Human ; Metals, Heavy ; Tobacco ; Tobacco Products

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.

BACKGROUND: Although smoking rates have been declining worldwide, new types of tobacco products have been gradually spreading in recent years, especially in Japan, where heated tobacco products (HTPs) users are rapidly increasing. Oxidative stress caused by reactive oxygen species (ROS) is one of the causes of smoking-induced carcinogenesis, respiratory diseases, and cardiovascular diseases. However, information on the amount of ROS contained in mainstream smoke from HTPs is limited. In this study, we measured the amount of ROS generated from HTPs to evaluate the oxidative stress-related toxicity of HTPs. METHODS: IQOS ILUMA, glo hyper+, and Ploom X ADVANCED were used as the HTP devices. Mainstream smoke was collected from each HTP according to Health Canada Intense regime (smoke volume, 55 mL; smoke duration, 2 s). The collected ROS were reacted with 2,7'-dichlorodihydrofluorescein reagents, and the amount of ROS was calculated as H₂O₂ equivalent from the fluorescence intensity obtained. RESULTS: The ROS in the mainstream smoke from IQOS ILUMA, glo hyper+ (high-temperature mode), and Ploom X ADVANCED was found to be 48.8 ± 8.6, 86.6 ± 12.6, and 40.8 ± 5.7 nmol H₂O₂/stick, respectively (n = 6, mean ± standard deviation), with the highest being from glo hyper+ (high-temperature mode). The amount of ROS was significantly higher in the high-temperature mode of glo hyper+ than in the standard mode of glo hyper+. Additionally, the estimated amount of ROS from smoking 20 heated sticks per day (674-2160 nmol H₂O₂/day) was equivalent to 2.2-96 times the amount of daily exposure to ROS in the urban atmosphere (approximately 22-300 nmol H₂O₂/day). CONCLUSIONS We found that ROS is generated from HTPs of different devices. This study suggests that HTPs users may be exposed to much more ROS than they are exposed to in normal life.
Reactive Oxygen Species/analysis* ; Tobacco Products/analysis* ; Smoke/analysis* ; Hot Temperature ; Japan ; Oxidative Stress

BACKGROUND: Heated tobacco products (HTPs) are widely used in Japan, following cigarettes, but their health effects remain unclear. HTPs are often considered a less harmful alternative to cigarettes and are commonly used by adults with asthma, even though smoking is one of the most obvious and treatable factors in asthma. We aimed to elucidate the association between HTP use and asthma symptoms in adults with asthma. METHODS: A total of 3,787 individuals with asthma were extracted from the data in the Japan COVID-19 and Society Internet Survey 2023, an ongoing longitudinal internet-based cohort study conducted by a nationwide internet research company in Japan. They were categorized into three groups (never, past, and current smokers) based on cigarette use. The association between HTP use and worsening of asthma symptoms within the previous 2 months in each group was analyzed using univariate and multivariate logistic regression analyses. Both exposure and outcomes were assessed by self-reporting. RESULTS: Among the participants, 2,470 (65.2%) were never smokers, 845 (22.3%) were past smokers, and 472 (12.5%) were current smokers. Overall, the proportion of HTP users was 429 (11.3%), and worsened asthma symptoms were observed in 400 (10.6%) individuals. The total proportion of HTP users and worsened asthma symptoms was 70 (2.8%) and 259 (10.5%) among never smokers, 180 (21.3%) and 72 (8.5%) among past smokers, and 179 (37.9%) and 69 (14.6%) among current smokers. After adjusting for confounders, the odds ratio (OR) was 3.25 (95% confidence interval [CI] 1.86-5.68, p < 0.001), 1.47 (95% CI 0.93-2.34, p = 0.1), and 2.23 (95% CI 1.46-3.43, p < 0.001) for never, past, and current cigarette smokers with HTP use, respectively, where never smokers without HTP use were set as the standard. CONCLUSION The use of HTPs, not only cigarette smoking, was associated with worsening of asthma symptoms in adults with asthma. Therefore, people need to understand the harmful effects of HTPs on asthma symptoms.
Humans ; Japan/epidemiology* ; Asthma/etiology* ; Male ; Female ; Middle Aged ; Adult ; Aged ; Tobacco Products/adverse effects* ; Internet ; Surveys and Questionnaires ; Young Adult ; Hot Temperature ; Longitudinal Studies

The protein kinase A/protein kinase G/protein kinase C-family (AGC kinase family) of eukaryotes is involved in regulating numerous biological processes. The 3-phosphoinositide- dependent protein kinase 1 (PDK1), is a conserved serine/threonine kinase in eukaryotes. To understand the roles of PDK1 homologous genes in cell death and immunity in tetraploid Nicotiana tabacum, the previuosly generated transgenic CRISPR/Cas9 lines, in which 5-7 alleles of the 4 homologous PDK1 genes (NtPDK1a/1b/1c/1d homologs) simultaneously knocked out, were used in this study. Our results showed that the hypersensitive response (HR) triggered by transient overexpression of active Pto (Pto^Y207D) or soybean GmMEKK1 was significantly delayed, whereas the resistance to Pseudomonas syrangae pv. tomato DC3000 (Pst DC3000) and tobacco mosaic virus (TMV) was significantly elevated in these partial knockout lines. The elevated resistance to Pst DC3000 and TMV was correlated with the elevated activation of NtMPK6, NtMPK3, and NtMPK4. Taken together, our results indicated that NtPDK1s play a positive role in cell death but a positive role in disease resistance, likely through negative regulation of the MAPK signaling cascade.
Nicotiana/virology* ; Disease Resistance/genetics* ; Plant Diseases/immunology* ; Plants, Genetically Modified/genetics* ; Gene Knockout Techniques ; Plant Proteins/genetics* ; CRISPR-Cas Systems ; Protein Serine-Threonine Kinases/genetics* ; 3-Phosphoinositide-Dependent Protein Kinases/genetics* ; Pyruvate Dehydrogenase Acetyl-Transferring Kinase ; Tobacco Mosaic Virus/pathogenicity*

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.

Nicotine addiction is a concern worldwide. Most mechanistic investigations are on nicotine substance dependence properties based on its pharmacological effects. However, no effective therapeutic treatment has been established. Nicotine addiction is reinforced by environments or habits. We demonstrate the neurobiological basis of the behavioural aspect of nicotine addiction. We utilized the conditioned place preference to establish nicotine-associated behavioural preferences (NABP) in rats. Brain-wide neuroimaging analysis revealed that the medial prefrontal cortex (mPFC) was activated and contributed to NABP. Chemogenetic manipulation of µ-opioid receptor positive (MOR⁺) neurons in the mPFC or the excitatory outflow to the nucleus accumbens shell (NAcShell) modulated the NABP. Electrophysiological recording confirmed that the MOR⁺ neurons directly regulate the mPFC-NAcShell circuit via GABA_A receptors. Thus, the MOR⁺ neurons in the mPFC modulate the formation of behavioural aspects of nicotine addiction via direct excitatory innervation to the NAcShell, which may provide new insight for the development of effective therapeutic strategies.
Animals ; Nucleus Accumbens/drug effects* ; Prefrontal Cortex/drug effects* ; Nicotine/pharmacology* ; Receptors, Opioid, mu/metabolism* ; Male ; Rats ; Rats, Sprague-Dawley ; Tobacco Use Disorder/metabolism* ; Neurons/drug effects* ; Neural Pathways/drug effects*

Objective: To investigate the association between physical exercise and non-alcoholic fatty liver disease (NAFLD) in people infected with HBV. Methods: The information about the 3 813 participants infected with HBV, including the prevalence of NAFLD, prevalence of physical exercise and other covariates, were collected from the National Science and Technology Major Project of China during 2016-2020. The logistic regression model was used to evaluate the association between physical exercise and NAFLD in HBV infected patients, and subgroup analysis was performed to identify the effect modifiers. Results: A total of 2 259 HBV infected participants were included in the final analysis and 454 (20.10%) had NAFLD. After adjusting for covariates, we found that moderate physical exercise was a protective factor for NAFLD (OR=0.66, 95%CI: 0.46-0.94). Subgroup analysis suggested that the protective effect of moderate physical exercise on NAFLD might be stronger in women (OR=0.61, 95%CI: 0.36-1.01), those <45 years old (OR=0.24, 95%CI: 0.06-0.80), those who had low education level (OR=0.16, 95%CI: 0.04-0.49), those who had low annual income (OR=0.39, 95%CI: 0.16-0.89 for <30 000 yuan RMB; OR=0.64, 95%CI: 0.40-1.00 for 30 000-80 000 yuan RMB), those who had hypertension (OR=0.45, 95%CI: 0.21-0.88), those with BMI ≥24.0 kg/m² (OR=0.66, 95%CI: 0.43-1.01), those who had more daily fruit or vegetable intake (OR=0.61, 95%CI: 0.38-0.97), those who had more daily meat intake (OR=0.49, 95%CI: 0.23-0.97), and those who had no smoking history (OR=0.66, 95%CI: 0.45-0.95) or passive smoking exposure (OR=0.61, 95%CI: 0.37-0.97). Conclusions: Among HBV infected patients, moderate physical exercise was negatively associated with the prevalence of NAFLD. Women, young people, those who had low education level, those who had low annual income, those with hypertension, those with high BMI, those who had more daily fruit or vegetable and meat intakes, and those who had no smoking history or passive smoking exposure might be more sensitive to the protective effect.
Humans ; Female ; Adolescent ; Middle Aged ; Non-alcoholic Fatty Liver Disease/epidemiology* ; Hepatitis B virus ; Risk Factors ; Tobacco Smoke Pollution ; Exercise ; Hypertension

OBJECTIVE: To analyze the association between exposure to second-hand smoke (SHS) and 23 diseases, categorized into four classifications, among the Chinese population. METHODS: We searched the literature up to June 30, 2021, and eligible studies were identified according to the PECOS format: Participants and Competitors (Chinese population), Exposure (SHS), Outcomes (Disease or Death), and Study design (Case-control or Cohort). RESULTS: In total, 53 studies were selected. The odds ratio (OR) for all types of cancer was 1.79 (1.56-2.05), and for individual cancers was 1.92 (1.42-2.59) for lung cancer, 1.57 (1.40-1.76) for breast cancer, 1.52 (1.12-2.05) for bladder cancer, and 1.37 (1.08-1.73) for liver cancer. The OR for circulatory system diseases was 1.92 (1.29-2.85), with a value of 2.29 (1.26-4.159) for stroke. The OR of respiratory system diseases was 1.76 (1.13-2.74), with a value of 1.82 (1.07-3.11) for childhood asthma. The original ORs were also shown for other diseases. Subgroup analyses were performed for lung and breast cancer. The ORs varied according to time period and were significant during exposure in the household; For lung cancer, the OR was significant in women. CONCLUSION The effect of SHS exposure in China was similar to that in Western countries, but its definition and characterization require further clarification. Studies on the association between SHS exposure and certain diseases with high incidence rates are insufficient.
Child ; Female ; Humans ; Asthma/epidemiology* ; Breast Neoplasms ; East Asian People ; Lung Neoplasms/etiology* ; Tobacco Smoke Pollution/adverse effects* ; China

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