned into three study groups each consisting of 35 participants: chronic e-cigarette users, combustible cigarette smokers, and a non-smoker control group. Basal demographic and clinical data were similar in all groups. Mean heart rates and respiratory rates were significantly higher among e-cigarette smokers and combustible cigarette smokers compared to non-smoker controls (p < 0.001). Chronic e-cigarette users and combustible cigarette smokers had shorter 6-MWT distances compared to non-smokers (508.3, 488, and 616.6 m, respectively, p < 0.001). Borg scale scores after performing the six-minute walking test were significantly higher in chronic e-cigarette users and combustible cigarette smokers groups compared to non-smokers, where perceived exertion (4.9, 5.5, 2.1, respectively, p < 0.001), dyspnea (5.7, 6.5, 0.1, respectively, p < 0.001) and leg fatigue (4.2, 5.4, 1.4, respectively, p < 0.001). Conclusion: In this cross-sectional study, significant evidence demonstrates that e-cigarette use is not harmless. This was particularly presented in apparently healthy e-cigarette users in comparison to the healthy non-smoker control group. Chronic e-cigarette use is associated with reduced functional capacity compared to non-smoker controls. This was signified by decreased 6MWT walking distances, higher Borg scale scores, and lower oxygen saturation percentages among the chronic electronic cigarette users as compared to non-smoker controls after performing the six-minute walking test. All the evaluated parameters in the current study were similarly reduced among both the e-cigarette users group and the combustible cigarette smokers group compared to non-smokers with no statistically significant differences between both smoker groups. [ABSTRACT FROM AUTHOR]

Aims: By performing three transcranial magnetic stimulation (TMS) experiments, we measured the motor‐specific modulatory mechanisms in the primary motor cortex (M1) at both the intercortical and intracortical levels when smokers actively approach or avoid smoking‐related cues. Design, Setting and Participants: For all experiments, the design was group (smokers versus non‐smokers) × action (approach versus avoidance) × image type (neutral versus smoking‐related). The study was conducted at the Shanghai University of Sport, CHN, TMS Laboratory. For experiment 1, 30 non‐smokers and 30 smokers; for experiment 2, 16 non‐smokers and 16 smokers; for experiment 3, 16 non‐smokers and 16 smokers. Measurements: For all experiments, the reaction times were measured using the smoking stimulus–response compatibility task. While performing the task, single‐pulse TMS was applied to the M1 in experiment 1 to measure the excitability of the corticospinal pathways, and paired‐pulse TMS was applied to the M1 in experiments 2 and 3 to measure the activity of intracortical facilitation (ICF) and short‐interval intracortical inhibition (SICI) circuits, respectively. Findings Smokers had faster responses when approaching smoking‐related cues (F1,58 = 36.660, P < 0.001, ηp2 = 0.387), accompanied by higher excitability of the corticospinal pathways (F1,58 = 10.980, P = 0.002, ηp2 = 0.159) and ICF circuits (F1,30 = 22.187, P < 0.001, ηp2 = 0.425), while stronger SICI effects were observed when they avoided these cues (F1,30 = 10.672, P = 0.003, ηp2 = 0.262). Conclusions: Smokers appear to have shorter reaction times, higher motor‐evoked potentials and stronger intracortical facilitation effects when performing approach responses to smoking‐related cues and longer reaction times, a lower primary motor cortex descending pathway excitability and a stronger short‐interval intracortical inhibition effect when avoiding them. [ABSTRACT FROM AUTHOR]

Background and aims: Exposure to chemicals contributes to harm from nicotine products, and e‐cigarette communications often refer to chemicals. However, while e‐cigarette studies commonly measure perceived harmfulness of e‐cigarettes relative to cigarettes, few have assessed comparative perceptions about chemicals. This study measured perceived levels of harmful chemicals in e‐cigarettes compared with cigarettes and associations with e‐cigarette/cigarette relative harm perceptions, e‐cigarette use and interest. Design, setting and participants: This was an on‐line cross‐sectional survey of adults/young adults from a nationally representative research panel in the United States conducted in January 2021. Participants were independent samples of 1018 adults who smoked cigarettes and 1051 young adult non‐smokers (aged 18–29 years). Measurements: Participants were asked their perceptions of the level of harmful chemicals in e‐cigarettes versus cigarettes (fewer/about the same/more/do not know), perceived harmfulness of using e‐cigarette versus cigarettes (less/about the same/more/do not know) and their current e‐cigarette use and use interest. Findings Approximately 20% of all participants (18.1% of adult smokers, and 21.0% of young adult non‐smokers) believed e‐cigarettes contain fewer harmful chemicals than cigarettes, while 35.6% of adult smokers and 24.9% of young adult non‐smokers responded 'do not know'. Participants more frequently reported 'do not know' to the chemicals item than the harm item. Approximately half (51.0–55.7%) of those who believed e‐cigarettes contain fewer harmful chemicals also believed e‐cigarettes are less harmful than cigarettes. Both beliefs were associated with higher odds of interest in using e‐cigarettes [less harmful belief, odds ratio (OR) = 5.53, 95% confidence interval (CI = 2.93–10.43); fewer chemicals belief, OR = 2.45, 95% CI = 1.40–4.29] and past 30‐day e‐cigarette use (less harmful belief, OR = 2.53, 95% CI = 1.17–5.44; fewer chemicals belief, OR = 5.09, 95% CI = 2.31–11.19) for adults who smoke, but not young adult non‐smokers. Conclusions: In the United States, most adults who smoke cigarettes and young adult non‐smokers do not appear to think that e‐cigarettes have fewer harmful chemicals than cigarettes, and many are uncertain about how these levels compare. [ABSTRACT FROM AUTHOR]

Background: Diagnosis of gastroesophageal reflux disease (GERD) relies on recognizing symptoms of reflux and mucosal changes during esophagogastroduodenoscopy. The desired response to acid suppression therapy is reliable resolution of GERD symptoms; however, these are not always reliable, hence the need for pH testing in unclear cases. Our objective was to identify potential predictors of a high DeMeester score among patients with potential GERD symptoms to identify patients most likely to have pathological GERD. Methods: We conducted a retrospective case-control study on patients who underwent wireless pH monitoring from January 2020 to April 2022. Cases were patients with a high DeMeester score (more than 14.7), indicating pathological reflux, and controls were those without. We collected clinical and demographic data, including age, sex, body mass index (BMI), smoking status, nonsteroidal anti-inflammatory drugs (NSAIDs) use, and presence of atypical symptoms. Results: 86 patients were enrolled in the study. 46 patients with high DeMeester scores were considered cases, and 40 patients with DeMeester scores less than 14.7 were considered controls. Esophagitis (grade A) was found in 41.1% of the cases and in 22.5% of the control group. In our study, age of more than 50 years compared with age of 20-29 years and being overweight appeared to be predictors of true pathological reflux among patients with reflux symptoms who underwent wireless pH monitoring. Conclusion: Age above 50 years compared with age between 20-29 years and being overweight appeared to be predictors of true pathological reflux among patients with reflux symptoms who underwent wireless oesophageal pH monitoring. The presence of oesophagitis was approximately four times more likely to be associated with true pathological reflux. [ABSTRACT FROM AUTHOR]

Simple Summary: The detailed role of the TP53 p.P72R (rs1042522) variant in the etiology and course of multiple myeloma (MM), as well as its association with chromosome 17 aberrations, has not been analyzed in a such a wide range. In our study, we have explored the significance of the p.P72R variant, expression level of TP53 gene, deletion of TP53 locus and chromosome 17 aneuploidies in MM development, and the response to bortezomib/thalidomide treatment in MM patients. We have shown that the p.R72R variant was associated with a higher age of MM patients at diagnosis and with a higher number of plasma cells. We have found higher expression of TP53 in MM smokers in comparison to MM non-smokers. TP53 gene expression and the p.P72R variant did not affect the MM outcome. Multiple myeloma (MM) is a multifactorial genetic disorder caused by interactive effects of environmental and genetic factors. The proper locus of the TP53 gene (17p13.1) and its protein is essential in genomic stability. The most common variant of the TP53 gene—p.P72R (rs1042522)—shows functional variation. The aim of our study was a complex analysis of the TP53 p.P72R variant and TP53 gene expression in relation to chromosomal changes of the TP53 gene locus, as well as MM risk and outcome. Genomic DNA from 129 newly diagnosed MM patients was analyzed by methods of automated DNA sequencing (for TP53 variant analysis) and cIg-FISH (for chromosomal aberrations analysis). RNA was used in real-time PCR to determine the TP53 expression. In MM patients, the TP53 variant was not in Hardy–Weinberg equilibrium. The RR genotype was associated with lower MM risk (OR = 0.44, p = 0.004). A higher number of plasma cells was found in patients with RR genotype in comparison to those with PP + PR genotypes (36.74% vs. 28.30%, p = 0.02). A higher expression of the TP53 gene was observed in PP + PR genotypes vs. RR homozygote (p < 0.001), in smokers vs. non-smokers (p = 0.02). A positive Pearson's correlation was found between the TP53 expression level and the number of plasma cells (r = 0.26, p = 0.04). The presence of chromosome 17 aberrations with or without TP53 locus did not affect the MM risk and outcome. Similar results were observed in the case of TP53 gene expression and the p.P72R variant. [ABSTRACT FROM AUTHOR]

Introduction: Although Indonesia is not a signatory to the World Health Organization Framework Convention on Tobacco Control, 84% of local governments have adopted Smoke-Free Areas (SFAs) as a national policy. This study examines exposure to secondhand smoke (SHS) in adolescents who have never smoked after 8 years of SFA implementation. Methods: We used data from the 2019 Global Youth Tobacco Survey and a cross-sectional research design to find 6121 students from 148 schools in 30 provinces in Indonesia who met the research inclusion criteria. To identify risk factors regarding SHS exposure, multivariable logistic regression analysis was performed. Results: Although the local government had adopted an SFA policy, 61.1% of adolescents aged 11–17 years, especially middle and high school students, have relatively high exposure to SHS. School environments had the highest prevalence of SHS exposure (50.5%), followed by public places (49.9%) and at home (46.2%). A significant risk factor for exposure to SHS in the school environment is observed in teachers smoking inside school buildings (odds ratio [OR] =4.32, 95% confidence interval [CI]: 3.81–4.89); exposure to SHS at home and in public place (OR = 3.29, 95% CI: 2.93–3.70), and exposure to tobacco advertising, promotion, and sponsorship on offline and online media (OR = 2.07, 95% CI: 1.70–2.52). Conclusion: SFA policies must be evaluated and strengthened before they can be implemented to reduce smoking-related illnesses and economic losses. In addition, it is important to educate families and society about implementing SFA in school environments, public places, and at home. [ABSTRACT FROM AUTHOR]

IntroductionThe severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the virus responsible for the COVID-19 pandemic, gains entry into the host cell when its Spike protein is cleaved by host proteases TMPRSS2 and furin, thereby markedly increasing viral affinity for its receptor, angiotensin-converting enzyme-2 (ACE2). In rodent and diseased human lungs, tobacco cigarette (TCIG) smoke increases ACE2, but the effect of electronic cigarette vaping (ECIG) is unknown. It is unknown whether nicotine (in both TCIGs and ECIGs) or non-nicotine constituents unique to TCIG smoke increase expression of key proteins in COVID-19 pathogenesis.MethodsImmune (CD45+) cells collected before the pandemic in otherwise healthy young people, including TCIG smokers (n = 9), ECIG vapers (n = 12), or nonsmokers (NS) (n = 12), were studied. Using flow cytometry, expression of key proteins in COVID-19 pathogenesis were compared among these groups.ResultsTCIG smokers and ECIG vapers had similar smoking or vaping burdens as indicated by similar plasma cotinine levels. TCIG smokers compared with NS had a significantly increased percentage of cells that were positive for ACE2 (10-fold, p < .001), TMPRSS2 (5-fold, p < .001), and ADAM17 (2.5-fold, p < .001). Additionally, the mean fluorescence intensity (MFI) consistently showed greater mean ACE2 (2.2-fold, p < .001), TMPRSS2 (1.5-fold, p < .001), furin (1.1-fold, p < .05), and ADAM17 (2-fold, p < .001) in TCIG smokers compared with NS. In ECIG vapers, furin MFI was increased (1.15-fold, p < .05) and TMPRSS2 MFI tended to be increased (1.1-fold, p = .077) compared with NS.ConclusionsThe finding that key instigators of COVID-19 infection are lower in ECIG vapers compared with TCIG smokers is intriguing and warrants additional investigation to determine if switching to ECIGs is an effective harm reduction strategy. However, the trend toward increased proteases in ECIG vapers remains concerning.Implications(1) This is the first human study to report a marked increase in proteins critical for COVID-19 infection, including ACE2, TMPRSS2, and ADAM17, in immune cells from healthy tobacco cigarette smokers without lung disease compared with e-cigarette vapers and nonsmokers. (2) These findings warrant additional investigation to determine whether switching to electronic cigarettes may be an effective harm reduction strategy in smokers addicted to nicotine who are unable or unwilling to quit. (3) The increase in proteases in electronic cigarette vapers remains concerning.

Home smoking bans can reduce tobacco smoke exposure, but little is known about the impact for Chinese American household pairs. In this study of 202 household pairs with low acculturation, 53.9% reported a home smoking ban, 31.7% had inconsistent reports, and 14.4% reported no ban. With decreasing home smoking ban enforcement, more nonsmokers had tobacco smoke exposure (66.1%-86.2%) as measured by the tobacco-specific nitrosamine biomarker urine NNAL (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol). Despite reported bans, about one-quarter of nonsmokers still reported tobacco smoke exposure at home (23.6%-30%) within the past 2 months and three-quarters reported outdoor exposure. In adjusted regression analyses of geometric mean NNAL ratios, nonsmokers in households with no ban had over two times higher levels than nonsmokers in households with a ban: adjusted log NNAL ratio = 2.70 (95% CI 1.21, 6.03). Higher smoker NNAL level and nonsmoker English fluency were also significantly associated with nonsmoker NNAL levels. Nonsmoker levels in households with an inconsistent ban were not significantly different compared to those with a ban. Although home smoking bans were generally associated with lower NNAL levels, tobacco smoke exposure in this immigrant population with low English proficiency was higher than that of the general population. From a health equity standpoint, there is a need for broader implementation and enforcement of comprehensive smoke-free policies.

BackgroundSmoking is a well-known risk factor of frailty. Handgrip strength (HGS) is highly representative of muscular strength and is used in the diagnosis of frailty; however, the relationship between smoking and HGS is not clear. We evaluated the relationship between smoking status and HGS.ObjectivesThis study aimed to evaluate the association between HGS and smoking status.MethodsWe enrolled adult males between the ages of 19 and 80 years who participated in the Korea National Health and Nutrition Examination Survey VII–VIII. A chi-square test and ANOVA were performed to compare the mean handgrip strength (mean HGS) between non-smokers, ex-smokers, and current smokers. Logistic regression analysis was performed to determine the association between the smoking status and mean HGS, and additional analyses were performed by dividing subgroups by age.ResultsA total of 7,649 participants were analyzed. When the mean HGS and mean dominant HGS were compared according to smoking status, HGS was higher in the right hand (value of p = 0.03) and left hand (value of p 60 years had a higher grip strength than non-smokers.ConclusionCurrent smokers had a stronger mean HGS than that of ex-smokers and non-smokers. Current smokers older than 60 years appeared to have a stronger mean HGS than ex-smokers and non-smokers of the same age group.

Background. A major issue is finding a valid biomarker able to diagnose periodontal disease with the presence and absence of risk factors. Indeed, the association between smoking and periodontal diseases and its impact on the manifestation of antimicrobial peptides has been delineated in clinical and epidemiological investigations. The antimicrobial peptide cathelicidin (LL-37) is pivotal in preserving periodontal health. Objectives. This investigation examines and contrasts the levels of cathelicidin in the saliva of smokers and nonsmokers of periodontitis. The study also seeks to establish this biomarker's diagnostic ability to differentiate between periodontal health and disease. Materials and Methods. The study involved the collection of unstimulated saliva samples from 160 participants, comprising 80 patients diagnosed with periodontitis (40 of whom were smokers and 40 were nonsmokers) and 80 periodontitis-free individuals (40 smokers and 40 nonsmokers). The clinical periodontal parameters were assessed, including recording the probing pocket depth, the level of clinical attachment, and the percentage of bleeding on probing. Subsequently, enzyme-linked immunosorbent assays were conducted to quantify the protein levels of LL-37 in the saliva samples obtained from the subjects mentioned above. Results. The highest level of salivary LL-37 was found in the nonsmoker periodontitis (NSP) patients, followed by the group of smoker periodontitis (SP) and then nonsmoker healthy (NSH) group, while the lowest level was found in the healthy smoker (HS) group. At the same time, the LL-37 seems to be a very good biomarker in differentiating periodontal health from disease with the presence and absence of smoking. Conclusion. Periodontitis results in a significant elevation of salivary LL-37 levels in smoker and nonsmoker patients compared to healthy individuals. These levels are positively correlated with the periodontal parameter and can serve as a valuable diagnostic tool to predict periodontitis, whereas smoking significantly reduces these levels. [ABSTRACT FROM AUTHOR]

Aims: Two phase 1 studies characterized the oral bioavailability of AZD4635 (potential anticancer therapy) and factors that may influence its pharmacokinetics (PKs; food, smoking, proton‐pump inhibitors [PPIs] and CYP1A2 inhibitors) to support continued clinical development of AZD4635. Methods: Study 1 (comparative PK study; nonsmokers) consists of Part A and Part B. Participants (fasted) in Part A were administered 50 mg of AZD4635 either as nanosuspension or capsule. In Part B, these participants were administered a 50‐mg capsule either following a high‐fat meal or with a PPI in the fasted state. In Study 2 (CYP1A2 mediated drug‐drug interaction study), a 25‐mg AZD4635 capsule was administered to smokers and nonsmokers (fasted) with or without 100 mg of fluvoxamine. Results: In Study 1 (N = 21), AZD4635 exposure was comparable between the capsule and nanosuspension. The high‐fat meal produced a 12% decrease in AUCinf, a ≥50% reduction in Cmax and delayed absorption (Tmax: 4.0 h vs 1.5 h) for the capsule. The PPI did not affect the oral bioavailability of the AZD4635 capsule. In Study 2 (N = 28), AZD4635 + fluvoxamine (compared with AZD4635 alone) produced ~5‐fold increases in AUCinf, 2‐fold increases in Cmax and prolonged AZD4635 elimination half‐life in smokers (22.7 vs 9.0 h) and nonsmokers (22.4 vs 9.2 h). All treatment regimens were well tolerated. The most common adverse events included dizziness, nausea and headache. Conclusions: The high‐fat meal reduced the rate but not the extent of AZD4635 absorption. The effect of gastric pH on AZD4635 was minimal. Smoking had no effect on the exposure (Cmax and AUCinf) of AZD4635, while fluvoxamine increased AZD4635 Cmax and total exposure. No new safety concerns were identified. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus disease 2019 (COVID-19) is the biggest health challenge of recent times. Studies so far reveal that vaccination is the only way to prevent this pandemic. There may be factors that decrease or increase vaccine effectiveness. In multiple sclerosis (MS), some of these factors may cause changes in the effectiveness of the vaccine, depending on the nature of the disease and disease-modifying treatments (DMT). In this study, we aimed to investigate the relationship between antibody titer and smoking in non-treated and DMT-treated MS patients who received inactivated vaccine (Sinovac) and messenger RNA BNT162b2 (BioNTech) mRNA vaccines. Method: Vaccine antibody responses were measured between 4--12 weeks after two doses of inactivated vaccine and mRNA vaccines. Patients were separated into 6 groups as: patients with MS without treatment PwMS w/o T, ocrelizumab, fingolimod, interferons (interferon beta-1a and interferon beta-1b), dimethyl fumarate, and teriflunomide. Antibody titers of smokers and non-smokers were compared for both vaccines and for each group. Results: The study included 798 patients. In the mRNA vaccine group, smokers (n=148; 2982±326 AU/mL) had lower antibody titers compared to the non-smokers (n=244; 5903±545 AU/mL) in total (p=0.020). In the inactivated vaccine group, no significant difference was detected between smokers (n=136; 383±51 AU/mL) and non-smokers (n=270; 388±49 AU/mL) in total (p=0.149). In both vaccine groups, patients receiving ocrelizumab and fingolimod had lower antibody titers than those receiving other DMTs or PwMS w/o T. In untreated MS patients, antibody levels in smokers were lower than in non-smokers in the mRNA vaccine group. No difference was found between antibody levels of smokers and non-smokers in any of the inactivated vaccine groups. Conclusion: Ocrelizumab and fingolimod have lower antibody levels than PwMS w/o T or other DMTs in both mRNA and inactivated vaccine groups. Smoking decreases antibody levels in the mRNA vaccine group, while it has no effect in the inactivated vaccine group. [ABSTRACT FROM AUTHOR]

Conventional cigarette smoking increases inflammation and white blood cell (WBC) counts. However, there have been limited studies on the relationship between heated cigarette smoking and WBC counts. This study aimed to examine this relationship using nationally representative population-based health data. This was a population-based cross-sectional study. The Korea National Health and Nutrition Examination Survey database was used to analyze this relationship. Data related to sex, age, body mass index (BMI), WBC count, and smoking history were obtained from the database. The smoking-related questionnaires included smoking status, smoking type (heated or conventional cigarettes), and smoking amount. The summary statistics of the WBC counts were calculated according to sex, smoking status, and smoking type. In addition, the exposure–response relationship between the smoking amount and WBC count was examined by smoking type, controlling for sex, age, and BMI. In total, 9747 WBC measurements were used in the analyses. WBC count increased in conventional cigarette smokers, while there was no significant difference in WBC count between heated cigarette smokers and non-smokers. The WBC count showed a positive dose–response relationship with the smoking amount in both conventional and heated cigarette smokers. The results confirm that conventional cigarette smoking increases WBC counts. Furthermore, the results suggest that heated cigarette smoking does not lead to a significant increase in WBC counts, although it indicates a potential dose–response relationship with WBC count. Further research with larger sample sizes is needed to confirm whether these results reflect true associations. [ABSTRACT FROM AUTHOR]

Background: Extrapulmonary small cell cancer (EPSCC) is a rare malignancy with an incidence of approximately 0.1%–0.4% of all cancers. Treatment of this disease is often based on small cell lung cancer. Aims: We aimed to investigate real‐world clinical outcomes of patients with extensive‐stage (ES) ESPCC. Methods: Patients diagnosed with ES EPSCC between 2010 and 2020 from multiple centres in New South Wales were identified. Patient, disease and treatment characteristics were collected and presented using descriptive statistics. Survival was analysed using the Kaplan–Meier method. Univariate and multivariate Cox regression hazard models were used to identify potential prognostic factors. Results: Sixty eligible ES EPSCC patients were identified, including 65% male and 35% female. The mean age was 69 years (range 37–88). Forty‐five per cent were never smokers, 42% ex‐smokers and 13% current smokers, and 17% of patients had limited‐stage disease prior to development of ES disease. The most common primary sites were genitourinary (42%; mainly prostate (n = 14) and bladder (n = 10)), gastrointestinal (28%; mainly oesophagus (n = 5) and colon (n = 4)) and unknown primary (22%). Treatments received included palliative chemotherapy (67%), palliative radiotherapy (53%), palliative surgery (13%) and best supportive care alone (13%). The median overall survival (OS) was 8.0 months. The median progression‐free survival was 5.4 months, and response rate to first‐line chemotherapy was 65%. Platinum‐based chemotherapy was prognostic of longer OS (HR 0.27, CI 0.12–0.60, P = 0.001). Conclusions: Patients with ES EPSCC had good response to palliative chemotherapy, but OS remained poor. Further research is required to improve the prognosis in this population. [ABSTRACT FROM AUTHOR]

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Objectives: In recent years, an increase in oral cancer among elderly nonsmokers has been noted. The aim of this study was to identify novel oncogenes in oral cancer in older nonsmokers. Material and Methods: Whole‐exome sequencing (WES) data from 324 oral cancer patients were obtained from The Cancer Genome Atlas. Single nucleotide variants (SNVs) and insertions/deletions (INDELs) were extracted from the WES data of older patients. Fisher's exact test was performed to determine the specificity of variants in these genes. Finally, SNVs and INDELs were identified by target enrichment sequencing. Results: Gene ontology analysis of 112 genes with significant SNVs or INDELs in nonsmokers revealed that nonsynonymous SNVs in HECTD4 were significantly more frequent in nonsmokers than in smokers by target enrichment sequencing (p =.02). Conclusions: Further investigation of the function of HECTD4 variants as oncogenes in older nonsmokers is warranted. [ABSTRACT FROM AUTHOR]

Cigarette smoking is known to adversely affect cellular metabolism and is a risk factor for various retinal diseases. Fluorescence lifetime imaging ophthalmoscopy (FLIO) has the potential to detect metabolic changes in the ocular fundus. Aim of this study was to analyze the influence of cigarette smoking on fluorescence lifetime (FLT) of healthy eyes using FLIO. Twenty-six non-smokers and 28 smokers aged between 20 and 37 years without systemic and ocular diseases were investigated by FLIO (excitation: 473 nm, emission: short spectral channel (SSC) 498–560 nm, long spectral channel (LSC) 560–720 nm). The FLT at the ETDRS grid regions were analyzed and compared. In SSC, the mean FLT (τm) of smokers was significantly longer in the ETDRS inner ring region, whereas the τm in LSC was significantly shorter in the outer ring. For the long component (τ2), smokers with pack year < 7.11 showed significantly shorter τ2 in SSC than non-smokers and the smokers with pack year ≥ 7.11. There were no significant differences in retinal thickness. The lack of obvious structural differences implies that the observed FLT changes are likely related to smoking-induced metabolic changes. These results suggest that FLIO may be useful in assessing retinal conditions related to lifestyle and systemic metabolic status. [ABSTRACT FROM AUTHOR]