Tobacco Induced Diseases[JOURNAL]
Sun
200 papers
Causal association of smoking and laryngeal cancer: A Mendelian randomization study.
Yang F, Chen X, Wei R … +2 more , Lv P, Alhoot MA
Tob Induc Dis · 2025 · PMID 41281583 · Full text
INTRODUCTION: Smoking is well-established as the primary risk factor for laryngeal cancer, yet high-quality clinical randomized controlled trials are lacking. To address this gap, we utilized Mendelian randomization (MR)...
INTRODUCTION: Smoking is well-established as the primary risk factor for laryngeal cancer, yet high-quality clinical randomized controlled trials are lacking. To address this gap, we utilized Mendelian randomization (MR), a novel research approach that offers an alternative to traditional randomized controlled trials. Our study aimed to reaffirm the connection between smoking and laryngeal cancer, while also contributing new insights for global public health prevention. METHODS: We performed a two-sample MR analysis using publicly released genome-wide association studies (GWAS) statistics. Smoking as exposure and laryngeal cancer as outcome. The inverse-variance weighted (IVW) method was used to analyze the genetic causal association between smoking and laryngeal cancer. We applied four complementary methods, including weighted median, weighted mode, MR-Egger regression, and MR pleiotropy residual sum and outlier (MR-PRESSO) to detect and correct for the effect of horizontal pleiotropy. RESULTS: Based on IVW, we found a causal association between smoking (cigarettes per day) and laryngeal cancer (OR=9.55; 95% CI: 1.26-72.27; p=0.03). There was a potential genetic causal association between smoking and laryngeal cancer. No heterogeneity (Q=34.06, p=0.89) or horizontal pleiotropy (Egger intercept, p=0.69) was found in any of the analyses. Sensitivity analyses confirmed robustness (MR-PRESSO global test, p=0.96). None of the leave-one-out tests in the analyses found any SNP that could affect the results of MR. CONCLUSIONS: Genetic liability to smoking is associated with a higher risk of laryngeal cancer. Our findings support a genetic link between smoking and laryngeal cancer, underscoring the importance of smoking prevention in public health strategies.
Evidence update on the respiratory health effects of vaping e-cigarettes: A systematic review and meta-analysis.
Kundu A, Feore A, Abu-Zarour N … +6 more , Sanchez S, Sutton M, Sachdeva K, Seth S, Schwartz R, Chaiton M
Tob Induc Dis · 2025 · PMID 41268099 · Full text
INTRODUCTION: In this review, we aimed to explore whether nicotine e-cigarette or vaping product use impact respiratory health. METHODS: We searched CINAHL, Embase, MEDLINE, PsycINFO, PubMed and Cochrane library database...
INTRODUCTION: In this review, we aimed to explore whether nicotine e-cigarette or vaping product use impact respiratory health. METHODS: We searched CINAHL, Embase, MEDLINE, PsycINFO, PubMed and Cochrane library databases initially in January 2023 and updated the search in January 2024. We included peer-reviewed human, animal, cell/ original studies published between July 2021 and December 2023 but excluded qualitative studies. Three types of e-cigarette exposure were examined: acute, short-to-medium term, and long-term. RESULTS: We included 119 studies in the main analysis, and 5 in meta-analysis. Over half of the studies had low risk of bias. Non-smoker current vapers had higher incident risk of respiratory symptoms (relative risk, RR=1.90; 95% CI: 1.28-2.83) but statistically non-significant risk of chronic obstructive pulmonary disease (COPD) (RR=2.53; 95% CI: 0.96-6.67) compared to never users. They also had lower incident risk of respiratory symptoms compared to non-vaper current smokers (RR=0.75; 95% CI: 0.64-0.89) and dual users (dual use vs vaping, RR=1.26; 95% CI: 1.03-1.55). Dual users had higher risk of incidence of respiratory symptoms and prevalence of COPD compared to never users (RR=2.53; 95% CI: 1.44-4.45 and RR=3.86; 95% CI: 1.49-10.02, respectively), and the risk was statistically similar to non-vaper current smokers (RR=0.97; 95% CI: 0.84-1.14 and RR=1.15; 95% CI: 1.00-1.33, respectively). All meta-analysis findings were of 'very low' to 'low' certainty evidence. Of the studies not included in meta-analysis, we found 'moderate' certainty evidence of higher risk of respiratory symptoms, COPD, asthma, lung inflammation and damage in non-smoker current vapers compared to non-users, inconsistent findings on the risk of COVID-19 and other respiratory infections, and no significant association with e-cigarette associated lung injury. CONCLUSIONS: E-cigarettes are associated with harms to the respiratory system. Further longitudinal research with special attention to measuring effects in different e-cigarette user populations are warranted.
Knowledge and awareness of tobacco user dental patients regarding effects of tobacco on oral health.
Habiba U, Choudhury R, Haque A … +5 more , Sadia S, Tamannur T, Haque M, Sultana N, Jahan S
Tob Induc Dis · 2025 · PMID 41262666 · Full text
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Reframing cigarettes as social currency: A randomized survey experiment on the role of warning images and pricing.
Xing Y, Wen W, Wang G … +1 more , Du K
Tob Induc Dis · 2025 · PMID 41221022 · Full text
INTRODUCTION: In China, cigarettes function as both consumer goods and 'social currency'. Despite increased awareness of smoking risks, cigarette gifting persists. This study examines whether graphic warning images and p...
INTRODUCTION: In China, cigarettes function as both consumer goods and 'social currency'. Despite increased awareness of smoking risks, cigarette gifting persists. This study examines whether graphic warning images and price increases can reduce the social value of cigarettes in gifting contexts. METHODS: A survey experiment was conducted (n=744), randomly assigning participants to a control group (n=189), a price treatment group (n=285), and an image warning group (n=270). Eligible participants were adults with stable incomes. Participants in the price treatment group viewed the same cigarette brands as in the control condition but with retail prices doubled relative to the market price, whereas those in the image treatment group viewed cigarette packs with added graphic warning images while prices remained unchanged. The primary outcomes were willingness to gift or receive cigarettes in strong and weak relationships (1=very unwilling to 5=very willing) and brand tier preference (1=low, 2=mid, 3=high), and logistic regressions were applied to assess treatment effects. All comparisons were made against the control group, and logistic regression results are presented as coefficients (β) with 95% confidence intervals (CI). RESULTS: Graphic warning images significantly reduced willingness to gift cigarettes (β= -0.88; 95% CI: -1.33 - -0.42, p<0.001) and expectations to receive cigarettes (β= -0.62; 95% CI: -1.08 - -0.16, p<0.01) in weak relationships but had no significant effect in strong relationships. Price increases did not affect gifting willingness but reduced brand preference in weak relationships (β= -0.67; 95% CI: -1.11 - -0.23, p<0.01). CONCLUSIONS: Graphic warnings effectively weaken the symbolic value of cigarettes in non-intimate relationships, while price increases alone are insufficient. Tobacco control strategies should prioritize altering symbolic meanings rather than relying solely on economic measures.
The causal mediating effect of smoking on the relationship between irritability and bipolar disorder: A two-step Mendelian randomization study.
Hu Q, Yue C, Xu Y … +3 more , Chen J, Luo X, Cong E
Tob Induc Dis · 2025 · PMID 41221021 · Full text
INTRODUCTION: Bipolar disorder is a periodic episode of extreme fluctuations in emotion that has been shown to be associated with smoking and irritability, but the relationship between the three has not been studied, esp...
INTRODUCTION: Bipolar disorder is a periodic episode of extreme fluctuations in emotion that has been shown to be associated with smoking and irritability, but the relationship between the three has not been studied, especially in terms of genetic causality. This study aimed to obtain potential causal estimates of the association between irritability and bipolar disorder while quantifying the mediating effects of the modifiable risk factor, smoking. METHODS: This study used a two-step Mendelian randomization (MR) method and employed the inverse variance weighted method for the two-sample MR, utilizing SNPs as genetic instruments. Sensitivity analyses were conducted to detect heterogeneity and horizontal pleiotropy. RESULTS: Irritability (OR=3.13; 95% CI: 1.23-7.93; p=0.016) and smoking (OR=2.00; 95% CI: 1.47-2.37; p<0.001) were significantly associated with bipolar disorder from a genetic perspective. Irritability was associated with a higher risk of smoking (OR=1.21; 95% CI: 1.07-1.37; p=0.002). Sensitivity analyses confirmed the robustness of these results. Mediation analysis indicated that smoking partially mediated the potential pathway from irritability and bipolar disorder, with the proportion of the effect of irritability on bipolar disorder mediated by smoking being 11.76% (95% CI: 2-21; p=0.012). CONCLUSIONS: Smoking plays a mediating role in the potential causal pathway linking irritability and bipolar disorder, suggesting that smoking cessation interventions may possibly help mitigate the risk of bipolar disorder among individuals with heightened irritability.
Support for tobacco endgame approaches: Results from a web-based survey of stakeholders from 28 African countries.
Egbe CO, Londani M, Gwambe S … +3 more , Sessou L, Fagbule OF, Bialous SA
Tob Induc Dis · 2025 · PMID 41221020 · Full text
INTRODUCTION: The tobacco 'endgame' concept proposes moving beyond traditional tobacco control measures towards a tobacco-free future. The aim of this study is to investigate the perceptions of tobacco control stakeholde...
INTRODUCTION: The tobacco 'endgame' concept proposes moving beyond traditional tobacco control measures towards a tobacco-free future. The aim of this study is to investigate the perceptions of tobacco control stakeholders in Africa on their agreement with what endgame approaches are suited for the region to achieve a tobacco-free society. METHODS: Data were collected using a web-based cross-sectional survey hosted on Redcap. A total of 146 stakeholders from 28 African countries took the survey. Participants rated agreement with 11 proposed endgame approaches drawn from the literature and the qualitative phase of this study. Descriptive analysis was used to summarize stakeholders' level of agreement while bivariate (chi-squared and Fisher's exact tests) and adjusted modified Poisson regression analyses examined association between agreement/disagreement to endgame approaches and demographic factors. Data were analyzed using STATA v17. RESULTS: All participants agreed to an integrated endgame approach while over 90% agreed with six measures (having non-addictive cigarettes, making cigarette unappealing, tobacco-free generation, regulated market model, quota/sinking lid and specific approaches for Africa). Agreements ranged from 70-85% for price caps, performance-based regulation, and non-combustible nicotine products, while only 35% supported government takeover of tobacco companies. Adjusted Poisson regression analyses showed that female stakeholders were less likely to support restricting tobacco sales by year of birth (relative risk ratio, RRR=0.89) and price caps (RRR=0.78), while PhD holders were more likely to support restricting tobacco sales by year of birth (RRR=1.29) and price caps (RRR=1.27). Stakeholders from Southern Africa were less likely to support a state takeover of tobacco companies (RRR=0.40) and performance-based regulation (RRR=0.76). Having more than 20 years of tobacco control experience lowered the support of price caps endgame measures (RRR=0.45). CONCLUSIONS: Policymakers are encouraged to use insights from this study to consider multifaceted approaches aimed at addressing the problem of commercial tobacco in the African region and pave the way for a tobacco-free Africa.
An observational study on the association between smoking and relative poverty in China: Evidence from two waves of China Family Panel Studies.
Wei Q, Wang H, Wan Q … +4 more , Liang S, Pang W, Zeng Q, Chai P
Tob Induc Dis · 2025 · PMID 41194939 · Full text
INTRODUCTION: Smoking is the leading, preventable factor which significantly increases the likelihood of household relative poverty in China. This study aimed to explore the association between smoking and relative pover...
INTRODUCTION: Smoking is the leading, preventable factor which significantly increases the likelihood of household relative poverty in China. This study aimed to explore the association between smoking and relative poverty across different households and provide evidence for targeted tobacco control measures and poverty reduction policies. METHODS: This study adopted a longitudinal design using two waves of unbalanced panel data from the China Family Panel Studies (CFPS) conducted in 2018 and 2020. Data were collected through structured questionnaires and self-reported responses. Smoking status of household members was considered the exposure factor, while household relative poverty status, measured by the Foster-Greer-Thorbecke indices, served as the outcome variable. A panel logit random effects model was employed to estimate the determinants of relative poverty across households with varying smoking status. RESULTS: At the 50% median income poverty line, China's relative poverty headcount ratio was 22.15% in 2018 and 22.54% in 2020, with the poverty gap index declining from 11.08% to 10.82% and the squared poverty gap index increasing slightly from 7.13% to 7.17%. Former-smoking households showed the highest poverty incidence (26.3% in 2018; 26.24% in 2020), followed by current-smoking (24.94%; 23.28%) and non-smoking households (22.75%; 22.37%). The panel logit model revealed significantly higher likelihood for current-smoking (adjusted odds ratio, AOR=1.63; 95% CI: 1.44-1.86, p<0.01) and former-smoking households (AOR=1.95; 95% CI: 1.60-2.36, p<0.01) compared to non-smoking households. Additional factors associated with increased odds of poverty included having ≥65 years members, members with chronic disease, and members reporting a two-week illness (all p<0.01). CONCLUSIONS: We conclude that China faces a substantial challenge of relative poverty, with tobacco use significantly increasing the likelihood of household poverty. Potential policy directions may include evaluating the effects of adjusting tobacco excise taxes and reforming tax collection mechanisms, exploring rural smokers' preferences for smoking cessation information to inform the development of targeted interventions and so on.
Socioeconomic and demographic determinants of tobacco use in Kenya: A secondary data analysis of findings from the Kenya Demographic and Health Survey 2022.
Magati PO, Drope J, Lencucha R … +4 more , Shade SB, Ouner JJ, Odhiambo F, Bialous S
Tob Induc Dis · 2025 · PMID 41194938 · Full text
INTRODUCTION: Tobacco use is a major public health crisis in Kenya, leading to over 6000 deaths annually. With a significant number of young people and adults using tobacco, the nation faces a rising health burden. The K...
INTRODUCTION: Tobacco use is a major public health crisis in Kenya, leading to over 6000 deaths annually. With a significant number of young people and adults using tobacco, the nation faces a rising health burden. The Kenyan government has implemented educational programs to curb consumption. This study analyzes data from the 2022 Kenya Demographic and Health Survey (KDHS) to assess changes in tobacco use from 2014 to 2022 and identify key demographic and socioeconomic determinants. METHODS: This study is a secondary data analysis of the 2022 Kenya Demographic and Health Survey (KDHS), a nationally representative survey of 46609 adults (aged 15-54 years). Data access was through the MEASURE DHS platform, ensuring ethical handling. A logistic regression model was used to estimate odds ratios of tobacco use, adjusting for socioeconomic and demographic factors. The analysis accounted for the survey's complex design using survey weights and clustering and was conducted in Stata 17 software. RESULTS: Between 2014 and 2022, overall tobacco use declined. Among men, prevalence dropped from 17.3% to 12.81% (25.95% decrease), and among women from 3.10% to 2.64% (14.84% decrease). While women's smoking slightly increased (0.18-0.35%), their smokeless use decreased (0.93-0.77%). Tobacco use was linked to age, marital status, residence, region, education level, and gender. Men's tobacco use odds increased with age, with those aged 20-24 years nearly five times more likely to use tobacco than those aged 15-19 years (AOR=4.44; 95% CI: 4.44-4.44). Married men were less likely to use tobacco than divorced, separated, or widowed men. CONCLUSIONS: The observed declines in tobacco use, especially among males, suggest that current tobacco control efforts are positively impacting public health. Given the financial strain of health costs, preventive interventions are crucial. Research on socioeconomic and demographic factors can guide targeted behavioral change strategies. Continued policy measures like increased tobacco taxation, raising the legal sale age, and enforcing advertising bans and smoke-free policies remain essential to further reduce tobacco's health burden in Kenya.
What types of tobacco control public service advertisements work for Chinese adolescents? A mixed-methods study.
Chen Y, Liu H, Liu S … +4 more , Cai Y, Xu J, Yang X, Chan KS
Tob Induc Dis · 2025 · PMID 41190309 · Full text
INTRODUCTION: Adolescent tobacco use has become a serious global public health problem, and effective tobacco control public service advertisements (PSAs) are crucial for reducing adolescent smoking rates. The study aims...
INTRODUCTION: Adolescent tobacco use has become a serious global public health problem, and effective tobacco control public service advertisements (PSAs) are crucial for reducing adolescent smoking rates. The study aims to employ a mixed-methods approach combining quantitative surveys and qualitative focus groups to evaluate the effectiveness of different types of tobacco control PSAs among Chinese adolescents, identify effective advertising characteristics and content elements, and provide empirical evidence for optimizing youth tobacco control communication strategies. METHODS: A total of 125 students aged 10-18 years were recruited from six primary and secondary schools in Beijing and Kunming from November 2020 to April 2021. Participants completed Likert-scale ratings measuring advertisement effectiveness after viewing eight tobacco control PSAs and participated in focus group interviews. Quantitative data were analyzed using independent samples t-tests, Spearman correlation analysis, and multivariable logistic regression analysis, while qualitative data were analyzed using thematic analysis. All statistical tests were two-tailed with significance set at p<0.05. RESULTS: Quantitative analysis revealed that PSAs employing 'testimonials' and 'disease' frameworks were most strongly associated with prevention intentions, while those using 'celebrity endorsement', 'humor' and 'appearance damage' frameworks showed the weakest associations. Kunming adolescents showed significantly higher advertisement acceptance scores than Beijing adolescents (mean difference=0.21; 95% CI: 0.04-0.38, p<0.05). The 10-item effectiveness scale demonstrated good internal consistency (Cronbach's α=0.82). Qualitative analysis identified effective characteristics including presentation of specific health hazards, use of testimonials, and fear appeals; ineffective characteristics included non-specific harm presentation, use of humorous elements, and appearance damage content. CONCLUSIONS: Tobacco control PSA design should consider strategies combining disease warnings with real-life testimonials, avoid humorous advertisements and industry-sponsored messaging, and consider regional cultural differences. Distribution through online and social media platforms frequently used by adolescents may enhance reach. Future longitudinal research with broader geographical sampling is needed to confirm these findings.
Global burden of vision impairment due to smoking-related cataract: A descriptive study of spatiotemporal trends based on GBD secondary data and projections to 2050.
Chen Y, Li Y, Hu P … +3 more , Chen T, Grzybowski A, Huang L
Tob Induc Dis · 2025 · PMID 41180462 · Full text
INTRODUCTION: Smoking is a major modifiable risk factor for cataract, with strong biological and epidemiological evidence supporting this association. Nevertheless, the global burden and regional variations in vision imp...
INTRODUCTION: Smoking is a major modifiable risk factor for cataract, with strong biological and epidemiological evidence supporting this association. Nevertheless, the global burden and regional variations in vision impairment attributable to smoking-related cataract have not been comprehensively assessed. METHODS: Using data from the Global Burden of Disease (GBD) 2021 study, we performed a secondary analysis of the global years lived with disability (YLDs) due to smoking-related cataract vision impairment, from 1990 to 2021. Analyses were stratified by age group (30-34 to ≥95 years). Trends were evaluated using age-standardized YLDs rates (ASYLDsR) and estimated annual percentage change (EAPC). Future burden was projected to 2050 using a Bayesian age-period-cohort (BAPC) model. RESULTS: In 2021, global YLDs due to smoking-related cataract reached 225174 cases (95% uncertainty interval, UI: 151200-325529), representing a 38.9% (95% UI: 35.2-42.5) increase compared with 1990. However, the ASYLDsR declined significantly (EAPC= -1.41%, 95% CI: -1.48 - -1.33). Population growth contributed over 360% to the increase in YLDs in low sociodemographic index (SDI) regions, whereas population aging was the dominant factor in high-SDI regions (contributing 165%). Males accounted for 82% of the global burden. In 2021, the male ASYLDsR was 5.3 times higher than that of females (4.59; 95% UI: 3.24-6.39 vs 0.87; 95% UI: 0.61-1.23, per 100000 population). Countries in Asia bore the heaviest absolute burden, with China and India collectively accounting for 53% of the global total. The BAPC model projected a continued decline in ASYLDsR through 2050, with predicted rates of 2.69 (95% CI: 0.59-4.77) males and 0.42 (95% CI: 0.09-0.82) females. CONCLUSIONS: Despite a declining age-standardized burden globally, the absolute burden is increasing due to population growth and aging, presenting ongoing challenges, particularly for low- and middle-income countries. Strengthening tobacco control and improving access to cataract surgery are recommended.
Marketing behind charity: Media narratives of tobacco industry donations in China.
Chen Y, Lin H, Zhao X … +7 more , Zhao Y, Wu K, Cai Y, Yu X, Yang X, Xu J, Chan KS
Tob Induc Dis · 2025 · PMID 41180461 · Full text
INTRODUCTION: While tobacco industry corporate social responsibility (CSR) activities as marketing strategies have been documented globally, the narrative mechanisms through which media coverage legitimizes tobacco indus...
INTRODUCTION: While tobacco industry corporate social responsibility (CSR) activities as marketing strategies have been documented globally, the narrative mechanisms through which media coverage legitimizes tobacco industry charitable donations remain understudied, particularly within China's unique state-monopoly context. This study examines how tobacco industry donations function as marketing through media narratives. METHODS: We conducted a secondary systematic content and narrative analysis of news coverage documenting tobacco industry charitable donations recorded in the 2021 China Tobacco Yearbook. Using purposive sampling, we identified 85 news reports from 2020, through comprehensive online searches. Two trained coders independently analyzed all materials using a coding framework based on narrative theory, examining eight dimensions including narrator types, character construction, narrative perspectives, and framing strategies (Cohen's κ=0.85; 95% CI: 0.78-0.91). RESULTS: Analysis revealed systematic narrative strategies designed to enhance tobacco companies' public image. Key findings include: 82.35% (n=70) of headlines explicitly mentioned tobacco company names; reporting frames emphasized national policy alignment (37.65%; n=32), health benefits (34.12%; n=29), and corporate social responsibility (30.6%; n=26); tobacco companies appeared as primary actors in 97.6% (n=83) of reports; 100% (n=85) of coverage maintained positive valence toward donations. Chi-squared analysis demonstrated significant associations between character construction and framing strategies (χ=42.84; degrees of freedom, df=4; p<0.001; Cramer's V=0.710). CONCLUSIONS: News coverage of tobacco industry donations employs sophisticated narrative strategies that function as a form of tobacco promotion and marketing with implications for World Health Organization Framework Convention on Tobacco Control (WHO FCTC) Article 13 implementation. These findings suggest the need for further research on regulatory approaches to address all forms of tobacco promotion, including charitable donations and their media coverage, to support effective WHO FCTC implementation.
Smad7 ameliorate small airway remodeling in COPD by modulating epithelial-mesenchymal transition.
Liu X, Sun S, He S … +1 more , Xie L
Tob Induc Dis · 2025 · PMID 41180460 · Full text
INTRODUCTION: Small airway remodeling is a key pathological feature of COPD, yet its mechanisms remain unclear. TGF-β1 induces epithelial-mesenchymal transition (EMT), contributing to airway remodeling. Smad7 is a negati...
INTRODUCTION: Small airway remodeling is a key pathological feature of COPD, yet its mechanisms remain unclear. TGF-β1 induces epithelial-mesenchymal transition (EMT), contributing to airway remodeling. Smad7 is a negative regulator of TGF-β signaling, but its role in COPD remains undefined. This study investigates whether Smad7 suppresses TGF-β1-induced EMT in COPD small airway remodeling. METHODS: Lung tissues from COPD patients (n=3 for each group) and mouse models (n=5 for each group) were analyzed for EMT markers and collagen deposition. BEAS-2B cells were exposed to cigarette smoke extract (CSE) to assess TGF-β1 secretion. EMT markers (E-Cadherin, N-Cadherin, and Vimentin) were evaluated using RT-qPCR, Western blot, and immunofluorescence staining. Morphological changes were examined, and Smad7 function was assessed via overexpression and knockdown experiments. RESULTS: COPD patients and mouse models showed increased EMT and collagen deposition. CSE exposure upregulated TGF-β1 in BEAS-2B cells, leading to decreased E-Cadherin and increased N-Cadherin and Vimentin. Morphological changes confirmed EMT induction. Overexpression of Smad7 reversed these effects, while its knockdown enhanced them. CONCLUSIONS: Smoking promotes TGF-β1-induced small airway remodeling in COPD by driving EMT. Smad7 suppresses this process.
A global media scan on plastic waste using Tobacco Watcher: Opportunities for tobacco control.
Kennedy RD, Walker EK, Kaur H … +1 more , Welding K
Tob Induc Dis · 2025 · PMID 41180459 · Full text
Abstract loading — click title to view on PubMed.
Tobacco and vaping exposure among Spanish adolescents: An analysis of digital, social, school, and family environments.
Rodrigo CS, Escolar-Llamazares MC, Val EIM … +2 more , Sáiz-Manzanares MC, Martínez Martín MÁ
Tob Induc Dis · 2025 · PMID 41180458 · Full text
INTRODUCTION: Involuntary exposure to secondhand tobacco smoke (SHS) and secondhand aerosol from electronic cigarettes (SHA) persists in homes, vehicles, educational settings, and recreational spaces, increasing adolesce...
INTRODUCTION: Involuntary exposure to secondhand tobacco smoke (SHS) and secondhand aerosol from electronic cigarettes (SHA) persists in homes, vehicles, educational settings, and recreational spaces, increasing adolescents' risk of respiratory infections, asthma, and impaired lung development. The study aim was to examine among Spanish adolescents, aged 12-21 years, the associations between: 1) the presence of social models who smoke or vape (parents, siblings, peers, teachers); 2) self-perceived exposure to smoke or aerosol in physical environments (home, school, car, public spaces); 3) digital exposure to both anti-tobacco messaging and vaping-related content on social media and video platforms; and 4) age-based sales restrictions for nicotine products. We hypothesized that higher levels of physical or digital exposure and the presence of smoking or vaping role models would be associated with greater likelihood of trying conventional or electronic cigarettes. METHODS: We conducted a cross-sectional survey of 2823 students (mean age=13.8 ± 1.2 years; 49.2% female) in public and charter schools between 2021 and 2024. A validated questionnaire (Cronbach's α=0.72-0.84) assessed experimental tobacco and vaping use, social models, physical and digital exposures, and purchase attempts/denials. Analyses included bivariate tests (χ, Cramér's V), logistic regression for tobacco experimentation and multiple linear regression for vaping. RESULTS: Among participants, 21% had tried cigarettes and 8.3% had used e-cigarettes. Tobacco experimentation was significantly associated with having smoking friends (adjusted odds ratio, AOR=4.47; 95% CI: 3.30-6.06), smoking siblings (AOR=1.87; 95% CI: 1.32-2.64), and exposure to smoking at school (AOR=1.87; 95% CI: 1.39-2.50) or concerts (AOR=1.83; 95% CI: 1.21-2.77). Conversely, exposure at beaches or swimming pools was linked to lower odds (AOR=0.54; 95% CI: 0.36-0.82). E-cigarette use was positively associated with exposure to anti-tobacco media messages (β=0.264, p<0.001), vaping content in online videos (β=0.098, p=0.021), and having smoking friends (β=0.118, p=0.038). Each β indicates the estimated increase in the normalized vaping score per unit increase in the corresponding exposure. Additionally, being denied nicotine product purchases due to age restrictions was linked to greater odds of e-cigarette experimentation (AOR=2.87; 95% CI: 1.94-4.23). CONCLUSIONS: Τhe findings suggest that family and peer models, as well as passive exposure in both physical and digital environments, may be associated with adolescent initiation of tobacco and vaping. These associations highlight the importance of conducting further longitudinal studies to explore causal mechanisms and inform the development of effective prevention strategies tailored to adolescents' social and digital contexts.
Unravelling sociodemographic inequities in household secondhand smoke exposure among non-smokers in Malaysia: A secondary analysis of National Health and Morbidity Survey (NHMS) 2019.
Lim KH, Cheong YL, Lim JH … +7 more , Ghazali SM, Cheong KC, Teh CH, Heng PP, Marine AA, Hashim MHM, Lim HL
Tob Induc Dis · 2025 · PMID 41180457 · Full text
INTRODUCTION: Secondhand smoke (SHS) exposure remains a significant global public health issue. Identifying the factors contributing to SHS exposure is crucial for developing targeted, evidence-based interventions to mit...
INTRODUCTION: Secondhand smoke (SHS) exposure remains a significant global public health issue. Identifying the factors contributing to SHS exposure is crucial for developing targeted, evidence-based interventions to mitigate its impact. This study examines the patterns and determinants of SHS exposure at home among non-smoking Malaysians. METHODS: Data were derived from the National Health and Morbidity Survey (NHMS) 2019, which employed a cross-sectional design and multistage sampling to gather a representative sample of Malaysians aged ≥15 years. Demographic data and information on SHS exposure at home within the past month, were collected via a structured questionnaire. Weighted data were analyzed using chi-square tests and multivariable logistic regression. RESULTS: Of the 1876 participants (representing an estimated 3.54 million individuals), 19.8% (95% CI: 18.5-21.1) reported SHS exposure at home. Several sociodemographic factors were significantly associated with SHS exposure. Logistic regression analysis revealed higher odds of exposure among females (adjusted odds ratio, AOR=1.85; 95% CI: 1.55-2.29), Malays (AOR=2.65; 95% CI: 1.86-3.78), Bumiputera Sabah (AOR=4.16; 95% CI: 2.72-6.37), and Bumiputera Sarawak (AOR=3.67; 95% CI: 2.32-5.80). Other significant factors included being aged ≤24 years (AOR=1.87; 95% CI: 1.26-2.78) and belonging to a low income group (quintile 1; AOR=1.42; 95% CI: 1.12-1.95). Interaction analysis also identified significant two-way interactions between sex and some sociodemographic independent variables. CONCLUSIONS: Approximately two in ten non-smoking Malaysians were exposed to SHS at home. These findings underscore the need for comprehensive tobacco control measures that raise awareness about the health risks of SHS exposure at home. Educational campaigns should focus on promoting smoke-free home environments, particularly among the high-risk groups identified in this study.
Real-world effectiveness of a community-based multicomponent maternal smoking cessation program in preventing low birthweight deliveries: Findings from the CTTP cohort.
Ahmed SD, Petersen AB, Nelson AP … +4 more , Martinez M, Shavlik D, Oshiro BT, Singh PN
Tob Induc Dis · 2025 · PMID 41142093 · Full text
INTRODUCTION: The effect of smoking cessation during pregnancy on preventing adverse birth outcomes has been shown in studies of US birth certificate data, and in other nations. There is a paucity of data to optimize com...
INTRODUCTION: The effect of smoking cessation during pregnancy on preventing adverse birth outcomes has been shown in studies of US birth certificate data, and in other nations. There is a paucity of data to optimize community-based maternal tobacco cessation programs to improve birth outcomes. Our objective is to evaluate the real-world effectiveness of a multi-component, community-based maternal smoking cessation program in preventing adverse infant outcomes using components of known efficacy. METHODS: The Comprehensive Tobacco Treatment Program (CTTP) was a state-funded maternal tobacco smoking cessation program serving pregnant women in San Bernardino County, California, the largest county in the contiguous US. CTTP used a six-to-eight-week behavioral intervention with components of known efficacy (i.e. incentives, biomarker testing, feedback, and motivational interviewing). We conducted a retrospective cohort study of the 1402 pregnant women enrolled in CTTP during 2012-2019. We conducted a multivariable logistic regression analysis with adverse infant outcomes [premature birth (PTB), low birthweight (LBW), and NICU admission] as the dependent variables, abstinence achieved during [prolonged abstinence (PA) through weekly urinary cotinine tests] or after the program [self-reported point prevalence abstinence (PPA)] as the main effect exposures, and pertinent confounders. RESULTS: We found that PA during the program significantly decreased the odds of LBW (OR=0.67; 95% CI: 0.47-0.96, p=0.03), and this association remained for self-report of PPA at 2-4 months after the program (OR=0.70; 95% CI: 0.54-0.90, p=0.006), and six months after the program (OR=0.65; 95% CI: 0.47-0.90, p=0.01). Similar, albeit weaker, trends were found for PTB (OR=0.80). In these models, older age, early trimester at enrollment, and African American/Black ethnicity also trended toward higher rates of LBW and PTB. CONCLUSIONS: Abstinence achieved during a multi-component behavioral smoking cessation intervention program using components of known efficacy, significantly reduced low birthweight deliveries in a multi-ethnic population.
Ethnic differences in prevalence and behaviors of smoking and their association with chronic obstructive pulmonary disease among the elderly in rural southwest China: A cross-sectional study.
Li GH, Wang GY, Liu L … +4 more , Zhao Y, Wu X, Golden AR, Cai L
Tob Induc Dis · 2025 · PMID 41142092 · Full text
INTRODUCTION: This study examines how prevalence and behaviors of smoking differ by ethnicity and their associations with chronic obstructive pulmonary disease (COPD) among elderly people of four ethnicities in rural sou...
INTRODUCTION: This study examines how prevalence and behaviors of smoking differ by ethnicity and their associations with chronic obstructive pulmonary disease (COPD) among elderly people of four ethnicities in rural southwest China. METHODS: A cross-sectional survey of 5642 adults aged ≥60 years was conducted in rural southwest China. Data on the demographics, smoking habits, and post-bronchodilator spirometry were collected. RESULTS: Among the participants, the prevalence of current smoking (48.8% vs 0.8%) and COPD (12.7% vs 4.5%) was significantly higher in males compared to females (p<0.01). Filtered cigarettes were the most popular form of tobacco used, comprising 76.6% of tobacco consumed. Bai ethnic minority participants had the highest prevalence of current smoking and COPD, and the highest number of cigarettes smoked per day compared to the other three studied ethnicities (p<0.01). Ha Ni ethnic minority participants had the lowest rate of smoking cessation (8.7%) and the highest rate of smoking in public places (66.8%) (p<0.01). The results of multivariable logistic regression indicated that current smokers were more likely to suffer from COPD across all four studied ethnicities (p<0.05). Further, the association of current smoking with COPD in Bai ethnicity elderly participants was stronger compared to other ethnic groups (p<0.01). CONCLUSIONS: The present study shows that ethnicity plays a significant role in influencing both the prevalence and behaviors related to smoking among elderly people in rural southwest China. Future efforts to prevent and reduce tobacco use in rural China should consider ethnicity, as culturally tailored tobacco control strategies could help prevent and manage the COPD epidemic.
Exploring effective characteristics of e-cigarette prevention videos among Chinese adolescents: A qualitative focus group study.
Chen Y, Liu H, Zhang R … +4 more , Zhao X, Cai Y, Xu J, Chan KS
Tob Induc Dis · 2025 · PMID 41142091 · Full text
INTRODUCTION: The rapid proliferation of electronic cigarettes (e-cigarettes) among adolescents represents a significant public health challenge globally. This qualitative study explored adolescents' perspectives on effe...
INTRODUCTION: The rapid proliferation of electronic cigarettes (e-cigarettes) among adolescents represents a significant public health challenge globally. This qualitative study explored adolescents' perspectives on effective characteristics of e-cigarette prevention videos to inform evidence-based prevention strategies. METHODS: We conducted four focus groups with 40 middle-school students aged 13-15 years in 2021 in Beijing and Kunming, China. Using purposive sampling, we selected participants (n=40) from schools in cities with contrasting tobacco control environments. After viewing four international e-cigarette prevention videos varying in style and content, participants discussed perceived effective and ineffective characteristics. We employed Braun and Clarke's six-phase reflexive thematic analysis approach, using NVivo 12 for data management. RESULTS: Thematic analysis identified two main domains: effective and ineffective video characteristics. Effective features included authentic case studies demonstrating real consequences, specific health hazards with visual impact, disclosure of harmful chemical components, and appropriately disturbing imagery that created emotional response. Fear appeals and emotional narratives proved particularly impactful when combined with concrete information. Ineffective characteristics included animation formats, overly complex or vague information, didactic expert testimonials, and excessive video length (>2 minutes). Participants recommended that future videos incorporate real-life cases, specific health consequences, moderate fear appeals, and concise messaging within 1-3 minutes. CONCLUSIONS: Chinese adolescents respond most effectively to prevention videos featuring authentic narratives and specific health consequences rather than animated or didactic content. The preference for fear appeals combined with factual information suggests that emotionally engaging yet informative content may optimize prevention effectiveness. These findings provide evidence for developing culturally appropriate e-cigarette prevention video development for Chinese youth, particularly given ongoing challenges in policy enforcement and youth access to e-cigarettes.
A cross-sectional study on the association between secondhand smoke exposure and suicide among adolescents in multicultural families: The mediating role of perceived stress.
Du W, Luo Y, Wu Y … +1 more , Wang Y
Tob Induc Dis · 2025 · PMID 41111567 · Full text
INTRODUCTION: Adolescent suicidality poses a serious barrier to healthy growth and development. This study examines the association between secondhand smoke (SHS) exposure and suicidality among adolescents from multicult...
INTRODUCTION: Adolescent suicidality poses a serious barrier to healthy growth and development. This study examines the association between secondhand smoke (SHS) exposure and suicidality among adolescents from multicultural families in South Korea, using a secondary analysis of the Korea Youth Risk Behavior Webbased Survey (KYRBS). METHODS: This cross-sectional study used pooled secondary data from the 2021 and 2024 waves of the KYRBS, a nationally representative survey of adolescents in South Korea, collected through self-administered questionnaires. This is a secondary dataset analysis of the KYRBS using logit regression models to assess the associations between the duration and setting-specific frequency of SHS exposure and suicidality among adolescents. The mediating role of perceived stress was examined using the Karlson-Holm-Breen (KHB) method. RESULTS: SHS exposure is significantly associated with increased suicidality likelihood among adolescents, with particularly strong associations observed in those from multicultural families. Among multicultural adolescents, each additional total day of SHS exposure is significantly associated with the likelihood of suicidal ideation (AOR=1.117; 95% CI: 1.084-1.151), suicide planning (AOR=1.095; 95% CI: 1.052-1.139), and suicide attempts (AOR=1.117; 95% CI: 1.069-1.168). SHS exposure showed a stronger association with suicidality in multicultural families versus non-multicultural families. A higher frequency of SHS exposure across multiple settings is significantly associated with elevated odds of suicidal ideation (AOR=1.422; 95% CI: 1.247-1.621), suicide planning (AOR=1.395; 95% CI: 1.153-1.689), and suicide attempts (AOR=1.524; 95% CI: 1.222-1.902). Further analysis reveals that perceived stress partially mediates the association between SHS exposure and suicidality among multicultural adolescents. Perceived stress indirectly mediated 23.19% of the effect of SHS exposure on suicide attempts. It also mediated 30.67% and 34.18% of the effects on suicidal ideation and planning, respectively. CONCLUSIONS: SHS exposure was associated with a higher likelihood of suicidality among adolescents, with this association observed in greater magnitude in adolescents from multicultural families. Moreover, perceived stress partially mediates the association between SHS exposure and suicide attempts among multicultural adolescents.
Association between serum copper and COPD: Insights from NHANES 2011-2016 and Mendelian randomization study.
Qu J, Zhang M, Hu C … +3 more , Liu Y, Zhao W, Qu Y
Tob Induc Dis · 2025 · PMID 41111566 · Full text
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) affects 390 million people globally, with oxidative stress playing a key pathogenic role. Smoking and other forms of tobacco exposure are major COPD drivers and...
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) affects 390 million people globally, with oxidative stress playing a key pathogenic role. Smoking and other forms of tobacco exposure are major COPD drivers and important sources of systemic oxidative stress, and potentially interact with metal homeostasis. Copper exhibits dual effects in lung homeostasis, as a cofactor for antioxidant enzymes and a potential catalyst for reactive oxygen species. However, the causal relationship between serum copper levels and COPD remains unclear. This study aimed to assess their association using a combination of observational and genetic approaches. METHODS: In stage one, we used multivariate regression to analyze the association between serum copper and COPD in 3166 participants in the National Health and Nutrition Examination Survey (NHANES), 2011-2016. Models adjusted for demographic and clinical covariates including smoking-related variables, and stratified analyses by smoking status. Stage two utilized Mendelian randomization (MR) analysis to explore a potential cause-and-effect link between copper levels in serum determined by genetics and COPD. RESULTS: Observational analysis showed increased COPD risk in the highest serum copper tertile (T3 vs T1, OR=1.65; 95% CI: 1.09-2.49; p-trend=0.0245). The association remained after adjustment for smoking-related covariates. However, MR analyses using both FinnGen and UK Biobank data suggested no causal effect (FinnGen IVW, OR=1.01; 95% CI: 0.98-1.04, p=0.37; UK Biobank IVW, OR=1.00; 95% CI: 1.00-1.00, p=0.55), with sensitivity analyses confirming result robustness. CONCLUSIONS: While elevated serum copper is associated with COPD prevalence observationally, the null MR finding suggests it may reflect tobacco-related systemic oxidative stress or reverse causation rather than being a direct causal driver. Therefore, serum copper may be more useful as a biomarker of smoking-induced redox disturbance than as a therapeutic target. These results underscore the importance of integrating tobacco exposure metrics in future studies examining metal biology in COPD.
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