Tobacco Induced Diseases[JOURNAL]
Sun
200 papers
Exploring the association of time-inconsistent preferences with smoking behavior: A cross-sectional survey study from Sichuan, China.
Li Y, Ling S, Zhou Y … +3 more , Li Y, He J, Yang L
Tob Induc Dis · 2025 · PMID 41000451 · Full text
INTRODUCTION: The high prevalence of tobacco use in China has led to a heavy social burden. There have been many studies on smoking behavior in China, but few have explored it from the perspective of behavioral economics...
INTRODUCTION: The high prevalence of tobacco use in China has led to a heavy social burden. There have been many studies on smoking behavior in China, but few have explored it from the perspective of behavioral economics. This study investigated the association between time-inconsistent preferences and smoking behavior. METHODS: We conducted a household-based cross-sectional survey in Sichuan Province, southwestern China, in 2022. Participants were selected using multistage stratified sampling. Data were collected through face-to-face, questionnaire-based household surveys, yielding 5446 valid responses. The smoking status of all participants was confirmed by cotinine test. Descriptive statistical analysis was performed on variables such as sociodemographic variables and time-inconsistent preference, and a binary logistic regression model was used to explore the relationship between time-inconsistent preference and smoking behavior. RESULTS: The smoking rate of the survey participants was 23.87%, among which that of drinkers was 45.90%, which was significantly higher than that of non-drinkers (15.10%); 712 participants (13.07%) both smoked and drank, and the average time-inconsistent preference (time-inconsistent preferences measured over 1-month and 12-month delay periods) of smokers (mean ± standard deviation: 0.91 ± 0.14) was significantly lower than that of non-smokers (0.95 ± 0.11, p<0.001). Thus, those with weaker time-inconsistent preferences were less likely to smoke (p<0.001, adjusted odds ratio, AOR=0.276; 95% CI: 0.140-0.544). This trend was significant in both drinkers and non-drinkers, with AOR of 0.253 (95% CI: 0.093-0.693) and 0.26 (95% CI: 0.102-0.661), respectively. CONCLUSIONS: Weaker time-inconsistent preferences show a significant negative association with smoking behavior in this Chinese sample, independent of alcohol consumption. Commitment mechanisms targeting time-inconsistent preferences may hold promise for smoking cessation interventions, although efficacy requires validation through randomized trials.
The impact of Shanghai's comprehensive smoke-free legislation on hospitalization and mortality rates of ischemic heart disease: An interrupted time series analysis.
Sun L, Yu H, Chen D … +7 more , Qin D, Shi Y, Hu Y, Gao J, Xie C, Chen X, Wang H
Tob Induc Dis · 2025 · PMID 41000450 · Full text
INTRODUCTION: Smoking and secondhand smoke are major global health threats, significantly contributing to the burden of ischemic heart disease (IHD). Despite the implementation of tobacco control policies worldwide, limi...
INTRODUCTION: Smoking and secondhand smoke are major global health threats, significantly contributing to the burden of ischemic heart disease (IHD). Despite the implementation of tobacco control policies worldwide, limited evidence exists on the health impacts in Shanghai. This study evaluates the effects of Shanghai's 2017 smoke-free legislation on IHD hospitalization and mortality rates. METHODS: We conducted Interrupted Time Series (ITS) method to analyze monthly data on IHD hospitalizations and mortality among registered residents of Shanghai from July 2013 to December 2021. Age-standardized rate, Poisson and negative binomial regression models were performed to control for covariates. RESULTS: We included 898535 hospitalizations and 180658 deaths caused by IHD from July 2013 to December 2021 in Shanghai. Following policy implementation, there was a significant immediate increase (β=8.29; 95% CI: 2.45-14.13) and post-trend decline (β= -0.73; 95% CI: -0.93 - -0.54) in IHD hospitalization, which is estimated to have prevented approximately 890 hospitalizations per year. Subgroup analysis revealed that the long-term decrease was more pronounced in individuals aged ≥65 years (β= -1.72; 95% CI: -2.21 - -1.24), compared to those aged 35-64 years (β= -0.33; 95% CI: -0.42 - -0.25). However, mortality rates showed no statistically significant immediate (β= -0.90, 95% CI: -4.76-2.95) or long-term changes (β= -0.0075; 95% CI: -0.14-0.12). CONCLUSIONS: Shanghai's comprehensive smoke-free legislation appears to be associated with a significant long-term reduction in hospitalization rates and a modest decrease in mortality rates from ischemic heart disease, particularly among older adults. These findings support the potential cardiovascular health benefits of smoke-free policies, which provide useful evidence for other cities considering the adoption or reinforcement of comprehensive public smoking bans to help reduce the burden of cardiovascular disease and improve population health.
Gender-specific effects of smoking and alcohol consumption on cardiometabolic diseases and multimorbidity: A cross-sectional study.
Sun P, Gao J, Liang X … +4 more , Zhang X, Zhang X, Yan X, Ni C
Tob Induc Dis · 2025 · PMID 40977949 · Full text
INTRODUCTION: Gender-specific variations in hormonal profiles, adipose tissue distribution, and metabolic pathways may differentially modulate the health impacts of smoking and alcohol use. Current population-based studi...
INTRODUCTION: Gender-specific variations in hormonal profiles, adipose tissue distribution, and metabolic pathways may differentially modulate the health impacts of smoking and alcohol use. Current population-based studies on the impact of smoking and alcohol consumption on cardiometabolic diseases (CMD) and multimorbidity (CMM) often lack gender-stratified analyses, thereby limiting the evidence base for gender-tailored preventive strategies. METHODS: This population-based cross-sectional study used data from the 2020 China Health and Retirement Longitudinal Study (CHARLS), and a total of 11447 participants were included in the analysis. Multinomial logistic regression was conducted to assess behavioral risk factors, with interaction terms evaluating effect modification by gender. RESULTS: The prevalence was 16.67% for CMD and 5.66% for CMM. Participants who smoked were more likely to report CMM than those who did not smoke (OR=2.70, p<0.05). Smoking was significantly associated with the prevalence of CMD in females (AOR=1.34, p<0.05), but not in males (p=0.556). Moreover, female smokers were more likely to report CMM compared to male smokers (AOR=3.53, AOR=2.02, p<0.05). No significant associations were found between alcohol consumption and the prevalence of CMD or CMM, nor were any gender-specific differences observed. CONCLUSIONS: Smoking may have a potential gender-specific effect on the risk of CMD and CMM, with female smokers exhibiting a higher prevalence of CMM than males. This highlights the need to integrate gender considerations into chronic disease prevention frameworks.
Projecting the impact of strengthened tobacco control policy on disparities in US states with persistently high smoking rates.
Donovan EM, Yoon SN, Hardy B … +2 more , Kreslake J, Maciosek MV
Tob Induc Dis · 2025 · PMID 40977948 · Full text
INTRODUCTION: Thirteen Southern and Midwestern states - termed 'Tobacco Nation' - have persistently higher smoking rates than other US states. Previous research indicates increased cigarette taxes and tobacco control exp...
INTRODUCTION: Thirteen Southern and Midwestern states - termed 'Tobacco Nation' - have persistently higher smoking rates than other US states. Previous research indicates increased cigarette taxes and tobacco control expenditures (TCE) may mitigate this geographical cigarette smoking disparity. The current study simulates the impact of these policies on racial and socioeconomic tobacco-related disparities within Tobacco Nation. METHODS: Using ModelHealth:Tobacco, we simulated 20-year changes in smoking and smoking-attributable (SA) outcomes by poverty status and race. We projected the impact of: 1) a 'tax-only scenario', increasing cigarette taxes by $1.50; and 2) a 'combined policy scenario', simultaneously increasing cigarette taxes by $1.50 and increasing state TCE to the Centers for Disease Control (CDC)-recommended level. RESULTS: Under the tax-only scenario, SA outcomes would be reduced for Tobacco Nation residents below 138% the federal poverty level (FPL) by about 4.3 the magnitude of those above 138% the FPL. Some SA outcomes would be reduced by about 10% more among Non-Hispanic (NH) Black residents than NH White residents. For all subgroups, the combined policy scenario would reduce SA outcomes by about eight times the magnitude of the tax-only scenario, even though the relative reduction in disparities by poverty status would be smaller (2.8 higher reductions for those below compared to above 138% the FPL). CONCLUSIONS: The combined policy scenario, compared to the tax-only scenario, would reduce SA harms by a substantially larger magnitude. Both scenarios are projected to reduce socioeconomic disparities in tobacco harms but not all racial disparities in Tobacco Nation without greater prioritization of targeted policies.
Corrigendum: The impacts on the economy, health, and environment resulting from tobacco cultivation: A cross-sectional survey of tobacco farmer perspectives in Thailand.
Phetphum C, Lencucha R
Tob Induc Dis · 2025 · PMID 40977947 · Full text
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Association between cigarette smoking and hearing loss: A cross-sectional study from the NHANES database.
Huang H, Zhou W, Chen K … +3 more , Du Y, Lin W, Ye Y
Tob Induc Dis · 2025 · PMID 40969778 · Full text
INTRODUCTION: Using data from the National Health and Nutrition Examination Survey (NHANES), this study aimed to assess the association between smoking and hearing loss and explore its heterogeneity across gender and age...
INTRODUCTION: Using data from the National Health and Nutrition Examination Survey (NHANES), this study aimed to assess the association between smoking and hearing loss and explore its heterogeneity across gender and age groups. METHODS: This secondary dataset analysis used a cross-sectional design and included NHANES data from 2005-2012 and 2015-2018. The study population consisted of adults without hearing-related disorders. Hearing loss was assessed by pure tone audiometry (PTA) and included low-frequency (LFHL), speech-frequency (SFHL) and high-frequency hearing loss (HFHL), expressed as continuous and categorical variables, respectively. Linear and logistic regression models were used to analyze the association between hearing loss and the exposure variable smoking status. RESULTS: A total of 4217 adult subjects were included. It was found that smokers had a higher prevalence of LFHL, SFHL and HFHL than non-smokers (LFHL: 15.62% vs 8.51%, SFHL: 23.22% vs 12.98%, HFHL: 53.48% vs 36.95%). In males, in Models 1 (unadjusted), 2 and 3 (adjusted), there were statistically significant differences (p<0.05) in LFHL (β=4.24; 95% CI: 3.32-5.17; β=1.65; 95% CI: 0.80-2.49; β=1.52; 95% CI: 0.66-2.38) in SFHL (β=5.63; 95% CI: 4.56-6.70; β=1.95; 95% CI: 1.05-2.84; β=1.62; 95% CI: 0.72-2.52) and in HFHL (β=10.20; 95% CI: 8.21-12.19; β=2.85; 95% CI: 1.33-4.37; β=2.19; 95% CI: 0.69-3.70) between smokers and non-smokers, for continuous variables of hearing loss. In male hearing loss, categorical variables also showed statistically significant differences between smokers and non-smokers (p<0.05). In the middle-aged group, compared with non-smokers, logistic regression of smoking with all three types of hearing loss showed statistically significant differences (p<0.05) in Models 1, 2 and 3. CONCLUSIONS: There was a significant association between smoking and hearing loss, with maybe more significant associations with all three types of hearing loss in male smokers and a significant relationship between smoking and hearing loss in the middle-aged group.
Mouse model validity for studying the impact of tobacco smoke on the human gut microbiota assessed via in silico and experimental approaches.
Bermúdez-Pérez IV, Meißner J, Bang C … +4 more , Hartmann JN, Baines JF, Krauss-Etschmann S, Häsler R
Tob Induc Dis · 2025 · PMID 40969777 · Full text
INTRODUCTION: The contribution of cigarettes to disease initiation, manifestation and progression is well-established for complex disorders, such as inflammatory bowel disease. However, studying its impact on disease pat...
INTRODUCTION: The contribution of cigarettes to disease initiation, manifestation and progression is well-established for complex disorders, such as inflammatory bowel disease. However, studying its impact on disease pathophysiology in a controlled setting is challenging in humans, resulting in the application of various model systems, amongst them tobacco smoke-exposed mice. While frequently employed, it is unclear to what extent this model reflects human responses to tobacco smoke. METHODS: Employing a mouse study of experimental nature, we assessed established parameters for monitoring responses to tobacco smoke, paralleled by 16S rRNA gene-based profiling of the murine gut microbiome in n=32 suitable animals. This was supplemented by a case-control study design, based on n=3 publicly available transcriptome datasets, from human oral mucosa, human large airway epithelium and murine lung tissues, where we assessed which components of the response to tobacco smoke observed in mice are functionally comparable to responses seen in humans. RESULTS: We observed several physiological responses in mice that paralleled human scenarios (weight loss, serum cotinine and Cyp1a1 mRNA expression), serving as a proof of principle. We identified shared microbiome-associated processes: stress related functions were enriched in mice and humans, while other processes, such as inflammatory functions, were discordant. The mouse microbiota showed significant changes in response to tobacco smoke, which mimicked patterns seen in human datasets, such as changes for and . In contrast, some families that show significant responses to tobacco smoke in humans, such as , could not be observed in mice. CONCLUSIONS: Considering the high inter-individual variation in humans and the well-controlled conditions in mice, our results suggest that mice, despite the identified limitations, most likely represent a suitable model for studying specific processes, such as stress responses, in the context of tobacco smoke exposure and its impact on the microbiota.
Prevalence of bereavement among current smokers in a state-wide cross-sectional surveillance survey.
Li C, Miles T
Tob Induc Dis · 2025 · PMID 40948677 · Full text
INTRODUCTION: Research consistently shows that bereavement is associated with subsequent poor self-rated health. In a separate line of research, smoking is common among persons with a mental illness diagnosis. In a popul...
INTRODUCTION: Research consistently shows that bereavement is associated with subsequent poor self-rated health. In a separate line of research, smoking is common among persons with a mental illness diagnosis. In a population-based survey, the following three hypotheses are tested: 1) Compared to non-smokers, smokers are not more likely to report bereavement; 2) Among the bereaved, demographic factors - gender, race, and age - do not influence the likelihood of being a current smoker; and 3) Smoking does not influence or mediate the effect of bereavement on poor self-rated health. METHODS: The sample consisted of 7354 respondents to the annual 2019 Georgia Behavioral Risk Factor Surveillance Survey (BRFSS). Multiple imputation, descriptive analysis, ordered logistic regression, and mediation models were used. RESULTS: With imputed datasets, we found that bereavement rates were higher among every day (52.2%) compared to former smokers (46.4%) and never smokers (43.3%). Bereaved persons who smoke are also more likely to report heavy drinking: females (OR=3.92; 95% CI: 2.96-5.18) and males (OR=3.64; 95% CI: 2.72-4.86). Bereavement rates are highest among males who report smoking some days (OR=52.7; 95% CI: 44.4-61.0) and among females who report smoking every day (OR=56.77; 95% CI: 50.9-62.7). CONCLUSIONS: Among all current smokers, bereavement is highly prevalent. However, gender, smoking and grief have a complex association. Bereaved female smokers typically smoke every day while bereaved male smokers on some days. Any bereaved smoker may benefit from cessation treatment to reduce health decline after loss.
Smoking and smoking cessation among smokers in Saudi Arabia: A cross-sectional study.
Arida H, Alhothali AA, AlOtaibi TH … +8 more , Almalki ON, Alosaimi AH, Alenazi AT, Al Boqami AA, Eldalo AS, Algarni MA, Althobaiti M, Abdelwahab SF
Tob Induc Dis · 2025 · PMID 40948676 · Full text
INTRODUCTION: This study assessed the general perceptions of smokers in Saudi Arabia about the harms of smoking and identified the different methods used by them to quit smoking. METHODS: A descriptive cross-sectional st...
INTRODUCTION: This study assessed the general perceptions of smokers in Saudi Arabia about the harms of smoking and identified the different methods used by them to quit smoking. METHODS: A descriptive cross-sectional study was designed using an online self-administered questionnaire to assess the smoker's perceptions on smoking and ways to quit smoking. A convenience sample of 1358 participants aged ≥18 years were enrolled from December 2022 to February 2023. Data analysis was carried out using the Statistical Package for Social Sciences (SPSS) software with p<0.05 indicating statistical significance. RESULTS: A total of 1358 participants completed the online survey. Most of the respondents were smokers (63.3%; n=860). Forty-six percent of the participants (n=396) started smoking when they were aged <18 years. Around 71% of the participants did not like the presence of any family member who smokes. More than half (52%) of the participants admitted that friends are the main reason for beginning smoking. Around 40% (n=229) of the 860 participants were enrolled in a smoking cessation program at some point. CONCLUSIONS: Around 46% of the study participants started smoking when they were aged <18 years. About two-thirds of them tried to quit smoking. Although many centers around the country are dedicated to helping smokers quit smoking, many smokers noted that their outreach should be further enhanced.
Strengthening the cognition of university students to refuse e-cigarette use: A pilot randomized controlled trial of a peer-to-peer intervention.
Chen Y, Lin S, Lin H … +8 more , Wang Z, Zhao X, Ao P, Cai Y, Xu J, Yu X, Yang X, Chan KS
Tob Induc Dis · 2025 · PMID 40948675 · Full text
INTRODUCTION: E-cigarette use among young adults represents a growing public health concern. This pilot randomized controlled trial evaluated the preliminary effects of Protection Motivation Theory (PMT)-based peer educa...
INTRODUCTION: E-cigarette use among young adults represents a growing public health concern. This pilot randomized controlled trial evaluated the preliminary effects of Protection Motivation Theory (PMT)-based peer education on strengthening university students' cognition to refuse e-cigarette use in China, where tobacco control policies remain limited. METHODS: A total of 289 participants completed baseline assessment and were randomly assigned to an intervention group (n=144) and a control group (n=145). The intervention consisted of a 1-month peer education program in which trained peer educators delivered PMT-based messages through weekly one-on-one conversations via phone or messaging platforms. Intervention participants received messages addressing all seven PMT constructs, while control participants received only messages about health risks of two PMT constructs. Primary outcomes were four PMT-based cognitive appraisals measured at baseline, 1 month, and 3 months. Linear mixed-models examined group × time interactions, and effect sizes were calculated for all comparisons. RESULTS: No statistically significant between-group differences were observed for primary outcomes. Subgroup analysis revealed significant intervention effects at 3 months among participants with family or friends who used cigarettes/e-cigarettes: lower perceived rewards (mean difference= -0.55; 95% CI: -1.07 - -0.03, p=0.04) and greater perceived efficacy (mean difference=0.34; 95% CI: 0.06-0.62, p=0.02). CONCLUSIONS: While overall effects were not statistically significant, observed effect sizes and significant subgroup findings suggest PMT-based peer education may influence cognitive precursors to e-cigarette use, particularly among students with social exposure to tobacco use. Larger trials with extended follow-up periods are warranted to confirm these preliminary findings.
Depression, smoking, and lung cancer vulnerability: Bridging mental-physical comorbidity through population-based evidence.
Lu Y, Chen H, Gan J … +3 more , Cai J, Huang C, Chen Q
Tob Induc Dis · 2025 · PMID 40936740 · Full text
INTRODUCTION: The complex relationship between smoking, depression, and lung cancer remains inadequately understood, particularly regarding smoking's association with depression risk among lung cancer patients. This stud...
INTRODUCTION: The complex relationship between smoking, depression, and lung cancer remains inadequately understood, particularly regarding smoking's association with depression risk among lung cancer patients. This study examines these interactions in a nationally representative sample. METHODS: This secondary dataset analysis used cross-sectional data from 1539 US adults aged ≥20 years from the pooled 2005-2016 National Health and Nutrition Examination Survey (NHANES). We employed survey-weighted logistic regression analyses to assess associations, adjusting for sociodemographic factors and clinical comorbidities. RESULTS: Weighted prevalence estimates were 3.14% (95% CI: 2.78-3.55) for lung cancer, 29.4% for current smoking (95% CI: 28.0-30.9), and 11.18% (95% CI: 10.12-12.34) for clinically significant depression (PHQ-9 ≥10) Females had significantly higher depression prevalence than males (AOR=2.18; 95% CI: 1.63-2.91; p<0.01). Current smokers demonstrated 3.12-fold higher odds of depression compared to non-smokers (AOR=3.12, 95% CI: 2.18-4.47; p<0.001). Recent quitters (<1 year) also showed elevated depression risk (AOR=2.89; 95% CI 1.15-7.25; p=0.024). Among participants with lung cancer, current smokers had a significantly higher prevalence of depression compared to non-smokers (16.82% vs 4.12%; p=0.0008). CONCLUSIONS: Smoking was strongly associated with depression in lung cancer patients, with recent cessation representing a high-risk period. Integrated smoking cessation and mental health interventions are needed, particularly for young females.
Effect of tobacco and other habitual dietary staining agents on the optical properties of lithium disilicate molar crowns: A laboratory study.
Al Moaleem MM, Daghrery A, Mitwalli H … +4 more , Jabarti E, Albar N, Khojah M, Khayat W
Tob Induc Dis · 2025 · PMID 40933691 · Full text
INTRODUCTION: The treatment of choice for posterior teeth is full-coverage crowns, but these materials should not be color-affected by external factors such as tobacco use. This laboratory study aimed to evaluate the mea...
INTRODUCTION: The treatment of choice for posterior teeth is full-coverage crowns, but these materials should not be color-affected by external factors such as tobacco use. This laboratory study aimed to evaluate the mean color change (ΔE*) values of lithium aluminum disilicate (LAD) full anatomical ceramic crowns after staining in different adverse materials consumed in different countries worldwide. METHODS: Ninety full anatomical crowns in the form of molars were constructed from LAD (Cerec Tessera blocks) with the use of computer-aided design/computerassisted manufacturing system. They were divided equally into nine groups, with 10 crowns for each group. The crowns were immersed for 15 days in different adverse materials (khat, shamma, yerba mate, snuff, soft drinks used daily as a mixture of fruit juice, Coca-Cola, Saudi coffee, and Nescafe). Instructions from the International Commission on Illumination were followed for color parameter measurements. The CIELab color space L* lightness value coordinate, a* red- green coordinate, and b* yellow-blue coordinate, were calculated before and after staining for 2 weeks. ΔE* values were calculated by spectrophotometry. One-way ANOVA followed by tests were used to assess significance differences between groups. The significance level was set at p<0.05. RESULTS: The ΔE* changed after immersion in all solutions except for the control group. The highest average ΔE* values and standard deviation were observed with yerba mate 6.3 ± 2.0, followed by shammah 4.6 ± 0.9, whereas the lowest ΔE* was recorded for the mixture of fruit juice 3.2 ±1.3. One-way ANOVA test showed a significant difference between the group of yerba mate, with p<0.001. Pearson's correlation coefficient test was used to assess the statistical relationship of ΔE* among groups. A highly positive significant correlation was found between shammah and Nescafe (r=0.798). A medium correlation was found between khat with yerba mate (r=0.520) and snuff and control groups (r=0.474), without significant differences. CONCLUSIONS: The overall recorded ΔE* values for LAD full anatomical ceramic crowns following 2 weeks of staining in different staining media were marginally higher than the clinically acceptable values except for the fruit-juice group.
Impact of smoking behaviors on asthma incidence and allcause mortality in middle-aged and older adults: A longitudinal study from China.
Fu T, Zhao S, Hu C … +2 more , Gao J, Xing L
Tob Induc Dis · 2025 · PMID 40933690 · Full text
INTRODUCTION: The impact of smoking behaviors on asthma incidence and all-cause mortality among middle-aged and older adults remains understudied. In particular, whether the potential effect of adolescent smoking initiat...
INTRODUCTION: The impact of smoking behaviors on asthma incidence and all-cause mortality among middle-aged and older adults remains understudied. In particular, whether the potential effect of adolescent smoking initiation on late-onset asthma is independent of cumulative tobacco exposure is unclear. METHODS: Cox proportional hazards models assessed longitudinal impact of smoking behaviors on asthma incidence and mortality risks using 2011-2018 China Health and Retirement Longitudinal Study (CHARLS) data. Cross-sectional smoking-asthma associations were analyzed with logistic regression. Additionally, restricted cubic splines were used to assess the nonlinear relationships between smoking characteristics and asthma incidence. RESULTS: Smokers had a 65% higher risk of incident asthma compared to non-smokers in middle-aged and older adults (HR=1.65; 95% CI: 1.10-2.46, p=0.015). According to stratified analysis, individuals with smoking duration ≥40 years (HR=1.95; 95% CI: 1.2-3.15, p=0.007), cumulative pack-years under 15 pack-years (HR=1.76; 95% CI: 1.04-2.99, p=0.035), and smoking onset before the age of 18 years (HR=2.31; 95% CI: 1.35-3.96, p=0.002) were at significantly greater risk for asthma. After controlling for cumulative pack-years, early smoking initiation (<18 years) remained an independent and significant predictor of asthma onset in middle and older age (HR=2.56; 95% CI: 1.29-5.06, p=0.007). Subgroup analysis revealed that smoking-related asthma risk was especially elevated among those aged <65 years, females, overweight individuals, and those without baseline comorbidities. Moreover, there was no significant difference in all-cause mortality between the smoking and non-smoking groups in asthma patients. CONCLUSIONS: The increased risk of asthma onset among middle-aged and older adults due to adolescent smoking initiation was independent of cumulative smoking pack-years, even though low pack-years and long-term smoking also contribute to increased risk. Targeted smoking cessation programs, especially adolescent prevention, are crucial to reduce asthma burden in this population.
Electronic cigarettes and cardiovascular diseases: An updated systematic review and network meta-analysis.
Tansawet A, Anothaisintawee T, Boonmanunt SW … +9 more , Pornsuriyasak P, Sukhato K, Chawala N, Inpithuk P, Savigamin C, Liampeng S, Attia J, McKay GJ, Thakkinstian A
Tob Induc Dis · 2025 · PMID 40917139 · Full text
INTRODUCTION: The association between electronic cigarettes (e-cigarettes) and the risk of cardiovascular disease (CVD) remains inconclusive. This study aims to compare CVD risk from the use of e-cigarettes, cigarettes,...
INTRODUCTION: The association between electronic cigarettes (e-cigarettes) and the risk of cardiovascular disease (CVD) remains inconclusive. This study aims to compare CVD risk from the use of e-cigarettes, cigarettes, combined cigarette and e-cigarette use, and non-use. METHODS: This study is a systematic review and network meta-analysis (NMA). MEDLINE and Scopus databases (through February 2024) were used to identify eligible studies. Observational studies that investigated the effect of e-cigarettes on the risk of composite CVD, myocardial infarction (MI), or stroke, compared to cigarette, dual use, or non-use, were included. NMA was applied to estimate relative effects (i.e. adjusted odds ratio, AOR) of e-cigarette, cigarette, and dual use, on composite CVD, MI, and stroke outcomes. Risk of bias was assessed using the Joanna Briggs Institute tool for surveys and the Newcastle-Ottawa scale for cohort studies. RESULTS: Eleven adult population studies were eligible for review. E-cigarette, cigarette, and dual use were significantly associated with composite CVD outcomes. Pooled AORs (95% CI) were 1.31 (1.05-1.62) for e-cigarette, 1.57 (1.30-1.88) for cigarette, and 1.67 (1.37-2.03) for dual use. Additionally, former cigarette and former dual use significantly increased the risk of composite CVD outcomes, compared to non-use. The pooled AORs (95% CI) were 1.29 (1.05-1.59) for former cigarette, and 1.46 (1.03-2.08) for former dual use, while former e-cigarette use was not significantly associated with composite CVD endpoints. For MI and stroke outcomes, only cigarette and dual use were significantly associated with these events. CONCLUSIONS: Current e-cigarette, cigarette, and dual use were significantly associated with increased risk of composite CVD outcomes, while only cigarette and dual use significantly increased the risk of MI and stroke, compared to non-use. However, these findings were primarily based on cross-sectional data limiting the temporality of effect; additional prospective cohort studies are needed to confirm our findings.
Rural and Appalachian cancer survivors' responses to tobacco use screening and tobacco treatment offer.
Feather AR, Shelton BJ, Blair C … +6 more , Davis DB, Scales J, Darville A, Valentino J, McLouth LE, Burris JL
Tob Induc Dis · 2025 · PMID 40917138 · Full text
INTRODUCTION: Smoking after a cancer diagnosis is associated with poor outcomes whereas smoking cessation improves survival and other outcomes. Although professional societies and practice guidelines call for equitable t...
INTRODUCTION: Smoking after a cancer diagnosis is associated with poor outcomes whereas smoking cessation improves survival and other outcomes. Although professional societies and practice guidelines call for equitable tobacco treatment delivery in healthcare, disparities in tobacco-related disease burden persist. METHODS: In the context of an outpatient US cancer center's population-based tobacco treatment program, this study examines associations between cancer survivors' rural and Appalachian residence status and: 1) current tobacco use status, 2) decision to decline tobacco treatment, and 3) reason for declining assistance. A cross-sectional, retrospective analysis was conducted using electronic health record data from 16839 adults: 64.04% female, 88.49% non-Hispanic White, mean age 59.19 ± 14.52 years, 35.97% rural residence, 53.14% Appalachian residence, who sought cancer care in 2019. Descriptive statistics and logistic regression models were applied. RESULTS: The portion of patients that reported current tobacco use was 21.75%. Rural patients had higher odds of tobacco use than urban (OR=1.22; 95% CI: 1.12- 1.34), as did Appalachian patients compared to non-Appalachian (OR=1.41; 95% CI: 1.28-1.54). Neither rural nor Appalachian residence status was significantly associated with responses to tobacco treatment offers (76.65% declined the offer) or reason for declining (65.19% declined because they were 'not ready to quit'). CONCLUSIONS: Findings highlight continued need for population-level tobacco use screening and proactive tobacco treatment offers, given elevated tobacco use in some minority groups and overall low rates of tobacco treatment acceptance. This large study helps shed light on the association between geographical residence and tobacco-related outcomes among patients with cancer, and underscores room for improvement in tobacco treatment uptake in cancer care.
Knowledge, perceptions, and usage patterns of nicotine pouches among Saudi medical students: A cross-sectional study.
Alshahrani NZ
Tob Induc Dis · 2025 · PMID 40917137 · Full text
INTRODUCTION: Tobacco smoking continues to pose a major global public health challenge. Medical students play a crucial role in shaping future smoking cessation practices. Nicotine pouches have recently emerged as a toba...
INTRODUCTION: Tobacco smoking continues to pose a major global public health challenge. Medical students play a crucial role in shaping future smoking cessation practices. Nicotine pouches have recently emerged as a tobacco-free alternative with a potentially reduced harm profile. However, little is known about their use and perception among medical students in Saudi Arabia. This study aimed to assess medical students' knowledge and perceptions of nicotine pouches and to examine usage patterns among those who consume these products. METHODS: A cross-sectional study was conducted between April and July 2024 among 295 medical students from three universities in Saudi Arabia. Data were collected through a self-administered electronic questionnaire covering demographics, smoking history, knowledge, perceptions, and usage behaviors. Statistical analyses, including chi-squared tests and logistic regression, were used to identify factors associated with knowledge and usage. RESULTS: Smoking prevalence among participants was 16.3%, with significantly higher rates among males. Overall, 58.6% of students demonstrated good knowledge of nicotine pouches. Higher knowledge scores were associated with male gender, senior academic year, and higher grade point average (GPA). Among users, 62.9% reported quitting smoking, and more than half noted health improvements. The 10 mg nicotine strength was the most commonly used. Social influence, particularly peer pressure, was the primary reason for use. Despite noting harm reduction potential, students expressed concern about nicotine dependence and the need for stronger regulation. CONCLUSIONS: Saudi medical students show moderate knowledge of nicotine pouches, influenced by academic and demographic factors. However, concerns about dependence and regulation highlight the need for targeted education and policy development. Integrating this topic into medical curricula may better prepare future physicians to address nicotine use in clinical practice.
Concept flavor names from English language ENDS advertising in the USA, 2015-2020.
Kennedy RD, Czaplicki L, Moran MB
Tob Induc Dis · 2025 · PMID 40896170 · Full text
INTRODUCTION: Some manufacturers of electronic nicotine delivery systems (ENDS) and liquids sell products with flavor names that use ambiguous terminology rather than explicitly characterize the product's flavor. These a...
INTRODUCTION: Some manufacturers of electronic nicotine delivery systems (ENDS) and liquids sell products with flavor names that use ambiguous terminology rather than explicitly characterize the product's flavor. These are often referred to as 'concept flavors'. This article presents a sample of ENDS concept flavor names to identify naming conventions the industry uses. METHODS: We reviewed 4546 English-language ENDS advertisements that ran in a variety of outlets including magazines, TV, radio, and direct-to-consumer emails, during the period 2015-2020. ENDS flavors in ads were identified and classified as 'concept' if the name contained no explicit characterizing flavor information. All concept flavor names were then reviewed by two coders to identify themes and practices used by ENDS manufacturers. RESULTS: The sample identified 215 unique concept flavor names. We found examples of flavor names that were suggestive of food or drink such as 'Citra Zing', as well as flavor names suggestive of sensations associated with drug use, such as 'Blurred Vision'. Some other concept flavor themes identified included the use of colors ('Red Venom'), numbers ('No 42.'), words associated with mythology ('God Nectar'), tropical imagery (Hawaiian Rainbow), and pop culture ('Miami Vice'). Some naming practices included the creation of flavor names using a portmanteau ('Grappleberry'), flavor names that used intentional misspelling or satiric misspelling, ('Gritz', and 'Cap'n Crunk'), and the use of malapropisms ('ohm sweet ohm'). CONCLUSIONS: The tobacco industry uses concept flavor names, and these names are presented in advertising in the US. This article identified themes and naming practices for concept flavors. Future work may continue to monitor the use of concept flavors and if concept flavor names are used in response to flavor restrictions. Additionally, future research may explore if concept flavors themes are associated with perceived risk, use intentions and behavior.
Lifestyle-attributable burden of young-onset stroke in Chinese and global populations aged 20-54 years: A three decades comparative study (1990-2021) using Global Burden of Disease study data.
Yang D, Fan G, Cheng J … +6 more , Meng Q, Liu K, Shirai K, Yatsuya H, Chen R, Zhang Y
Tob Induc Dis · 2025 · PMID 40896169 · Full text
INTRODUCTION: Young-onset stroke represents a growing public health crisis globally along with rapid lifestyle changes. This study investigated the mortality and disability burden of young-onset stroke attributable to mo...
INTRODUCTION: Young-onset stroke represents a growing public health crisis globally along with rapid lifestyle changes. This study investigated the mortality and disability burden of young-onset stroke attributable to modifiable lifestyle factors in China compared with global trends, aiming to identify critical intervention targets. METHODS: Utilizing Global Burden of Disease 1990-2021 data, we analyzed age-stratified mortality and disability-adjusted life years for four lifestyle risk factors (tobacco, high alcohol use, dietary risk, and low physical activity). Temporal trends were assessed through joinpoint regression and age-period-cohort modeling, with population-attributable fractions compared between Chinese and global populations over three decades. RESULTS: China demonstrated persistently greater burdens from tobacco and high alcohol use than global averages did, particularly among males, where alcohol-attributable disability-adjusted life years (DALYs) increased 21% faster than mortality rates did. Gender disparities were prominent, with male population attributable fractions (PAFs) for alcohol exceeding female levels by 9.3-fold. Paradoxically, Chinese females presented rising low physical activity-related DALYs despite declining mortality. Midlife adults (aged ≥40 years) showed accelerated risk accumulation, whereas dietary risk reductions in China outpaced global declines by 2.4-fold. Age effects for all risks were weaker than global estimates, although period and cohort patterns aligned closely. CONCLUSIONS: The diverging trajectories of mortality and disability burdens underscore China's dual challenge: curbing substance-related mortality in young males while containing midlife disability escalation. Culturally tailored strategies addressing gender-specific risk profiles and alcohol-DALY decoupling are urgently needed. These findings provide pivotal evidence for global stroke prevention in transitioning societies.
Exploring the relationship between secondhand smoke exposure in different indoor environments and depression symptoms among non-smoking adults: A cross-sectional study from NHANES.
Liu Y, Yu J, Meng F
Tob Induc Dis · 2025 · PMID 40896168 · Full text
INTRODUCTION: The existing evidence regarding the relationship between secondhand smoke (SHS) exposure and depression symptoms in non-smoking adults remains inconclusive. This cross-sectional study aims to further invest...
INTRODUCTION: The existing evidence regarding the relationship between secondhand smoke (SHS) exposure and depression symptoms in non-smoking adults remains inconclusive. This cross-sectional study aims to further investigate this relationship using data from the National Health and Nutrition Examination Survey (NHANES). METHODS: SHS exposure was assessed through self-reported passive exposure to indoor tobacco products, such as those encountered at work or in vehicles. Depression symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9) scale. Logistic regression and stratified analyses were conducted to evaluate the association between exposure to seven different indoor sources of SHS and depression symptoms. RESULTS: This study included 6272 never smoker adults from the US. Compared to individuals not exposed to any indoor SHS, exposure to specific types of SHS was positively associated with depression symptoms: exposure to cars (AOR=1.64; 95% CI: 1.17-2.31), exposure to other indoor areas (AOR=2.03; 95% CI: 1.33-3.10), and exposure to e-cigarettes (AOR=1.78; 95% CI: 1.14-2.77). When cumulative SHS exposure was calculated based on the number of SHS environments to which participants were exposed, those exposed to 1-2 sources of SHS were 1.47 times more likely (AOR=1.47; 95% CI: 1.13-1.91) and those exposed to ≥3 sources were 1.96 times more likely (AOR=1.96; 95% CI: 1.17-3.28) than unexposed individuals to experience depression symptoms. CONCLUSIONS: Exposure to specific SHS environments, particularly simultaneous exposure to multiple SHS environments, seems to be significantly associated with depression symptoms among US adults. Establishing causality and understanding the health implications of this connection will require future longitudinal investigations.
The effect of smoking and other tobacco product use on perceptions of skin quality and health, approaches to skin care, and minimally invasive cosmetic procedures: A cross-sectional study.
Etgü F, Yılmaz ES
Tob Induc Dis · 2025 · PMID 40861880 · Full text
INTRODUCTION: It is well-established that smoking adversely affects the skin. This study aimed to compare skin properties, skin care product usage patterns, and the status of minimally invasive cosmetic procedures and se...
INTRODUCTION: It is well-established that smoking adversely affects the skin. This study aimed to compare skin properties, skin care product usage patterns, and the status of minimally invasive cosmetic procedures and self-evaluated skin quality in active smokers, ex-smokers, and non-smokers. METHODS: This cross-sectional study was conducted in Department of Dermatology, Faculty of Medicine, Ordu University, Türkiye in 2024, with participants aged 18-65 years. Data were collected through a validated self-administered questionnaire. Categorical data were analyzed using chi-squared or Fisher's exact tests. Intergroup differences were examined using one-way analysis of variance with Bonferroni tests. Correlations between smoking duration, daily cigarette consumption, and total skin quality scores were assessed using Pearson and Spearman correlation analyses and modeled with linear regression. Receiver Operating Characteristic (ROC) analysis was used to assess the skin quality score's ability to distinguish smokers from non-smokers. Logistic regression analysis was conducted to examine the association between smoking and skin quality. Structural Equation Modeling (SEM) was used to explore the relationships between smoking, age, gender, and skin quality. RESULTS: The study included 286 men and 393 women. Active smokers had worse skin quality, with more wrinkles, spots, and pigmentation (p<0.001). E-cigarette users showed poorer skin in the forehead, around the eyes, mustache, mouth, neck, and back (p=0.007-0.034). Hookah use was linked to worse skin and more spots on the back (p=0.004 and 0.009). Average skin quality scores were 25.47 for active smokers, 27.35 for ex-smokers, and 32.1 for non-smokers. Skin quality declined as smoking duration and daily cigarette count increased (p=0.00). Active smokers more frequently received neurotoxin injections and mesotherapy for skin spots (p=0.006 and 0.026). CONCLUSIONS: This study confirms the detrimental effects of smoking - including e-cigarette and hookah use - on skin. These findings may serve as motivation for smoking cessation efforts.
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