Tobacco Induced Diseases[JOURNAL]
Sun
200 papers
Investigation of smoking cessation intention and the associated factors in patients diagnosed with chronic obstructive pulmonary disease: A cross-sectional study.
Dogru S, Akbayram HT, Aytaç S … +1 more , Ovayolu Ö
Tob Induc Dis · 2026 · PMID 41696537 · Full text
INTRODUCTION: Intention to quit is an important early step and a strong predictor of smoking cessation success. In this study, individuals with chronic obstructive pulmonary disease (COPD) were evaluated with a newly dev...
INTRODUCTION: Intention to quit is an important early step and a strong predictor of smoking cessation success. In this study, individuals with chronic obstructive pulmonary disease (COPD) were evaluated with a newly developed scale for patients' intention to quit smoking using the current COPD staging system. METHODS: This cross-sectional study was conducted in Gaziantep, Turkey, from 1 March to 1 December 2024, and included 160 people with COPD who currently smoke, to investigate factors associated with smoking cessation intention using a questionnaire. Patients attending the chest diseases outpatient clinic were evaluated through face-to-face interviews using a structured questionnaire assessing demographic, clinical, and disease-specific measures. Shortness of breath was assessed using the modified Medical Research Council (mMRC) score, and COPD symptoms were evaluated using the COPD Assessment Test (CAT). COPD staging was performed according to the Global Initiative for Obstructive Lung Disease (GOLD) 2023 guidelines. Additionally, the Fagerström test for nicotine dependence and the Smoking Cessation Intention Scale were employed. GOLD staging (A, B, E) was defined as: GOLD A (≤1 non-hospitalized exacerbation, mMRC 0-1, CAT <10); GOLD B (mMRC ≥2 and/or CAT ≥10); and GOLD E (≥2 moderate or ≥1 hospitalized exacerbations).Descriptive statistics, non-parametric tests (Mann-Whitney U and Kruskal-Wallis), and Spearman's rho correlation were used. In addition, generalized linear regression model (GLM) was applied. RESULTS: The mean age of the patients was 59.43 ± 10.54 years; 148 patients (92.5%) were male, and 104 patients (65%) had primary education. A weak but significant positive correlation was found between the Smoking Cessation Scale scores and both CAT (r=0.245, p=0.002) and mMRC scores (r=0.164, p=0.039). Lower cessation scores were significantly associated with single status (p=0.009), no quit attempts in the last year (p<0.001), lack of information about smoking cessation methods (p=0.016), absence of intention to quit smoking (p<0.001), lack of knowledge that smoking causes heart disease (p=0.035), and GOLD stage A (p=0.001). In the multivariate GLM analysis conducted with eight variables that were found to be significantly associated with the smoking cessation intention score in univariate analyses, three factors remained statistically significant: being married compared to being single (B=4.958; 95% CI: 1.203-8.714, p=0.010), having knowledge about smoking cessation methods compared to not having such knowledge (B=2.432; 95% CI: 0.192-4.672, p=0.033), and having the intention to quit smoking compared to lacking such intention (B=3.327; 95% CI: 1.117-5.536, p=0.003). CONCLUSIONS: Physicians should assess quit-smoking intention factors in COPD patients who continue smoking and should consider these factors in cessation interventions and referrals.
The dilemma of coordinated communication in China's e-cigarette governance: A computational discourse analysis of a social media controversy.
Li Z, Zhao Y, Wang X … +3 more , Gao L, Yao X, Chen Y
Tob Induc Dis · 2026 · PMID 41696536 · Full text
INTRODUCTION: Amid increasingly stringent e-cigarette regulations in China - including taxation, flavor bans, and advertising restrictions - coordinated communication has emerged as a key challenge in tobacco control. Th...
INTRODUCTION: Amid increasingly stringent e-cigarette regulations in China - including taxation, flavor bans, and advertising restrictions - coordinated communication has emerged as a key challenge in tobacco control. This study investigates a viral incident involving Blackpink's Jennie to explore how failures in strategic narrative coordination have undermined the legitimacy of regulatory efforts. METHODS: This study combined web scraping, large language models (LLMs) topic modeling, and critical discourse analysis (CDA) to collect and analyze an e-cigarette-related event on the Chinese social media platform Weibo from July to October 2024. RESULTS: Findings reveal that although e-cigarette-related content was widely circulated, public discourse largely lacked critical health framing. Instead, discussions often shifted toward moral judgments, cultural identity, and individual freedoms. This discursive vacuum weakened the normative foundation of tobacco control and enabled counter-narratives that questioned the state's regulatory intent. CONCLUSIONS: The study introduces 'coordinated communication' as both an analytical framework and a practical imperative for effective tobacco governance. Our Research argues that legal regulation must be accompanied by proactive narrative leadership to sustain public health legitimacy. A multi-stakeholder governance mechanism involving health authorities, media institutions, and digital platforms is recommended to rebuild a coherent, health-centered public discourse in the digital.
Association of serum cotinine with phenotypic age acceleration and oxidative stress markers in US adults: A cross-sectional study.
Zhong H, Bao S, Cao W … +2 more , He X, Ban Z
Tob Induc Dis · 2026 · PMID 41657542 · Full text
INTRODUCTION: Tobacco exposure is a plausible accelerator of biological aging, yet population-level evidence and mechanisms remain insufficiently defined. We examined the association between serum cotinine and phenotypic...
INTRODUCTION: Tobacco exposure is a plausible accelerator of biological aging, yet population-level evidence and mechanisms remain insufficiently defined. We examined the association between serum cotinine and phenotypic age acceleration (PhenoAgeAccel), and assessed whether oxidative-stress biomarkers were related to the serum cotinine-PhenoAgeAccel association. METHODS: We conducted a cross-sectional, survey-weighted analysis of n=19744 adults from NHANES 2011-2018. PhenoAgeAccel was computed as the residual from regressing PhenoAge on chronological age. Multivariable linear regressions related serum cotinine to PhenoAgeAccel across hierarchical adjustment models. Restricted cubic splines assessed non-linearity. Mediation analysis was conducted to quantify the extent to which oxidative-stress biomarkers contribute to this association. RESULTS: Higher serum cotinine was associated with accelerated biological aging: each doubling of serum cotinine corresponded to a 0.22-year increase in PhenoAgeAccel (β=0.22; 95% CI: 0.16-0.29). Mediation analyses indicated that γ-glutamyl transferase (GGT) and uric acid (UA) statistically accounted for 9.5% of the association between serum cotinine and PhenoAgeAccel (p<0.001). Interactions were observed for sex and PIR, with stronger associations among women and participants with lower socioeconomic status. There was no evidence of non-linearity in the relationships of the serum cotinine with GGT, PhenoAgeAccel, or UA. CONCLUSIONS: In this nationally representative cross-sectional study of US adults, higher serum cotinine levels were associated with greater phenotypic age acceleration. Oxidative-stress biomarkers were related to the observed association, although causal inferences cannot be drawn.
Tobacco use trends in South Korea, 2013-2023: Persistent disparities and emerging challenges in a repeated cross-sectional study.
Lee B, Kwon M, Park AH … +1 more , Kim H
Tob Induc Dis · 2026 · PMID 41657541 · Full text
INTRODUCTION: The emerging non-combustible tobacco products have complicated the tobacco landscape in Korea. This study aimed to assess subgroup trends in conventional cigarette (CC), electronic cigarette (EC), heated to...
INTRODUCTION: The emerging non-combustible tobacco products have complicated the tobacco landscape in Korea. This study aimed to assess subgroup trends in conventional cigarette (CC), electronic cigarette (EC), heated tobacco product (HTP), and poly-tobacco use in South Korea from 2013 to 2023. METHODS: We analyzed secondary data from the 2013-2023 Korea National Health and Nutrition Examination Survey, a nationally-representative cross-sectional data of adults (aged ≥19 years) (n=62935). Joinpoint regressions were used to estimate average annual percent changes (AAPCs) in tobacco use, stratified by sociodemographic and health-related characteristics. All measures were based on self-reports. RESULTS: Among men, the prevalence of CC smoking declined from 42.1% in 2013 to 32.2% in 2023 (AAPC= -3.4; 95% CI: -4.6 - -2.3), with small declines among those with a lower income, less-educated, manual workers, and those with multiple risk behaviors, and severe mental illness. EC use increased modestly overall, with a significant rise among in men aged 25-39 years; HTP use showed a slight overall decline. Poly-tobacco use increased, particularly among young adults (aged 19-24 years) and middle-aged adults (aged 40-64 years) the lowest-income group, manual workers, and those with multiple risk behaviors. Among women, overall prevalence of CC, EC, and HTP use remained below 7%, but prevalence rose among young women aged 19-24 years (CC: 9.6% to 16.1%; EC: 0.7% to 5.6%; HTP: 3.1% to 5.8%), although the corresponding AAPCs were not statistically significant (CC: 4.6; 95% CI: -1.9-12.4; EC: 15.1; 95% CI: -0.1-39.7; HTP: 26.3; 95% CI: -21.4-125.0). CONCLUSIONS: Korea's progress in reducing CC smoking has not extended to vulnerable populations, and rising EC and poly-tobacco use, particularly among young adults, present new challenges. These findings underscore the need for tailored cessation interventions for vulnerable populations and for ongoing efforts to tackle the emerging use of novel tobacco products.
Negotiating health: A qualitative analysis of home smoking rules among families with medically vulnerable infants.
Villarreal YR, Northrup TF, Fischer SM … +2 more , Norwood JS, Stotts AL
Tob Induc Dis · 2026 · PMID 41657540 · Full text
INTRODUCTION: Approximately 5000 child deaths are attributed to secondhand smoke exposure (SHSe) annually, which is three times the number of childhood cancers combined. Infants, medically fragile infants, are highly vul...
INTRODUCTION: Approximately 5000 child deaths are attributed to secondhand smoke exposure (SHSe) annually, which is three times the number of childhood cancers combined. Infants, medically fragile infants, are highly vulnerable to the harmful effects of SHSe, including respiratory infections and sudden infant death syndrome. While having a home smoking ban may mitigate these risks, implementation remains a challenge for many families. Our primary aim was to explore the familial and sociocultural factors associated with smoking-ban initiation and maintenance in households with medically fragile infants. METHODS: Qualitative interviews were conducted with 20 mothers participating in a behavioral intervention from 2015 to 2016 aimed at reducing SHSe in infants discharged from a large urban, children's hospital in Houston, Texas. Interviews explored family structure, cultural influences, social networks, and smoking history. Thematic analysis was used to identify key themes. RESULTS: Three primary themes emerged: 1) Household structure and power dynamics - mothers in multigenerational homes often lacked authority to enforce smoking bans, especially when the primary authority figure was a smoker; 2) Sole responsibility - mothers felt burdened as the only advocates for SHSe reduction, often without support from other household members; and 3) Variable level of support for SHS bans - while emotional and logistical support was common during infants' hospital stays, this support rarely extended to smoking-related behavior change. Participants felt these factors significantly influenced smoking-ban initiation and sustainability. CONCLUSIONS: Findings underscore the need to move beyond individual-level interventions and engage the broader household context. Intervention sessions should include all household members - particularly individuals who smoke - and incorporate collaborative care models that offer behavioral counseling, pharmacological aids (e.g. nicotine replacement therapy), and real-time feedback technologies. Tailoring interventions to reflect household power structures and support systems may enhance their effectiveness in reducing SHSe and protecting medically vulnerable infants.
Smoking-driven systemic inflammation elevates mortality risk in hypertensive patients: A cross-sectional study using insights from NHANES 1999-2018.
Wu T, Ren C, Wei C … +4 more , Yu Y, Jin T, Wang Y, Chen H
Tob Induc Dis · 2026 · PMID 41623894 · Full text
INTRODUCTION: Existing evidence on the association between smoking and hypertension (HTN) remains conflicting, and the potential role of systemic inflammation in mediating smoking-related mortality among hypertensive pat...
INTRODUCTION: Existing evidence on the association between smoking and hypertension (HTN) remains conflicting, and the potential role of systemic inflammation in mediating smoking-related mortality among hypertensive patients is poorly understood. This study aimed to investigate the association between smoking status, smoking volume, and HTN risk in a large, nationally representative sample. Furthermore, we sought to determine whether systemic inflammation, measured by the systemic inflammation index (SII), mediates the association between smoking and all-cause mortality in hypertensive individuals. METHODS: This cross-sectional, pooled secondary data analysis study utilized data from 10 cycles of the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Data on smoking, covariates, and hypertension status were collected through standardized interviews, questionnaires, and laboratory/physical examinations. A total of 28967 participants were included after excluding those with incomplete data. Propensity score matching (PSM) analysis was employed to adjust for confounding factors such as age, gender, BMI, race, and other sociodemographic variables. Logistic regression and restricted cubic spline regression were used to assess the dose-response relationship between smoking and HTN. Mediation analysis was performed to evaluate the role of systemic inflammation, as measured by the systemic inflammation index (SII), in the increased mortality risk among hypertensive smokers. RESULTS: Smoking significantly increased the likelihood of HTN after adjusting for confounders (adjusted odds ration, AOR=1.18; 95% CI: 1.10-1.27). A dose-response relationship was observed, with individuals smoking >30 cigarettes/day having the highest likelihood of HTN (AOR=1.37; 95% CI: 1.07-1.75). PSM analysis confirmed these findings, showing a significant increase in HTN prevalence among smokers (p=0.045). Smoking was also associated with increased overall mortality in hypertensive patients (HR=1.993; 95% CI: 1.766-2.249). Mediation analysis revealed that systemic inflammation, as measured by SII, accounted for 87.70% of the increased mortality in hypertensive smokers (ACME=0.068, p<0.001). CONCLUSIONS: This study establishes a significant association between smoking, HTN and mortality. The findings underscore a potential dose-response trend between cigarette consumption and HTN, with systemic inflammation playing a key role in mediating the higher mortality observed in hypertensive smokers. Interventions targeting smoking cessation and systemic inflammation may significantly reduce the burden of HTN-related morbidity and mortality.
Analysis of pooled cross-sectional study data on smoking among pregnant and nursing mothers after a disaster: Pregnancy and birth survey of the Fukushima health management survey.
Nakano H, Goto A, Ishii K … +6 more , Mori M, Suzuki K, Rahman N, Fujimori K, Ohira T, Yasumura S
Tob Induc Dis · 2026 · PMID 41623893 · Full text
INTRODUCTION: Japan is one of the countries most affected by both the global tobacco epidemic and disasters, which are often interrelated. This study aimed to analyze factors related to continuation of smoking or relapse...
INTRODUCTION: Japan is one of the countries most affected by both the global tobacco epidemic and disasters, which are often interrelated. This study aimed to analyze factors related to continuation of smoking or relapse after childbirth among women who smoked before pregnancy and inform approaches to help them continue smoking cessation in a post-disaster setting, such as that after the Fukushima nuclear accident. METHODS: We conducted a pooled analysis of secondary data collection from Fukushima prefecture-wide cross-sectional self-administered questionnaire-based surveys. Participants were recruited from women given a Maternal and Child Health Handbook by their city of residence in Fukushima Prefecture from 2013 to 2016. A total of 17211 responses to the Pregnancy and Birth Survey were analyzed. Women who smoked before pregnancy were divided according to smoking status during pregnancy and after childbirth, and then compared with those who did not smoke before pregnancy in terms of evacuation status, radiation risk perception, age, parity, subjective health, and depression tendency. RESULTS: A total of 16417 respondents did not smoke before pregnancy. Among those who smoked before pregnancy, 634 quit smoking during pregnancy and maintained cessation after childbirth, 182 quit smoking during pregnancy but relapsed afterward, 195 smoked during pregnancy but quit after childbirth, and 582 continued smoking during and after pregnancy. Age ≤24 years (AOR=2.36), multiparity (AOR=1.61), and depression tendency (AOR=1.85) were associated with relapse. Current evacuation status (AOR=1.65), radiation risk perception (AOR=0.55), age ≤24 years (AOR=2.19), multiparity (AOR=1.90), disease history (AOR=1.33), and depression tendency (AOR=1.85) were associated with continuation of smoking. CONCLUSIONS: Previous smokers who continue smoking or relapse after childbirth need support that addresses complex underlying factors, including mental health. Continuation of smoking was particularly associated with disaster-related factors, suggesting that disaster-affected mothers need multifaceted support for health promotion.
Factors associated with adolescent use of tobacco products in the Upper East Region of Ghana: A cross-sectional study.
Logo DD, Kodali PB, Anaman-Torgbor J … +4 more , Chaffee BW, Ling PM, Bialous S, Owusu-Dabo E
Tob Induc Dis · 2026 · PMID 41623892 · Full text
INTRODUCTION: Tobacco use among adolescents is a concern in the Upper East Region of Ghana. We estimated the prevalence and identified factors contributing to single and multiple use of tobacco products among junior high...
INTRODUCTION: Tobacco use among adolescents is a concern in the Upper East Region of Ghana. We estimated the prevalence and identified factors contributing to single and multiple use of tobacco products among junior high school students in Ghana. METHODS: We conducted a cross-sectional analysis of a baseline survey of a school-based tobacco control intervention among adolescents in the Upper East Region of Ghana in 2022. A multi-stage cluster sampling approach was employed to identify the study sample, and data were collected using self-administered questionnaires. Current use of single tobacco products (at least one: cigarette, e-cigarette, shisha, or smokeless tobacco products) and multiple products (≥2 products) in the past 30 days was assessed. Multinomial logistic regression was used to assess the association of sociodemographic characteristics, perceptions towards tobacco's health risks, and exposure to tobacco products with single and multiple product use. Adjusted relative risk ratios (ARRR) and their corresponding 95% confidence intervals (CI) were computed. RESULTS: We surveyed 1328 adolescents, comprising an equal proportion of males (49.8%) and females (50.4%). One in five (21.7%) reported using tobacco products, with 11.5% using single products and 13.0% using multiple products. Shisha (13.6%), cigarettes (10.6%), e-cigarettes (8.2%), and smokeless tobacco (6.0%) were used. A number of factors were identified to be associated with tobacco use among adolescents. CONCLUSIONS: One in five junior high school students used at least one form of tobacco product. Adolescent tobacco use is impacted by demographic factors and risk perceptions. Further studies are needed to better understand these associations.
Quit attempts and cessation support among youth smokers in Saudi Arabia: A cross-sectional analysis of the 2022 Global Youth Tobacco Survey.
Aldarmasi MA
Tob Induc Dis · 2026 · PMID 41613985 · Full text
INTRODUCTION: Tobacco use among adolescents continues to pose a major public-health challenge in Saudi Arabia. Despite national prevention efforts and declining smoking rates, many youths remain vulnerable to nicotine ad...
INTRODUCTION: Tobacco use among adolescents continues to pose a major public-health challenge in Saudi Arabia. Despite national prevention efforts and declining smoking rates, many youths remain vulnerable to nicotine addiction and experimentation with emerging products such as shisha and e-cigarettes. Understanding factors that influence quit attempts and cessation awareness is essential to guide effective school- and community-based tobacco-control interventions. This study assessed the prevalence of quit attempts and identified behavioral and environmental correlates of cessation motivation among Saudi youth using data from the 2022 Global Youth Tobacco Survey. METHODS: A cross-sectional analysis was conducted using data from 6983 students aged 11-17 years who participated in the 2022 Global Youth Tobacco Survey. Weighted analyses described tobacco-use patterns and cessation behaviors. Chi-squared tests examined bivariate relationships, while multivariable logistic regression identified independent factors associated with quit attempts, including adjusting for age, sex, parental and peer smoking, and media exposure. Significance was defined as p<0.05. RESULTS: Approximately 33% of respondents had ever used tobacco or nicotine, and 10.8% were current users. Among those who used tobacco within the past 12 months (n=411), 77.4% had attempted to quit, 64% wanted to stop, and 79.8% had received advice to quit. Factors associated with quit attempts included having no close friends who smoke (AOR=4.38; 95% CI: 1.73-11.07), exposure to school-based anti-tobacco lessons (AOR=3.25; 95% CI: 1.51-6.99), noticing health warnings on shisha packs (AOR=2.59; 95% CI: 1.02-6.55), and exposure to tobacco imagery in media (AOR=3.19; 95% CI: 1.64-6.17). CONCLUSIONS: Most Saudi youth who use tobacco express a desire to quit, and social context strongly influences their cessation behavior. Reinforcing school-based anti-tobacco education, expanding adolescent cessation programs, and strengthening policy enforcement could further reduce tobacco use and improve cessation outcomes among young people.
Cigarette smoke-induced circFOXO3 upregulation enhances autophagy-regulated senescence of type II alveolar cells through interacting with E2F1.
Zhou X, Wang Y, Lu J … +5 more , Wang B, Zhou F, Pan J, Zhou L, Du C
Tob Induc Dis · 2026 · PMID 41585093 · Full text
INTRODUCTION: Senescence of type II alveolar (AT-II) cells is involved in the pathogenesis of chronic obstructive pulmonary disease (COPD). We have reported that circRNA FOXO3 (circFOXO3) is upregulated after exposure to...
INTRODUCTION: Senescence of type II alveolar (AT-II) cells is involved in the pathogenesis of chronic obstructive pulmonary disease (COPD). We have reported that circRNA FOXO3 (circFOXO3) is upregulated after exposure to cigarette smoke (CS) and that circFOXO3 knockdown has protective effects on CS-induced inflammation. Here, we investigate whether circFOXO3 upregulation is involved in CS-induced AT-II cell senescence. METHODS: Within this experimental cell-based and animal study, the effects of circFOXO3 on CSE-induced senescence in AT-II cell line MLE12 were determined by senescence-associated β-galactosidase staining and western blotting analyses of p16 and p21 expression. Immunofluorescence staining was used to determine the expression of γ-H2AX to analyze DNA damage. Then the autophagy level of CSE-treated MLE12 cells was evaluated by western blotting analyses of LC3B and Beclin-1 expression. Furthermore, we analyzed interactions between circFOXO3 and E2F transcription factor 1 (E2F1) in RNA binding protein immunoprecipitation studies. RESULTS: Our results show that circFOXO3 knockdown suppressed CS extract (CSE)-induced senescence in the AT-II cell line MLE-12. Additionally, CSE-induced autophagy impairment was reduced by circFOXO3 knockdown, and the autophagy inhibitor 3-methyladenine abrogated the effects induced by circFOXO3 knockdown on cell senescence. Mechanistic investigations revealed that circFOXO3 interacts with E2F1 and suppresses its nuclear translocation. E2F1 knockdown reduced the positive regulation of circFOXO3 knockdown on autophagy and prevented the suppressive effects of circFOXO3 knockdown on cell senescence. Consistent with this, circFOXO3 knockdown mitigated CS-induced senescence in AT-II cells . CONCLUSIONS: Overall, these findings suggest that CS-induced circFOXO3 upregulation promotes autophagy-dependent senescence of AT-II cells, leading to enhanced lung injury.
The association of tobacco use on gastrointestinal cancers: A secondary dataset analysis of the Global Burden of Disease Study 2021 and Mendelian randomization.
Liu Y, Liu C, Li X … +4 more , He J, Zhou Q, Chen Y, Tang J
Tob Induc Dis · 2026 · PMID 41585092 · Full text
INTRODUCTION: Gastrointestinal cancers remain a major global health issue, with tobacco use as a key factor. Understanding the impact of tobacco use on these cancers and its regional trends is essential for effective pre...
INTRODUCTION: Gastrointestinal cancers remain a major global health issue, with tobacco use as a key factor. Understanding the impact of tobacco use on these cancers and its regional trends is essential for effective prevention strategies. METHODS: Using data from the Global Burden of Disease (GBD) study, we analyzed mortality and disability-adjusted life years (DALYs) related to tobacco from 1990 to 2021. Joinpoint regression estimated average annual percent change (AAPC), and ARIMA predicted disease burden up to 2036. Two-sample Mendelian randomization (MR) analysis with GWAS data, applied methods such as inverse variance weighting (IVW) and MR-Egger for causal inference. RESULTS: Esophageal cancer had the highest burden in 2021, with a mortality rate of 2.54 deaths per 100000 population and a DALY rate of 58.49 DALYs per 100000 population. Stomach cancer showed the most significant decrease, with mortality dropping from 2.81 to 1.25 deaths per 100000 population (AAPC= -2.58; 95% uncertainty interval, UI: -2.61- -2.55) and DALY rates decreasing from 71.71 to 29.01 DALYs per 100000 population (AAPC= -2.87; 95% UI: -2.90 - -2.84). The disease burden was higher in older males. ARIMA analysis showed a general decline in disease burden, though some regions had an increasing trend. MR analysis did not provide genetic evidence supporting an association between tobacco use and these cancers. CONCLUSIONS: From 1990 to 2021, the global burden of gastrointestinal cancers linked to tobacco use showed a declining trend. However, mortality and DALY rates remain high, with significant regional, age, and gender differences, highlighting the need for continued tobacco control efforts.
Cigarette smoking abstinence at follow-up at 12 months among US adults who regularly used Electronic Nicotine Delivery Systems and smoked in the past year: A prospective cohort study.
Nyman AL, Henderson KC, Ashley DL … +4 more , Spears CA, Huang J, Duan Z, Weaver SR
Tob Induc Dis · 2026 · PMID 41585091 · Full text
INTRODUCTION: Regular use of electronic nicotine delivery systems (ENDS) by people who smoke cigarettes may impact smoking trajectories. ENDS brands are used by different populations in different ways, but their associat...
INTRODUCTION: Regular use of electronic nicotine delivery systems (ENDS) by people who smoke cigarettes may impact smoking trajectories. ENDS brands are used by different populations in different ways, but their associations with smoking cessation are not well understood. This study evaluated whether regular use of Juul or Alto ENDS differently impacted smoking abstinence one year later among adults who had smoked cigarettes. METHODS: This prospective cohort study surveyed a national sample of US adults who used ENDS in 2022-2023 and again after one year to assess cigarette smoking. Multivariable logistic regression models used data from 237 people who had smoked cigarettes in the past year and regularly used ENDS products Juul or Alto at baseline to examine the characteristics and behaviors associated with abstaining from cigarette smoking at follow-up at 12 months. RESULTS: Whereas no overall differences in smoking abstinence at follow-up at 12 months were found between adults who used Juul versus adults who used Alto, adults who used Juul and had quit smoking by baseline were more likely than their Alto-using counterparts to remain abstinent at follow-up at 12 months (AOR=7.07). Other characteristics that were associated with abstaining from cigarettes at follow-up included being 18-29 years (vs older) (AOR=3.64), identifying as White, non-Hispanic (vs another race/ethnicity) (AOR=3.03), not currently smoking at baseline (vs currently smoking) (AOR=20.25), using their Juul or Alto product to quit smoking or remain quit (AOR=2.77), and use of menthol cigarette flavors (vs tobacco flavor) (AOR=2.54). CONCLUSIONS: This longitudinal study found limited differences in smoking abstinence after one year between those who regularly used Juul versus Alto. However, people who used ENDS products specifically to quit smoking were more likely to achieve smoking abstinence and there were important sociodemographic differences. Future research is needed to inform interventions to increase the likelihood that people who use ENDS completely stop smoking and eventually quit all consumer nicotine products.
Unraveling the mechanisms of nicotine-induced osteoporosis via network toxicology, bioinformatics, and molecular docking.
Xu S, Wang G, Liu J … +4 more , Zhang X, Dong X, Liang J, Bai T
Tob Induc Dis · 2026 · PMID 41568086 · Full text
INTRODUCTION: Osteoporosis (OP) is linked to smoking. Nicotine may disrupt bone homeostasis through various pathways, but its molecular mechanisms are unclear. This study aims to explore the molecular networks and key re...
INTRODUCTION: Osteoporosis (OP) is linked to smoking. Nicotine may disrupt bone homeostasis through various pathways, but its molecular mechanisms are unclear. This study aims to explore the molecular networks and key regulatory factors underlying nicotine-induced OP. METHODS: Nicotine toxicity was assessed via ProTox-3.0, with its Simplified Molecular Input Line Entry System (SMILES) structure retrieved from PubChem. Potential targets were predicted using five databases, including SuperPred. OP-related gene data (GSE56815) were extracted from Gene Expression Omnibus (GEO) and combined with GeneCards and Comparative Toxicogenomics Database (CTD) for target screening. Overlapping genes were identified by Venn diagram analysis, followed by protein-protein interaction (PPI) network construction. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed using HipLot, while Hallmark Gene Sets provided insights into key biological pathways. Core targets were screened via Cytoscape 3.9.1, and molecular docking was conducted using AutoDockTools 1.5.7. RESULTS: In all, 388 nicotine-associated targets and 1777 OP genes were predicted, with 116 overlapping. Enrichment analyses revealed associations with multiple signaling pathways, particularly those involving apoptosis and estrogen. Eight core targets, including SRC, BCL2, and CASP3, were identified. Molecular docking showed strong binding affinity (approximately -5 kcal/mol), with enhanced binding stability through hydrophobic interactions and hydrogen bonding. CONCLUSIONS: This study suggests nicotine exacerbates OP by regulating key targets, such as CASP3 and ESR1, and pathways like apoptosis and estrogen signaling. These findings provide insights into the molecular mechanisms underlying nicotine's role in OP and potential therapeutic targets.
Perceptions of nicotine harm among adults who use little cigars and cigarillos: A cross-sectional analysis of wave 7 of the Population Assessment of Tobacco and Health (PATH) Study 2022-2023.
Fidalgo A, Halenar MJ, Merson B … +1 more , Rajan-Sharma AO
Tob Induc Dis · 2026 · PMID 41551946 · Full text
INTRODUCTION: Little is known about nicotine perceptions among people who use little cigars and cigarillos (LCCs). Nicotine perceptions may influence how people respond to changes in the tobacco marketplace, including ch...
INTRODUCTION: Little is known about nicotine perceptions among people who use little cigars and cigarillos (LCCs). Nicotine perceptions may influence how people respond to changes in the tobacco marketplace, including changes that would result from regulatory actions such as a proposed nicotine product standard. This study examines differences in nicotine harm misperceptions between adults who use LCCs, those that use cigarettes, and those that use both products. METHODS: We conducted a cross-sectional analysis of a nationally representative sample of US adults (aged ≥18 years) that use LCCs and/or cigarettes (n=5507) from the Population Assessment of Tobacco and Health (PATH) Study Wave 7 (2022-2023). We estimated the percentage of people who used LCCs that overestimated (perceived nicotine as 'very' or 'extremely' harmful) or were incorrect (either overestimate the harm or perceive nicotine as 'not at all' harmful) about nicotine harms and compared this to those who exclusively used cigarettes and those who dual used both products. RESULTS: Approximately 63.0% of respondents who use LCCs overestimated nicotine harms and 65.7% reported nicotine misperceptions. We found no significant difference in nicotine harm perceptions between people who exclusively used LCCs (overestimation, adjusted odds ratio AOR=1.05; 95% CI: 0.82-1.34; incorrect AOR=1.19; 95% CI: 0.93-1.53), exclusively use cigarettes (base category), and used both products (overestimation AOR=1.05; 95% CI:0.80-1.39; incorrect AOR=1.16; 95% CI: 0.88-1.53). People who used other tobacco products in addition to LCCs and/or cigarettes were significantly less likely (overestimation AOR=0.70; 95% CI: 0.61-0.81; incorrect AOR=0.73; 95% CI: 0.63-0.84) to overestimate the harms of nicotine compared to those who did not use other tobacco products. CONCLUSIONS: People who use LCCs are equally likely to overestimate or be incorrect about nicotine harms as those who exclusively or dual use cigarettes, but using additional products is associated with correct responses about nicotine harms.
The effect of cigarette and e-cigarette use on periodontal health: A cross-sectional study in Eastern Province, Saudi Arabia.
Aljoghaiman EA, Albrahim A, Aldarisi A … +2 more , Alsafwani M, Alhalal F
Tob Induc Dis · 2026 · PMID 41551945 · Full text
INTRODUCTION: Periodontal disease is a prevalent inflammatory condition influenced by various risk factors, including tobacco use. With the rising popularity of electronic cigarettes (e-cigarettes), their potential impac...
INTRODUCTION: Periodontal disease is a prevalent inflammatory condition influenced by various risk factors, including tobacco use. With the rising popularity of electronic cigarettes (e-cigarettes), their potential impact on periodontal health warrants investigation. The aim was to assess the association between e-cigarette use and periodontal disease compared to traditional cigarette smokers and non-smokers in a Saudi adult population. METHODS: This cross-sectional study included 169 adults in the Eastern Province of Saudi Arabia. Participants completed questionnaires on demographics, tobacco use, and oral hygiene practices. Periodontal status was clinically assessed. Logistic regression was used to evaluate the association between tobacco type and periodontal disease, adjusting for confounders. RESULTS: Periodontal disease was diagnosed in 66.9% of participants. Tobacco use was reported by 88%, with 37.3% using e-cigarettes exclusively. Cigarette and mixed users had the highest prevalence of disease, followed by e-cigarette users, with non-smokers showing the lowest rates. Logistic regression revealed significantly increased odds of periodontal disease in cigarette smokers (adjusted odds ratio, AOR=16.31; 95% CI: 2.16-123.18; p=0.0071), and elevated odds in e-cigarette users (AOR=4.74; 95% CI: 0.84-26.80; p=0.0784) compared to non-smokers. Poor oral hygiene, defined as visible plaque and calculus on multiple tooth surfaces with gingival inflammation, was the strongest independent factor associated with disease (AOR=38.98; 95% CI: 4.79-317.11; p=0.0012). CONCLUSIONS: Both cigarette and e-cigarette use were associated with worse periodontal health compared to non-smokers. The elevated odds for e-cigarette users, although accompanied by wide confidence intervals, indicate a potential harmful effect that warrants cautious interpretation. Dental professionals should recognize all forms of tobacco use, including e-cigarettes, as potential risk factors for periodontal disease and emphasize preventive care.
Joinpoint trend analysis of prevalence of combustible and non-combustible tobacco product use by adults in the United States, using cross-sectional data from NHIS 2015-2023.
Mok Y, Cummings KM, Randol CW … +3 more , Roberson A, Levy DT, Meza R
Tob Induc Dis · 2026 · PMID 41551944 · Full text
INTRODUCTION: We describe population-level trends in the prevalence of any tobacco use, combustible and non-combustible tobacco use in US adults, by age and sex, from 2015 to 2023. METHODS: Cross-sectional data collected...
INTRODUCTION: We describe population-level trends in the prevalence of any tobacco use, combustible and non-combustible tobacco use in US adults, by age and sex, from 2015 to 2023. METHODS: Cross-sectional data collected in the annual US National Health Interview Surveys (NHIS) conducted between 2015 and 2023 were used to characterize trends in adult current prevalence of any tobacco use, combustible and non-combustible tobacco product use. All NHIS participants with valid data on tobacco use, age and sex were included in the analyses. Joinpoint regression was used to estimate the annual percentage change (APC) from 2015 to 2023 and 95% confidence intervals (CIs) overall for each outcome and by different age groups (18-24, 25-34, 35-54, and ≥55 years) and for males and females. All statistical tests were two tailed and based on a p<0.05 significance level. RESULTS: Between 2015 and 2023 any tobacco use decreased at a statistically non-significant APC rate of -1.0% (95% CI: -2.1-0.12) across all age and sex groups combined. Overall, combustible tobacco decreased at a statistically significant APC rate of -3.6% (95% CI -4.6 - -2.6), with differences by age group (18-24: -12.2%, 95% CI: -14.6 - -9.7; 25-34: -5.2%, 95% CI: -6.6 - -3.8; 35-54: -2.5%, 95% CI: -4.2 - -0.9; ≥55: -1.2%, 95% CI: -1.8 - -0.5). Non-combustible tobacco product prevalence increased at a statistically significant APC of 8.9% (95% CI: 6.5-15.8) after 2017, with increases in all age groups and both sexes. The decrease in combustible tobacco was due to decreasing cigarette use while the increase in non-combustible tobacco products after 2017 was due to increases in electronic cigarette (EC) use. CONCLUSIONS: Tobacco products use by US adults shifted between 2015 and 2023, with combustible use decreasing, particularly in young adults, while non-combustible use increased.
Validating the working alliance inventory in a mobile health smoking cessation program: A quasi-experimental study among Mexican adults who smoke.
Gallegos-Carrillo K, Ramírez-Palacios P, Chávez-Iñiguez A … +3 more , Cupertino AP, Cartujano-Barrera F, Rodríguez-Bolaños R
Tob Induc Dis · 2026 · PMID 41537125 · Full text
INTRODUCTION: The therapeutic alliance has been identified as a key factor influencing smoking cessation success. This study aimed to evaluate the psychometric properties - internal consistency, factorial validity, and c...
INTRODUCTION: The therapeutic alliance has been identified as a key factor influencing smoking cessation success. This study aimed to evaluate the psychometric properties - internal consistency, factorial validity, and concurrent validity - of the Spanish version of the Working Alliance Inventory-Short (WAI-S) in a mobile health (mHealth) smoking cessation program for Mexican adults who smoke. Additionally, it examined the association between WAI-S score, smoking-related outcomes and program satisfaction. METHODS: A quasi-experimental study was conducted in Mexico between June and October 2021 with 100 adults who smoke intending to quit. The 12-week mHealth cessation program, grounded in Social Cognitive Theory, combined automated text messages and tailored counselor feedback. At program completion, 80 participants completed the 12-item WAI-S. Psychometric analyses included exploratory factor analysis, Kaiser-Meyer-Olkin and Bartlett's tests, Cronbach's alpha, and item-total correlations. Logistic regression models assessed the association of WAI-S scores with program satisfaction and smoking cessation outcomes. RESULTS: Exploratory factor analysis (n=80) revealed that two negatively worded items weakened internal consistency; their removal produced a refined 10-item scale with a robust two-factor structure and excellent reliability (Cronbach's α=0.91). Higher reported therapeutic alliance scores were associated with greater odds of satisfaction with the overall program (AOR=1.12; 95% CI: 1.04-1.21), the digital application (AOR=1.10; 95% CI: 1.02-1.19), and the text message content (AOR=1.10; 95% CI: 1.03-1.18), compared with participants reporting lower alliance scores. No significant association emerged between WAI-S scores and self-reported or biochemically verified smoking abstinence. CONCLUSIONS: The 10-item Spanish WAI-S demonstrated strong psychometric validity for evaluating therapeutic alliance in an mHealth smoking cessation among Mexican adults. While not predictive of abstinence, higher alliance score correlated with greater satisfaction, underscoring the instrument's potential for monitoring engagement and informing the design of more effective digital cessation programs.
The associated factors of smoking cessation intention among husbands in gestational households: A census-based cross-sectional survey.
Wang X, Yu F, Chen D … +4 more , Chen X, Li Q, Ding J, Chen Y
Tob Induc Dis · 2026 · PMID 41522431 · Full text
INTRODUCTION: Secondhand smoke (SHS) exposure poses health risks to pregnant women, with spousal smoking identified as the primary source of SHS exposure among Chinese pregnant women. This study examines smoking cessatio...
INTRODUCTION: Secondhand smoke (SHS) exposure poses health risks to pregnant women, with spousal smoking identified as the primary source of SHS exposure among Chinese pregnant women. This study examines smoking cessation intention and its associated factors among smoking husbands during their wives' pregnancy. METHODS: This was a cross-sectional study in Shanghai from April 2021 to December 2024, enrolling all registered pregnant women and their cohabiting smoking husbands in Jinshan District, Shanghai (n=1754 couples). Separate structured questionnaires were administered to collect demographic data and smoking-related behaviors. Double data entry was performed using EpiData 3.1, with SPSS 26.0 employed for statistical analyses. RESULTS: Among the participants, 47.4% of the smoking husbands expressed a willingness to quit smoking. The results of the univariate analysis indicate that a husband's willingness to quit smoking is associated with several factors, including his age, health status, and the surrounding environment (p<0.05). Multivariable logistic regression analysis revealed that husbands' willingness to quit smoking was significantly associated with several factors. Specifically, compared to husbands younger than 25 years old, those older than 35 years were less willing to quit smoking (adjusted odds ratio, AOR=0.52; 95% CI: 0.38-0.70). Additionally, husbands in poor health were less likely to quit than those in good health (AOR=0.65; 95% CI: 0.50-0.93). Furthermore, husbands with higher levels of education were less likely to quit than those with lower levels (AOR=0.62; 95% CI: 0.46-0.82). When comparing smoking habits, husbands who smoked ≥11 cigarettes per day were less willing to quit than those who smoked ≤5 cigarettes daily (AOR=0.56; 95% CI: 0.42-0.75). CONCLUSIONS: Smoking cessation intentions among husbands are influenced by multidimensional interactions of individual characteristics (age, health status), smoking behavior patterns (intensity, duration), and family and social environments (smoking bans, peer influence). Future research should elucidate the mechanisms underlying the interactions among these variables.
Association between smoking behavior and sleep health among South Korean adolescents: A cross-sectional study 2020-2023.
Cho N, Cho SI
Tob Induc Dis · 2025 · PMID 41480051 · Full text
INTRODUCTION: Tobacco use has been associated with poor sleep quality among adolescents. Given the rising prevalence of poly tobacco use among South Korean adolescents, it is crucial to examine its cumulative impact on s...
INTRODUCTION: Tobacco use has been associated with poor sleep quality among adolescents. Given the rising prevalence of poly tobacco use among South Korean adolescents, it is crucial to examine its cumulative impact on sleep health. This study aims to assess the association between various smoking behaviors and sleep health outcomes in this population. METHODS: This cross-sectional pooled secondary data analysis utilized data from the 2020-2023 Korea Youth Risk Behavior Web-based Survey (KYRBS), comprising 172457 middle and high school students (aged 12-18 years). Information was collected via a self-administered web-based questionnaire. Multinomial logistic regression models were employed to evaluate the relationship between smoking behaviors with sleep health, adjusting for potential confounders. RESULTS: Overall, 40.3% of tobacco users and 25.3% of non-users reported insufficient sleep accompanied by poor satisfaction. Adolescents engaged in triple use (concurrent use of conventional cigarettes, e-cigarettes, and heated tobacco products) demonstrated the highest odds of insufficient and poor sleep (adjusted odds ratio, AOR=2.32; 95% confidence interval CI: 2.01-2.67). A graded pattern was observed whereby increased poly tobacco use corresponded to poorer sleep outcomes. CONCLUSIONS: Poly tobacco use is significantly associated with poor sleep health among South Korean adolescents. Future longitudinal studies are needed to establish causal pathways and provide sufficient evidence to guide effective interventions and policies.
Secondhand smoke exposure and sleep disturbances among Korean adolescents: A nationally representative cross-sectional study.
Hua F, Wu Y, Xu S … +2 more , Du W, Xu Y
Tob Induc Dis · 2025 · PMID 41480050 · Full text
INTRODUCTION: Inadequate sleep duration among adolescents is increasingly recognized as a significant public health concern, with potential associations with various environmental exposures. This study investigates the a...
INTRODUCTION: Inadequate sleep duration among adolescents is increasingly recognized as a significant public health concern, with potential associations with various environmental exposures. This study investigates the association between secondhand smoke (SHS) exposure and sleep duration in Korean adolescents. METHODS: This study employed a pooled cross-sectional design using data from the nationally representative Korea Youth Risk Behavior Web-based Survey from 2021 to 2024 (n=195664). This study analyzed self-reported sleep duration (hours/minutes) from the Korea Youth Risk Behavior Web-based Survey (KYRBS). Ordinary least squares regression models were used to analyze the association between SHS exposure days and sleep duration, adjusting for individual, school, and family-level control variables. The moderating effect of tobacco use was examined through interaction terms. RESULTS: SHS exposure demonstrated a significant negative association with adolescent sleep duration. After full adjustment for control variables, each additional day of SHS exposure was associated with a reduction in weekly average sleep duration (β= -0.027; 95% CI: -0.029 - -0.024, p<0.01), weekday sleep duration (β= -0.030; 95% CI: -0.03 - -0.028, p<0.01), and weekend sleep duration (β= -0.018; 95% CI: -0.023 - -0.013, p<0.01). Tobacco use significantly moderated this relationship, with the interaction term showing positive coefficients across all sleep duration models. CONCLUSIONS: SHS exposure significantly associated with sleep deprivation among Korean adolescents, with this association being influenced by individual tobacco use habits.
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