BACKGROUND

The Philippines implemented a law on the inclusion of graphic health warning (GHW) labels in cigarette packs to increase awareness about the health effects of smoking, to quit smoking, or to deter potential users from engaging in cigarettes. Investigating its impact on senior high school (SHS) students may provide insights into enhancing and reinforcing the law to achieve its purpose at the adolescent developmental stage.

The objective of this study was to determine the perceived emotional and cognitive reactions as well as the perceived health risks of GHWs among nonsmoking SHS students in Leyte and their relationship to their level of exposure.

A cross-sectional design was employed involving 247 students from public high schools in Pastrana, Leyte, who were selected through stratified random sampling. A self-report questionnaire was used to gather the data. Spearman’s rho correlation coefficient was used to test the hypothesis.

The majority of the participants reported positive perceptions of GHW labels. Moreover, the majority of them have seen GHW at least once a week on cigarette packs and evoked variable agreement about the high arousal and low arousal negative emotion, but have positive cognitive reactions. They have a strong agreement on the perceived health risks posed by cigarette smoking through GHWs. There was a positive and significant correlation between the level of exposure and the perceived health risks of smoking through the GHWs.

Adolescent learners reported variable agreement on emotional reactions, but had positive cognitive reactions to tobacco GHW labels. They also have reported that GHWs in cigarette packs provide positive visual information on the health effects and other consequences of smoking. Those who have frequent exposure to the GHWs of the cigarette packs were more likely to report knowledge and information on the health risks of smoking. Thus, the GHWs on cigarette packs are still necessary to decrease the new smoker rate, especially among adolescents. Policy implications toward the continuous development of GHWS are offered.

INTRODUCTION

Smoking is one of the biggest global public health problems. It is known that the use of tobacco can have detrimental effects on a person’s overall health. Thus, this study is geared towards determining the knowledge and attitude of medical residents about tobacco cessation.

The study determined the knowledge and attitudes of smoking cessation among VSMMC residents and assessed their understanding of the risks associated with tobacco use.

A descriptive cross-sectional research design was used employing an online survey of 171 medical residents from December 2022 to March 2023. An in-depth analysis of categorical variables related to demographic factors using chi-square and Fisher’s exact tests was subsequently done.

Most have average knowledge and a good knowledge foundation about tobacco cessation. The majority, primarily aged 25 to 34, single are more knowledgeable about quitting smoking and its benefits as well as the women, although statistically not significant in proportion of the knowledge base. Approximately 69% were nonsmokers, and 87.7% lacked training in tobacco cessation. Only 8.2% demonstrated poor knowledge of smoking cessation, while 91.8% had average to good knowledge. Knowledge levels did not significantly differ based on demographics, smoking status, or training, except for residency type. Generally, they have a positive attitude towards tobacco cessation and agreed that it is part of their responsibility to assist and motivate patients. They recognized the positive impact on healthcare provider-patient relationships, and the minority felt discomfort counseling patients. Most believed in the availability of time to provide advice, and some acknowledged potential patient resistance or viewed quitting smoking as an individual choice.

The significant difference in knowledge based on residency type emphasizes the necessity for interventions to fill knowledge gaps and suggest areas for targeted educational interventions. The findings also underscore the importance of early education, as evidenced by the majority obtaining training during medical school.

Humans ; Smoking Cessation ; Smoking/adverse effects* ; Primary Health Care

Humans ; Electronic Nicotine Delivery Systems ; Prevalence ; Mental Disorders/epidemiology* ; Smoking/epidemiology* ; Perception

INTRODUCTION

Tobacco smoking is one of the most significant preventable lifestyle risk factors, causing a wide range of diseases and causing harm to millions of people worldwide. Nicotine replacement treatment (NRT) and behavioral counseling have long been used to help people quit smoking. However, because pharmacologic and behavioral therapy only have a 22% to 45% success rate in smoking cessation, a systematic review and meta-analysis was conducted to evaluate ear acupuncture’s usefulness as an adjunct to nicotine replacement therapy and behavioral counseling for smoking cessation.

This systematic review only included randomized controlled trials which involved current smokers aged 19 years or older, and who were in the contemplation stage according to the Transtheoretical Model of Intentional Behavior of Change. The RevMan 5 software was used in the analysis of data. The primary outcome that was measured is the rate of continuous abstinence based on participant/patient report at the end of treatment and secondary outcome of the study was reporting of nicotine withdrawal symptoms.

Of the 1,661 identified records, only 2 studies were included (both RCTs) in the meta- analysis. The studies were rated with low to unclear selection bias and high risk of performance bias. The pooled estimates of effect were statistically significant in favor of ear acupuncture plus counseling (standard therapy), RR= 2.28, 95% CI 1.27, 4.08, p= 0.006, I2= 0%. Nicotine withdrawal symptoms were noted to be less pronounced in those who received the intervention of ear acupuncture even after 3 months post-treatment. The evidence was graded as low quality, indicating that more research is needed and would extremely likely have a significant impact on confidence in the estimate of effect.

The results of this systematic review and meta-analysis suggest that ear acupuncture produces an additive benefit on counseling (standard of care) as a means of smoking cessation. Future research should be conducted using RCTs of a high quality in order to address the substantial risk of bias that was present in the studies that were included and to improve the quality of the evidence.

BACKGROUND: Heated tobacco product (HTP) use has increased substantially between 2016 and 2017 in Japan. This study aims to clarify how HTP use (IQOS, Ploom, and glo) spread across the different combustible cigarette smoking statuses during 2015-16 and 2017-18 in Japan. METHODS: We compared the two periods of (i) 2015 to 2016 (N = 5,366) and (ii) 2017 to 2018 (N = 3,422) from a longitudinal study randomly sampling members from the Japan "Society and New Tobacco" Internet Survey (JASTIS). Multivariable logistic regression models for current HTP use in the previous 30 days by combustible cigarette smoking status in the previous year were used adjusting for socio-demographic factors. RESULTS: HTP use increased by 10 times in the 2017-18 cohort compared with the 2015-16 cohort according to the adjusted odds ratio (95% confidence interval) for current HTP use as 10.2 (7.03-14.8). According to smoking status, significantly higher adjusted ORs (95% CIs) of current HTP use for the after period were observed: 2.60 (1.37-4.94) for never smokers, 7.82 (3.64-16.8) for former smokers, 21.1 (5.73-77.9) for current smokers with intention to quit, and 17.0 (9.58-30.3) for current smokers without intention to quit. CONCLUSION During 2015 to 2018 in Japan, HTP use dramatically increased in all subgroups except for never smokers.
Humans ; Japan/epidemiology* ; Longitudinal Studies ; Tobacco Products ; Tobacco ; Cigarette Smoking ; Surveys and Questionnaires

BACKGROUND: Sex- and age-specific impacts of cardiovascular risk factors on the development of dementia have not been well evaluated. We investigated these impacts of smoking, overweight/obesity, hypertension, and diabetes mellitus on the risk of disabling dementia. METHODS: The study participants were 25,029 (10,134 men and 14,895 women) Japanese aged 40-74 years without disabling dementia at baseline (2008-2013). They were assessed on smoking status (non-current or current), overweight/obesity (body mass index ≥25 kg/m² and ≥30 kg/m², respectively), hypertension (systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg or any antihypertensive medication use), and diabetes mellitus (a fasting serum glucose ≥126 mg/dL, non-fasting glucose ≥200 mg/dL, hemoglobin A1c ≥6.5% by the National Glycohemoglobin Standardization Program or glucose-lowering medication use) at baseline. Disabling dementia was identified as the level of care required ≥1 and cognitive disability grade ≥IIa according to the National Long-term Care Insurance Database. We used a Cox proportional regression model to estimate hazard ratios and 95% confidence intervals (95% CIs) of disabling dementia according to the cardiovascular risk factors and calculated the population attributable fractions (PAFs). RESULTS: During a median follow-up of 9.1 years, 1,322 (606 men and 716 women) developed disabling dementia. Current smoking and hypertension were associated with a higher risk of disabling dementia in both sexes, whereas overweight or obesity was not associated with the risk in either sex. Diabetes mellitus was associated with a higher risk only in women (p for sex interaction = 0.04). The significant PAFs were 13% for smoking and 14% for hypertension in men and 3% for smoking, 12% for hypertension, and 5% for diabetes mellitus in women. The total PAFs of the significant risk factors were 28% in men and 20% in women. When stratified by age, hypertension in midlife (40-64 years) was associated with the increased risk in men, while diabetes mellitus in later-life (65-74 years) was so in women. CONCLUSIONS A substantial burden of disabling dementia was attributable to smoking, and hypertension in both sexes and diabetes mellitus in women, which may require the management of these cardiovascular risk factors to prevent dementia.
Male ; Humans ; Female ; Adult ; Middle Aged ; Overweight/complications* ; East Asian People ; Cardiovascular Diseases/epidemiology* ; Hypertension/etiology* ; Diabetes Mellitus/etiology* ; Obesity/etiology* ; Smoking/epidemiology* ; Risk Factors ; Age Factors ; Dementia/etiology*

OBJECTIVES: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a vaso-specific inflammatory marker that exacerbates atherosclerotic through inflammatory responses. It can be used to predict the occurrence of adverse cardiovascular events and to assess the residual risk of cardiovascular diseases. This study aims to investigate the correlation between smoking and serum Lp-PLA2 levels in overweight and obese men, and to provide evidence for preventing the cardiovascular diseases. METHODS: Male subjects, who participated in health examination at the Health Management Center, Third Xiangya Hospital, Central South University from May 1, 2020 to April 30, 2021, were selected. The smoking status and other information were collected by the Self-test Scale of Physical Examination. According to the smoking status, they were divided into a never-smoking group, a current smoking group, a quit smoking group and a passive smoking group. According to the daily smoking amount, the current smoking subjects were divided into a <10 cigarettes group, a 10 to 20 cigarettes group, a 21 to 30 cigarettes group, and a >30 cigarettes group. According to the smoking years, the current smoking subjects were divided into a <5 years group, a 5 to 10 years group, a 11 to 20 years group, and a >20 years group.Serum Lp-PLA2 levels and other clinical indexes in different smoking groups were measured and compared, the correlation between smoking and serum Lp-PLA2 levels in overweight and obese men was analyzed by logistic regression analysis. RESULTS: Serum Lp-PLA2 levels were significantly different between the never-smoking group and the current smoking group (P<0.05). Logistic regression analysis showed that, before adjusting other influencing factors and in terms of smoking status, the current smoking group (OR=1.81, 95% CI 1.27 to 2.58, P<0.01) and the quit smoking group (OR=2.09, 95% CI 1.12 to 3.90, P<0.05) were positively correlated with serum Lp-PLA2 levels compared with the never-smoking group, while the passive smoking group had no correlation with serum Lp-PLA2 levels (OR=1.27, 95% CI 0.59 to 2.73, P>0.05). In terms of daily smoking amount, the 10 to 20 cigarettes group (OR=2.09, 95% CI 1.40 to 3.12, P<0.001) and the 21 to 30 cigarettes group (OR=1.98, 95% CI 1.22 to 3.20, P<0.01) were positively correlated with serum Lp-PLA2 levels compared with the never-smoking group, while the <10 cigarettes group (OR=1.45, 95% CI 0.81 to 2.60, P>0.05) and the >30 cigarettes group (OR=1.17, 95% CI 0.60 to 2.28, P>0.05) had no correlation with serum Lp-PLA2 levels. In terms of smoking years, the 5 to 10 years group (OR=1.94, 95% CI 1.07 to 3.53, P<0.05), the 11 to 20 years group (OR=2.06, 95% CI 1.33 to 3.18, P<0.01), and the >20 years group (OR=1.66, 95% CI 1.11 to 2.47, P<0.05) were positively correlated with serum Lp-PLA2 levels compared with the never-smoking group, while the <5 years group had no correlation with serum Lp-PLA2 levels (OR=1.12, 95% CI 0.38 to 3.33, P>0.05). After adjusting for age and other indicators, the correlation between smoking years and serum Lp-PLA2 levels was the same as before adjustment among the above smoking groups, except that the correlation between the smoking 5 to 10 years group and serum Lp-PLA2 levels was not significant (OR=1.77, 95% CI 0.95 to 3.29, P>0.05). CONCLUSIONS Smoking is correlated with serum Lp-PLA2 levels in overweight and obese men.
Humans ; Male ; 1-Alkyl-2-acetylglycerophosphocholine Esterase ; Overweight ; Cardiovascular Diseases ; Tobacco Smoke Pollution ; Biomarkers ; Obesity ; Smoking ; Risk Factors

OBJECTIVE: To systematically review the efficacy of acupuncture for the treatment of tobacco withdrawal syndrome. METHODS: The randomized controlled trials (RCTs) regarding acupuncture for treatment of tobacco withdrawal syndrome were searched in CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane, Medline and EMbase databases. The search period was from January 1st of 2011 to December 31st of 2021. After data extraction and bias risk assessment of the included literature, the Meta-analysis was performed using RevMan5.4.1 software. RESULTS: Totally 23 RCTs were included, including 2 120 patients. The Meta-analysis results showed that compared with medication, acupuncture showed no significant difference at improving Fagerström test for nicotine dependence (FTND) score (MD=0.16, 95%CI: -0.08, 0.41), heaviness of smoking index (HSI) score (MD=0.11, 95%CI: -0.13, 0.36), Minnesota nicotine withdrawal scale (MNWS) score (MD=0.12, 95%CI: -0.11, 1.35), questionnaire of smoking urges (QSU) score (MD=-0.30, 95%CI: -2.78, 2.18), Hamilton depression scale (HAMD) score (MD=0.76, 95%CI: -1.54, 3.06), abstinence rate (RR=0.95, 95% CI: 0.82, 1.10) and effective rate (RR=1.01, 95%CI: 0.95, 1.07). Acupuncture was superior to sham acupuncture in reducing MNWS score (MD=-4.88, 95%CI: -5.21, -4.55, P<0.000 01). Acupuncture was superior to cognitive behavioral therapy in reducing FTND score (MD=-1.41, 95%CI: -1.74, -1.08), MNWS score (MD=-4.28, 95%CI: -5.31, -3.25) and increasing abstinence rate (RR=2.19, 95%CI: 1.39, 3.45, P<0.000 01, P<0.001). CONCLUSION Acupuncture could effectively improve tobacco withdrawal syndrome, increase abstinence rate and effective rate. Limited by the quantity and quality of the included studies, this conclusion needs to be verified by more studies.
Humans ; Tobacco ; Acupuncture Therapy ; Syndrome ; Nicotine ; Smoking

Humans ; Smoking Cessation ; Beijing/epidemiology* ; COVID-19/epidemiology* ; Pandemics/prevention & control* ; Smoking/epidemiology*