Tag: tobacco

Categories : AddictionTags :

Lessons Learned from Combating Smoking and Other Market-driven Epidemics

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Researchers share insights from US reduction of cigarette, sugar, and opioid consumption

Photo by Sara Kurfess on Unsplash

A case definition of market-driven epidemics (MDEs) could help address critical barriers to timely, effective prevention and mitigation, according to a study published this week in the open-access journal PLOS Global Public Health by Jonathan Quick from Duke University School of Medicine, US, and colleagues.

The misuse and overconsumption of certain consumer products have become major global risk factors for premature deaths at all ages, with their total costs in trillions of dollars. Progress in reducing such deaths has been difficult, slow, and too often unsuccessful. To address this challenge, Jonathan Quick and colleagues introduced a case definition of MDEs, which arise when companies aggressively market products with proven harms, deny these harms, and actively oppose mitigation efforts. To demonstrate the application of this concept, the researchers selected three MDE products: cigarettes, sugar, and prescription opioids. Based on the histories of these three epidemics, the researchers described five MDE phases: market expansion, evidence of harm, corporate resistance, mitigation, and market adaptation.

From the peak of consumption to the most recent available data, US cigarette sales fell by 82%, sugar consumption by 15%, and prescription opioid prescriptions by 62%. In each case, the consumption tipping point occurred when compelling evidence of harm, professional alarm, and an authoritative public health voice or public mobilisation overcame the impact of corporate marketing and resistance efforts. Among the three epidemics, the gap between suspicion of harm and the consumption tipping point ranged from one to five decades – much of which was attributable to the time required to generate sufficient evidence of harm. Market adaptation to the reduced consumption of target products had both negative impacts (eg, geographical shift of corporate marketing efforts) and positive impacts (eg, consumer shift away from sugar-sweetened beverages).

According to the authors, this is the first comparative analysis of three successful efforts to change the product consumption patterns of millions of people – and, over time, some of the associated adverse health impacts of these products. The MDE epidemiological approach of shortening the latent time between phases provides the global health community with a new method to address existing and emerging potentially harmful products and their health, social, and economic impacts.

While the specific product and circumstances are unique to each MDE, understanding the epidemiology of consumption and health impacts, and epidemic milestones, should help public health leaders combat current MDEs and more swiftly recognise future MDEs. Given the similar patterns among different MDEs, public health leaders, researchers, civil society and others can apply the mitigation strategies presented in the review article to save lives and lessen the impact of continuing and emerging MDEs.

The authors add: “The use of cigarettes and other unhealthy products costs the world millions of lives and trillions of dollars each year.  An analysis of U.S. progress against three such market-driven epidemics demonstrates that we can save lives through earlier, more decisive action by public health leaders, researchers, and public mobilization,” concluding: “The use of cigarettes and other unhealthy products often follow patterns similar to infectious disease epidemics, causing widespread harm before any public health response. We can save lives by recognizing these market-driven epidemics earlier and acting more decisively to control them.”

Provided by PLOS

Categories : Healthcare Politics and RegulationsTags :

BAT Calls for Progressive Regulation to Achieve a Smoke-free South Africa

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Photo by Sara Kurfess on Unsplash
  • As the globe recognises both World Vape Day and World No Tobacco Day this month, BAT calls for regulatory framework that encourages adult smokers to switch to smokeless alternatives.
  • South Africa’s adult smoking prevalence is growing; studies suggest switching exclusively to reduced risk¹ alternatives could significantly reduce smoking related disease associated with smoking.
  • BAT advocates for regulatory principles focused on adult-only access, product quality, and enforcement, while investing in smokeless products.

BAT, a leading tobacco and nicotine products company, publicly re-affirmed its position that no underage person should use nicotine products. As such, the Company has called for a regulatory framework in South Africa that encourages adult smokers to switch to smokeless alternatives and that facilitates the robust prevention of underage access.

The smoking prevalence among adults in South Africa is 27.4%², which seems to be growing. This is partly attributable to the rampant sale of illicit cigarettes across the country, which BAT South Africa’s internal estimates put at around 70% of the market. More than 9.7 million² people in South Africa continue to smoke, despite the serious risks. According to population modelling studies³, a significant reduction in smoking related disease could be achieved if smokers switched exclusively to reduced risk¹ alternatives.

Dr Edward Makgotlho, Area Head of Scientific Affairs for BAT Sub-Saharan Africa, said:

“We believe that underage consumers should never use nicotine, and the role of regulation in helping to ensure this is vital. As well as mandating appropriate age limits, age verification solutions need to be introduced at points of sale, and the importance of enforcing regulation cannot, and should not, be forgotten.”

BAT has set out four principles that should be applied in South Africa for effective and impactful regulation relating to smokeless tobacco and nicotine products:

1.      Consumer access to relevant products: Regulations in all countries where cigarettes are sold should also allow a wide range of smokeless alternatives, to ensure that consumers can access these alternatives and make informed choices about switching, based on the best available scientific evidence.

2.      Adult-only consumers: The use and sale of smokeless tobacco and nicotine products by and to underage consumers should be prohibited by law.

3.      Product quality and safety: Robust and properly enforced quality and safety standards should be at the heart of regulation, to protect consumers.

4.      Robust enforcement: Regulation should provide enforcement authorities with the necessary powers to apply penalties and sanctions to those who fail to comply with regulations, particularly those who supply non-compliant products and provide product to those who are underage.

Countries that have implemented regulation that recognises the harm reduction potential of smokeless products and support their use for adult smokers have experience a rapid decline in smoking. The United Kingdom, United States and Japan are all reporting their lowest smoking rates on record, while Sweden is on track to declare itself smoke-free this year – 16 years ahead of the European Union’s 2040 target.

“The migration of smokers to these alternatives is crucial both for countries looking to reduce their smoking rates and for global public health more broadly. Whether or not governments are able to take advantage of these products and maximise their harm reduction potential depends as much on the implementation of progressive, risk-proportionate regulation as it does on changes in consumer behaviour,” said Dr Makgotlho.

BAT’s global purpose is to create A Better Tomorrow™ by Building a Smokeless World. This commitment is demonstrated in various ways, including the Company’s investment of more than R6.9 billion a year in the development of smokeless tobacco and nicotine products, which are sold in 75+ markets globally, including South Africa.

References:

1.       Based on the weight of evidence and assuming a complete switch from cigarette smoking. These products are not risk-free and are addictive.

2.       BATSA market research as at 2024, conducted by an external market research house.

3.       Camacho OM & Ebajemito J, et al. 2021. Evidence from the Scientific Assessment of Electronic Cigarettes’ Role in Tobacco Harm Reduction. Contributions to Tobacco & Nicotine Research, 30(2): 63-108. Available: https://doi.org/10.2478/cttr-2021-0007

Levy DT & Gartner C, et al. 2023. The Australia Smoking and Vaping Model: the Potential Impact of Increasing Access to Nicotine Vaping Products. Journal of Nicotine & Tobacco Research, 25(3): 486-497. Available: https://doi.org/10.1093/ntr/ntac210

Yach D & Human D, et al. 2023. Integrating Harm Reduction into Tobacco Control. SmokeFreeSweden.org. Available: https://smokefreesweden.org/lives-saved.pdf

Categories : Immune SystemTags :

Smoking Affects the Immune System Many Years after Quitting

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Researchers from Institut Pasteur have discovered that the immune impacts of smoking can last for many years, leaving smokers with effects on some of their bodies’ defence mechanisms acquired while smoking. These findings, which for the first time reveal a long-term memory of the effects of smoking on immunity, are published in the journal Nature.

Individuals’ immune systems vary significantly in terms of how effectively they respond to microbial attacks. But how can this variability be explained? What factors cause these differences? “To answer this key question, we set up the Milieu Intérieur cohort comprising 1000 healthy individuals aged 20 to 70 in 2011,” explains Darragh Duffy, Head of the Translational Immunology Unit at the Institut Pasteur and last author of the study. While certain factors such as age, sex and genetics are known to have a significant impact on the immune system, the aim of this new study was to identify which other factors had the most influence.”

The scientists exposed blood samples taken from individuals in the Milieu Intérieur cohort to a wide variety of microbes and observed their immune response by measuring levels of secreted cytokines(1). Using the large quantities of data gathered for individuals in the cohort, the team then determined which of the 136 investigated variables (body mass index, smoking, number of hours’ sleep, exercise, childhood illnesses, vaccinations, living environment, etc) had the most influence on the immune responses studied. Three variables stood out: smoking, latent cytomegalovirus infection(2) and body mass index. “The influence of these three factors on certain immune responses could be equal to that of age, sex or genetics,” points out Darragh Duffy.

As regards smoking, an analysis of the data showed that the inflammatory response, which is immediately triggered by infection with a pathogen, was heightened in smokers, and moreover, the activity of certain cells involved in immune memory was impaired. In other words, this study shows that smoking disrupts not only innate immune mechanisms, but also some adaptive immune mechanisms. “A comparison of immune responses in smokers and ex-smokers revealed that the inflammatory response returned to normal levels quickly after smoking cessation, while the impact on adaptive immunity persisted for 10 to 15 years,” observes Darragh Duffy. “This is the first time it has been possible to demonstrate the long-term influence of smoking on immune responses.”

Basically, the immune system appears to have something resembling a long-term memory of the effects of smoking. But how? “When we realised that the profiles of smokers and ex-smokers were similar, we immediately suspected that epigenetic processes were at play(3),” says Violaine Saint-André, a bioinformatician in the Institut Pasteur’s Translational Immunology Unit and first author of the study. “We demonstrated that the long-term effects of smoking on immune responses were linked to differences in DNA methylation(4) – with the potential to modify the expression of genes involved in immune cell metabolism – between smokers, ex-smokers and non-smokers.” It therefore appears that smoking can induce persistent changes to the immune system through epigenetic mechanisms.

“This is a major discovery elucidating the impact of smoking on healthy individuals’ immunity and also, by comparison, on the immunity of individuals suffering from various diseases,” concludes Violaine Saint-André.

Notes:

(1) proteins secreted by a large number of immune cells to communicate among themselves and participate in immune defense.

(2) a virus in the herpes family that is often asymptomatic though dangerous to foetuses.

(3) changes in DNA that affect how genes are expressed, i.e. how they are used by cells.

(4) methylation is a type of chemical modification. Methyl groups position themselves on DNA, changing the way in which the genome is read in the cell.

Source: Institut Pasteur

Categories : Genetics Respiratory DiseasesTags :

Fathers Who Smoked as Young Teens Pass Epigenetic Changes to Offspring

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A new study suggests boys who smoke in their early teens risk damaging the genes of their future children, increasing their chances of developing asthma, obesity and low lung function.

This research, published in Clinical Epigenetics, is the first human study to reveal the biological mechanism behind the impact of fathers’ early teenage smoking on their children.

Researchers from the University of Southampton and the University of Bergen in Norway investigated the epigenetic profiles of 875 people, aged 7 to 50, and the smoking behaviours of their fathers.

They found epigenetic changes at 19 sites mapped to 14 genes in the children of fathers who smoked before the age of 15. These changes in the way DNA is packaged in cells (methylation) regulate gene expression (switching them on and off) and are associated with asthma, obesity and wheezing.

“Our studies in the large international RHINESSA, RHINE and ECRHS studies have shown that the health of future generations depends on the actions and decisions made by young people today – long before they are parents – in particular for boys in early puberty and mothers/grandmothers both pre-pregnancy and during pregnancy,” says Professor Cecilie Svanes from the University of Bergen and Research Director of the RHINESSA study. “It is really exciting that we have now been able to identify a mechanism that explains our observations in the cohorts.”

‘Unique markers’

“Changes in epigenetic markers were much more pronounced in children whose fathers started smoking during puberty than those whose fathers had started smoking at any time before conception,” says co-lead author of the paper Dr Negusse Kitaba, Research Fellow at the University of Southampton. “Early puberty may represent a critical window of physiological changes in boys. This is when the stem cells are being established which will make sperm for the rest of their lives.”

The team also compared the paternal preconception smoking profiles with people who smoked themselves and those whose mothers smoked before conception.

“Interestingly, we found that 16 of the 19 markers associated with fathers’ teenage smoking had not previously been linked to maternal or personal smoking,” says Dr Gerd Toril Mørkve Knudsen from the University of Bergen and co-lead author of the study. “This suggests these new methylation biomarkers may be unique to children whose fathers have been exposed to smoking in early puberty.”

Teenage vaping ‘deeply worrying’

The number of young people smoking has fallen in the UK in recent years. But co-author Professor John Holloway, from the University of Southampton and the NIHR Southampton Biomedical Research Centre, is concerned about children taking up vaping.

“Some animal studies suggest that nicotine may be the substance in cigarette smoke that is driving epigenetic changes in offspring,” says Professor Holloway. “So it’s deeply worrying that teenagers today, especially teenage boys, are now being exposed to very high levels of nicotine through vaping.

“The evidence from this study comes from people whose fathers smoked as teenagers in the 60s and 70s, when smoking tobacco was much more common. We can’t definitely be sure vaping will have similar effects across generations, but we shouldn’t wait a couple of generations to prove what impact teenage vaping might have. We need to act now.”

The new findings have significant implications for public health. They suggest a failure to address harmful exposures in young teenagers today could damage the respiratory health of future generations, further entrenching health inequalities for decades to come.

Source: University of Southampton

Categories : Ageing NeurologyTags :

Memory Loss and Confusion More Common among Middle-aged Smokers

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Middle-aged smokers are much more likely to report having memory loss and confusion than nonsmokers, and the likelihood of cognitive decline is lower for those who have quit, even recently, according to a new study appearing in the Journal of Alzheimer’s Disease.

The study is the first to examine the relationship between smoking and cognitive decline using a one-question self-assessment asking people if they’ve experienced worsening or more frequent memory loss and/or confusion.

The findings build on previous research that established relationships between smoking and Alzheimer’s Disease and other forms of dementia, and could point to an opportunity to identify signs of trouble earlier in life, said Jenna Rajczyk, lead author of the study.

It’s also one more piece of evidence that quitting smoking is good not just for respiratory and cardiovascular reasons, but to preserve neurological health, said Rajczyk, a PhD student in Ohio State’s College of Public Health, and senior author Jeffrey Wing, assistant professor of epidemiology.

“The association we saw was most significant in the 45–59 age group, suggesting that quitting at that stage of life may have a benefit for cognitive health,” Wing said. A similar difference wasn’t found in the oldest group in the study, which could mean that quitting earlier affords people greater benefits, he said.

Researchers used data from the 2019 Behavioral Risk Factor Surveillance System Survey to compare subjective cognitive decline (SCD) measures for current smokers, recent former smokers, and those who had quit years earlier. The analysis included 136 018 people 45 and older, and about 11% reported SCD.

The prevalence of SCD among smokers in the study was almost 1.9 times that of nonsmokers. The prevalence among those who had quit less than 10 years ago was 1.5 times that of nonsmokers. Those who quit more than a decade before the survey had an SCD prevalence just slightly above the nonsmoking group.

“These findings could imply that the time since smoking cessation does matter, and may be linked to cognitive outcomes,” Rajczyk said.

The simplicity of SCD, a relatively new measure, could lend itself to wider applications, she said.

“This is a simple assessment that could be easily done routinely, and at younger ages than we typically start to see cognitive declines that rise to the level of a diagnosis of Alzheimer’s Disease or dementia,” Rajczyk said. “It’s not an intensive battery of questions. It’s more a personal reflection of your cognitive status to determine if you’re feeling like you’re not as sharp as you once were.”

Many people don’t have access to more in-depth screenings, or to specialists, making the potential applications for measuring SCD even greater, she said.

Wing said it’s important to note that these self-reported experiences don’t amount to a diagnosis, nor do they confirm independently that a person is experiencing decline out of the normal ageing process. But, he said, they could be a low-cost, simple tool to consider employing more broadly.

Source: Ohio State University

Categories : Respiratory Diseases Substance UseTags :

Emphysema Found to be More Common in Marijuana Smokers

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Anatomical model of lungs
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Airway inflammation and emphysema are more common in marijuana smokers than cigarette smokers, according to a study published in Radiology. Researchers said the difference may be due to the way that marijuana is smoked, which is usually inhaled more deeply and without a filter.

Marijuana is one of the most widely used psychoactive substances in the world and the most-commonly smoked substance after tobacco. Its use has increased in recent years amid legalisation of recreational marijuana in many countries. The growing use has created an urgent need for information on marijuana’s effects on the lungs, something that is currently lacking.

“We know what cigarettes do to the lungs,” said study author Giselle Revah, MD, a cardiothoracic radiologist and assistant professor at the University of Ottawa. “There are well researched and established findings of cigarette smoking on the lungs. Marijuana we know very little about.” 

To find out more, Dr Revah and colleagues compared chest CT results from 56 marijuana smokers with those of 57 non-smoking controls and 33 tobacco-only smokers.

Pulmonary emphysema in (A, B) marijuana and (C, D) tobacco smokers. (A) Axial and (B) coronal CT images in a 44-year-old male marijuana smoker show paraseptal emphysema (arrowheads) in bilateral upper lobes. (C) Axial and (D) coronal CT images in a 66-year-old female tobacco smoker with centrilobular emphysema represented by areas of centrilobular lucency (arrowheads). (Murtha, et al.)

Lack of filtering partly to blame

Three-quarters of the marijuana smokers had emphysema, a lung disease that causes difficulty with breathing, compared with 67% of the tobacco-only smokers. Only 5% of the non-smokers had emphysema. Paraseptal emphysema, which damages the tiny ducts that connect to the air sacs in the lungs, was the predominant emphysema subtype in marijuana smokers compared to the tobacco-only group.

Airway inflammation was also more common in marijuana smokers than non-smokers and tobacco-only smokers, as was gynecomastia, enlarged male breast tissue due to a hormone imbalance. Gynecomastia was found in 38% of the marijuana smokers, compared with 11% of the tobacco-only smokers and 16% of the controls. 

The researchers found similar results among age-matched subgroups, where the rates of emphysema and airway inflammation were again higher in the marijuana smokers than the tobacco-only smokers.

There was no difference in coronary artery calcification between age-matched marijuana and tobacco-only groups.

Dr. Revah said the results were surprising, especially considering that the patients in the tobacco-only group had an extensive smoking history.

“The fact that our marijuana smokers – some of whom also smoked tobacco – had additional findings of airway inflammation/chronic bronchitis suggests that marijuana has additional synergistic effects on the lungs above tobacco,” she said. “In addition, our results were still significant when we compared the non-age-matched groups, including younger patients who smoked marijuana and who presumably had less lifetime exposure to cigarette smoke.” 

The reasons for the differences between the two groups is likely due to several factors. Marijuana is smoked unfiltered, Dr Revah noted, while tobacco cigarettes are usually filtered. This results in more particulates reaching the airways from smoking marijuana.

In addition, marijuana is inhaled with a longer breath hold and puff volume than tobacco smoke.

“It has been suggested that smoking a marijuana joint deposits four times more particulates in the lung than an average tobacco cigarette,” Dr Revah said. “These particulates are likely airway irritants.”

The higher incidence of emphysema may also be due to the way that marijuana is smoked. Full inhalation with a sustained Valsalva manoeuvre, an attempt at exhalation against a closed airway, may lead to trauma and peripheral airspace changes. 

More research is needed, Dr Revah said, with larger groups of people and more data on how much and how often people are smoking. Future research could also look at the impact of different inhalation techniques, such as through a bong, a joint or a pipe.

“It would be interesting to see if the inhalation method makes a difference,” Dr Revah said.

For More Information

Read the Radiology study, “Chest CT Findings in Marijuana Smokers,” and the related editorial.

Source: Radiological Society of North America

Categories : Addiction Obstetrics & GynaecologyTags :

Falling Pregnant Unconsciously Curbs Smoking

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pregnant woman holding her belly
Source: Anna Hecker on Unsplash

Pregnant smokers reduced their smoking by an average of one cigarette per day before becoming aware they were pregnant, according to a new study in in Addiction Biology. In the month after learning of their pregnancy, participants reduced smoking by another four cigarettes per day.

“Our findings suggest that pregnancy could curb smokers’ desire to smoke before they are even aware of having conceived,” said the study’s lead author and principal investigator, Dr Suena Huang Massey, associate professor of psychiatry and behavioural sciences and medical social sciences at Northwestern University Feinberg School of Medicine.

“While recognition of pregnancy is a common motivation to reduce or quit smoking, if biological processes in early pregnancy are also involved as suggested by this study, identifying precisely what these processes are can lead to the development of new smoking-cessation medications.”

The vast majority of research in this field focuses on the impact of a person’s smoking on the pregnancy and the baby. This study examines, instead, the impact of pregnancy on a person’s smoking behaviour.

Though it is well known that smoking is reduced in pregnancy, it was not known when it started and whether the smokers knew they were pregnant.

“Before this paper, it was largely assumed that the only thing causing pregnant smokers to cut down was a desire to protect the baby,” Dr Massey said. “While our study does support the discovery of pregnancy as a salient event, levels of pregnancy smoking began to decline before smokers suspected they were pregnant.”

These findings support a new line of research into what happens biologically during pregnancy that might be interrupting addictive behaviours, Massey said. Her hope is that the answer to this question will lead to the discovery of new and improved ways to treat addiction.

Pregnancy hormones a contributing factor?

Human chorionic gonadotropin (hCG) is a hormone produced by the placenta in early pregnancy that is linked to morning sickness (nausea and vomiting during pregnancy).

“Strikingly, we observed the steepest declines in smoking precisely when hCG levels typically peak – between five and 10 weeks of pregnancy,” Massey said. “What’s more, pregnant smokers who do not quit during the first trimester (when hCG levels are elevated) are unlikely to quit before delivery, even with assistance from medications or financial incentives.”

Study methodology

Scientists estimated changes in cigarettes per day smoked, reported retrospectively, by 416 participants from two independent cohorts (145 from 2000 to 2005 and 271 from 2006 to 2009). Every participant was a smoker prior to becoming pregnant. Women in the study were interviewed about their smoking habits at 16 weeks of pregnancy and provided urine samples, so researchers could verify their reports.

On average, participants smoked about 10 cigarettes per day before conception. Between conception and the date they realised they were pregnant (highly variable and reported by each participant), smoking fell by an average of one cigarette per day. In the month after recognising the pregnancy, smoking dropped from an average of 9 cigarettes per day to five. Importantly, these declines were seen whether pregnancies were planned or unplanned, and whether smokers quit or did not quit.

Source: Northwestern University

Categories : General InterestTags :

Social Media Viewing of Tobacco Content Linked to Use

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People who have viewed tobacco content on social media are more than twice as likely than non-viewers to report using tobacco and, among those who have never used tobacco, more predisposed to use in the future.

A meta-analysis of 29 studies published in JAMA Pediatrics analysed data from a total of 139 624 participants. The study draws on data across age groups, countries, content types and platforms and is the first large-scale effort linking social media content to tobacco use.

“We casted a wide net across the tobacco and social media literature and synthesised everything into a single association summarising the relationship between social media exposure and tobacco use,” said Scott Donaldson, PhD, the study’s first author. “What we found is that these associations are robust and have public health implications at the population level.”

The findings come amid growing concerns about the potential harms of social media use, particularly among young people. They build a compelling argument that online tobacco content has the power to influence viewers’ offline tobacco use.

“The proliferation of social media has offered tobacco companies new ways to promote their products, especially to teens and young adults,” said Assistant Professor Jon-Patrick Allem, the paper’s senior author. “Our hope is that policymakers and other stakeholders can use our study as a basis for decision making and action.”

Effects across age, content type and platform

Compared to those not reporting exposure tobacco content, people who did report exposure were more than twice as likely to use tobacco in their lifetime, to have used it in the past 30 days, or to be susceptible to future tobacco use if they had never used tobacco before.

“Of particular importance is the fact that people who had never before used tobacco were more susceptible,” Prof Allem said. “This suggests that exposure to tobacco-related content can pique interest and potentially lead nonusers to transition to tobacco use.”

The sample included populations from across the United States, India, Australia, and Indonesia. Adolescents made up 72% of the participants, while young adults and adults accounted for 15% and 13%, respectively.

Tobacco content included both ‘organic’ or user-generated posts, such as videos of friends smoking or vaping, and promotional material, including advertising or sponsorships from tobacco companies. Items depicted in posts ranged from cigarettes and e-cigarettes to cigars, hookah and smokeless tobacco products. Tobacco content appeared on a range of social media platforms, including Facebook, Instagram, Twitter, YouTube, Snapchat, Pinterest and Tumblr.

Both active engagement with tobacco content (eg commenting or liking) and passive engagement (just viewing) were associated with lifetime use, recent use and susceptibility to future use. People who saw content on two or more social media platforms faced even higher odds of use or susceptibility to use than those who saw tobacco-related content on just one platform.

The researchers suggest that future research should use longitudinal or experimental designs to determine whether exposure to tobacco content on social media directly leads to tobacco use. As the data in meta-analysis was drawn mostly from surveys conducted at a single point in time, a causal relationship between viewing and use could not be established.

Preventing harm from tobacco content

The study’s authors point to three levels of action that can help address the abundance of tobacco content on social media.

“First of all, we can work on designing and delivering interventions that counter the influence of pro-tobacco content, for example by educating teens about how the tobacco industry surreptitiously markets its products to them,” Allem said.

Social media platforms can also implement safeguards to protect users, especially young people, from tobacco content, for instance by including warning labels on posts that include tobacco-related terms or images. At the federal level, regulators might also choose to place stricter limits on the way tobacco companies are permitted to promote their products online.

The researchers next plan to explore the effectiveness and reach of social media tobacco prevention campaigns. They also aim to delve deeper into specific platforms used by young people, such as TikTok, and investigate how tobacco-related videos can impact susceptibility.

Source: University of Southern California

Categories : Addiction GenderTags :

Despite Smoking Less, Women Find it Harder to Quit

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A large study has found that women smoke fewer cigarettes than men but are less likely to quit.

Study author Ms Ingrid Allagbe, PhD student at the University of Burgundy, said: “In our study, women who used smoking cessation services had higher rates of overweight or obesity, depression, and anxiety compared to men and kicked the habit less often. Our findings highlight the need to provide smoking cessation interventions tailored to the needs of women.”

This study, presented at ESC Congress 2021, compared characteristics and abstinence rates of men and women visiting smoking cessation services between 2001 and 2018 in France, obtained from a nationwide database. The participants were smokers with at least one additional risk factor for cardiovascular disease: overweight/obese (body mass index [BMI] 25 kg/m² or above); high cholesterol; diabetes; high blood pressure; history of stroke, heart attack or angina.

Participants were classified as having mild, moderate, or severe nicotine dependence. Smoking abstinence (at least 28 consecutive days) was self-reported and confirmed by measurement of exhaled carbon monoxide less than 10 parts per million (ppm).

Participant height, weight, age, education level, chronic conditions, and number of cigarettes smoked each day were recorded. Participants were classified as having anxiety and depression symptoms or not according to their medical history, use of anti-anxiety medication or antidepressants, and the Hospital Anxiety and Depression Scale (HADS).

A total of 37 949 smokers were included in the study, of whom 43.5% were women. The average age of women in the study was 48 years, while the average age of men was 51 years. More women (55%) reported a bachelor’s degree level of education or higher compared to men (45%).

Both men and women had a high burden of cardiovascular risk factors. High cholesterol was more common in men (33%) than women (30%), as was high blood pressure (26% vs 23%, respectively) and diabetes (13% vs 10%, respectively).

Women were more likely (27%) to be overweight or obese compared to men (20%), and more likely (37.5%) to have symptoms of anxiety or depression than men (26.5%). Chronic obstructive pulmonary disease was more common in women (24%) compared to men (21%) as was asthma (16% vs 9%, respectively).

However, women smoked fewer cigarettes per day (23) than men (27). Severe nicotine dependence was less common, 56% of women compared to 60% of men, and abstinence was less common in women (52%) than men (55%).

Ms Allagbe said: “The findings suggest that despite smoking fewer cigarettes and being less nicotine dependent than men, women find it more difficult to quit. Possible contributors could be the higher prevalence of anxiety, depression and overweight or obesity among women. It has previously been reported that women may face different barriers to smoking cessation related to fear of weight gain, sex hormones, and mood.”

She concluded: “The results indicate that comprehensive smoking cessation programmes are needed for women that offer a multidisciplinary approach involving a psychologist, dietitian, and physical activity specialist.”

Source: European Society of Cardiology

Categories : Cardiovascular DiseaseTags :

Angioplasty Needed by Smokers 10 years Before Non-smokers

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Smokers needed their blocked arteries fixed nearly 10 years earlier than non-smokers, and patients with obesity underwent these procedures four years earlier than non-obese patients, according to a new US study.

Angioplasty is a nonsurgical procedure that opens clogged or narrow coronary arteries. The procedure involves inserting an inflatable balloon-tipped catheter through the skin in extremities and then inflating the balloon once it reaches the stenosed arterial site. The balloon pushes the atherosclerotic intraluminal plaque against the arterial wall and restores the luminal diameter, and so restores blood flow to the heart muscle.

The study included patients with no heart attack history, treated at hospitals across Michigan. The patients had all undergone angioplasty and/or stenting to widen or unblock their coronary arteries and restore blood flow. Nearly all of them had at least one traditional risk factor, including smoking, obesity, high blood pressure, high cholesterol and diabetes. Most patients had three or more.

Furthermore, compared to men, women generally had their first procedure at a later age. Over the past ten years, among patients undergoing their first angioplasty or stent procedure, obesity and diabetes rates have increased, while smoking and high cholesterol have decreased.

“Smoking is a completely preventable risk factor,” said senior author Devraj Sukul, MD, MSc, an interventional cardiologist and a clinical lecturer at the University of Michigan Health Frankel Cardiovascular Center. “If we direct additional efforts at preventing smoking and obesity we could significantly delay the onset of heart disease and the need for angioplasty and stenting.”

“In Michigan, we will work to help every smoker quit at the time of cardiac care because it is an unmatched teachable moment for patients,” said Michael Englesbe, M.D., a surgeon and professor at Michigan Medicine who serves as portfolio medical director for the Collaborative Quality Initiatives.

Source: Medical Xpress

Journal information: Zoya Gurm et al, Prevalence of coronary risk factors in contemporary practice among patients undergoing their first percutaneous coronary intervention: Implications for primary prevention, PLOS ONE (2021). DOI: 10.1371/journal.pone.0250801