1.Analysis of the current status and related factors of oral nutritional supplements intake among 18-79 years old in Beijing in 2017.
Ying Qi WEI ; Ai Juan MA ; Kai FANG ; Jing DONG ; Jin XIE ; Chen XIE ; Kun QI ; Zhong DONG
Chinese Journal of Epidemiology 2022;43(2):227-233
Objective: To understand the current status of taking nutrient supplements for residents aged 18 to 79 years old in Beijing and its related factors. Methods: Data were gathered from the 2017 Beijing Non-communicable and Chronic Disease Surveillance Program. Multiple classified cluster sampling method was used, and participants aged 18-79 were sampled from 16 districts. The questionnaire included chronic diseases and related risk factors, health knowledge, and oral nutritional supplements within 12 months. Multivariate logistic regression models were established to analyze associated factors that affect the intake of nutrient supplements. Results: The weighted prevalence of supplements use was 13.1% among 12 696 subjects within the past 12 months. The proportions of multivitamins (4.7%), B vitamins (4.5%), and folic acid (3.2%) were higher. The prevalence of supplement use of young people (18-39 years old) and the elderly (60-79 years old) was higher than middle-aged people (40-59 years old) (χ2=54.09, P<0.001). Except for the age group of 70-79 years old, the consumption rate of women was significantly higher than that of men (P<0.05). After adjusting age and sex, among patients with hypertension, diabetes, or dyslipidemia, the control rates of blood pressure, glucose and lipids of patients who take nutrient supplements were higher than those who do not (P<0.05). And participants who took nutrient supplements had a more heightened awareness rate of health knowledge, such as the hazards of smoking and second-hand smoke, and recommended amount of salt per day (P<0.001). The multi-factor logistic analysis found that nutrient supplement-related factors include women, old age, higher education level, living in urban, insufficient physical activity, sleeping problems, active physical examination, blood pressure control among patients, and health knowledge (P<0.05). Conclusions: The factors of nutrient supplements use were related to sex, age, education level, health status, and health literacy. We should pay attention to key populations and guide them to establish the correct concept of taking nutrient supplements.
Adolescent
;
Adult
;
Aged
;
Beijing/epidemiology*
;
Dietary Supplements
;
Female
;
Folic Acid
;
Humans
;
Male
;
Middle Aged
;
Smoking/adverse effects*
;
Vitamin B Complex
;
Young Adult
2.Hokkaido birth cohort study on environment and children's health: cohort profile 2021.
Reiko KISHI ; Atsuko IKEDA-ARAKI ; Chihiro MIYASHITA ; Sachiko ITOH ; Sumitaka KOBAYASHI ; Yu AIT BAMAI ; Keiko YAMAZAKI ; Naomi TAMURA ; Machiko MINATOYA ; Rahel Mesfin KETEMA ; Kritika POUDEL ; Ryu MIURA ; Hideyuki MASUDA ; Mariko ITOH ; Takeshi YAMAGUCHI ; Hisanori FUKUNAGA ; Kumiko ITO ; Houman GOUDARZI
Environmental Health and Preventive Medicine 2021;26(1):59-59
BACKGROUND:
The Hokkaido Study on Environment and Children's Health is an ongoing study consisting of two birth cohorts of different population sizes: the Sapporo cohort and the Hokkaido cohort. Our primary objectives are to (1) examine the effects that low-level environmental chemical exposures have on birth outcomes, including birth defects and growth retardation; (2) follow the development of allergies, infectious diseases, and neurobehavioral developmental disorders, as well as perform a longitudinal observation of child development; (3) identify high-risk groups based on genetic susceptibility to environmental chemicals; and (4) identify the additive effects of various chemicals, including tobacco.
METHODS:
The purpose of this report is to provide an update on the progress of the Hokkaido Study, summarize recent results, and suggest future directions. In particular, this report provides the latest details from questionnaire surveys, face-to-face examinations, and a collection of biological specimens from children and measurements of their chemical exposures.
RESULTS:
The latest findings indicate different risk factors of parental characteristics on birth outcomes and the mediating effect between socioeconomic status and children that are small for the gestational age. Maternal serum folate was not associated with birth defects. Prenatal chemical exposure and smoking were associated with birth size and growth, as well as cord blood biomarkers, such as adiponectin, leptin, thyroid, and reproductive hormones. We also found significant associations between the chemical levels and neuro development, asthma, and allergies.
CONCLUSIONS
Chemical exposure to children can occur both before and after birth. Longer follow-up for children is crucial in birth cohort studies to reinforce the Developmental Origins of Health and Disease hypothesis. In contrast, considering shifts in the exposure levels due to regulation is also essential, which may also change the association to health outcomes. This study found that individual susceptibility to adverse health effects depends on the genotype. Epigenome modification of DNA methylation was also discovered, indicating the necessity of examining molecular biology perspectives. International collaborations can add a new dimension to the current knowledge and provide novel discoveries in the future.
Biomarkers/blood*
;
Child
;
Child Health
;
Child, Preschool
;
Cohort Studies
;
Environmental Exposure/adverse effects*
;
Environmental Health
;
Environmental Pollutants/adverse effects*
;
Female
;
Fetal Blood/chemistry*
;
Follow-Up Studies
;
Growth/drug effects*
;
Humans
;
Hypersensitivity/etiology*
;
Infant
;
Japan/epidemiology*
;
Male
;
Neurodevelopmental Disorders/etiology*
;
Pregnancy
;
Prenatal Exposure Delayed Effects/etiology*
;
Prevalence
;
Smoking/adverse effects*
3.Relationship between using cell phone and the risk of accident with motor vehicles: An analytical cross-sectional study.
Mohammad KOGANI ; Seyed Ahmad ALMASI ; Alireza ANSARI-MOGADDAM ; Sahar DALVAND ; Hassan OKATI-ALIABAD ; Seyed Mehdi TABATABAEE ; Seyedeh Zeinab ALMASI
Chinese Journal of Traumatology 2020;23(6):319-323
PURPOSE:
Traffic accidents are one of the major health problems in the world, being the first cause of burden of illness and the second leading cause of death in Iran. The Sistan-Baluchestan province is one of the most accidental provinces of Iran with the highest rate of accidents-caused deaths. This study was conducted to determine the risk factors associated with traffic accidents in Zahedan through 2013 to 2016.
METHODS:
This analytical cross-sectional study was carried out on 223 drivers from Zahedan who were traumatized by traffic accident and sent to Zahedan hospitals. The data were obtained through interviews taken by the trained interviewers via refereeing to the medical records and collected in the researcher-made checklist. Census was obtained from the study subjects. For data analysis, independent t-test, one-way ANOVA, Chi-square and logistic regression were used with the Stata software version 11.0.
RESULTS:
In this study, 223 male subjects with the mean age of (32.54 ± 12.95) years, 39.8% single and 60.2% married, entered for investigation. Most accidents (38.8%) occurred between 12:00 to 17:59. While driving, 47.1% of the study subjects were using cell phones, 89.1% had manual use of mobile phones, 21.9% had a habit of sending short message service (SMS) and 23.4% had sent SMS within 10 min before the accident. The one way analysis of variance showed that the mean age of individuals with marital status, driving experience, education and accident with motorcycle were significantly different (p < 0.05). Also, the multivariate logistic regression test indicated a significant relationship of smoking, ethnicity, insurance and SMS typing while driving with motorcycle accident (p < 0.05).
CONCLUSION
In this study, SMS and smoking while driving had the highest risk among the variables studied in the motorcycle accidents. Therefore, effective education attempting to enhance people's awareness about the consequences of using cell phone and smoking during driving to reduce traffic accidents seems necessary.
Accidents, Traffic/statistics & numerical data*
;
Adolescent
;
Adult
;
Aged
;
Aged, 80 and over
;
Automobile Driving
;
Cause of Death
;
Cell Phone Use/adverse effects*
;
Cross-Sectional Studies
;
Female
;
Health Education
;
Humans
;
Iran/epidemiology*
;
Male
;
Marital Status
;
Middle Aged
;
Risk
;
Smoking/adverse effects*
;
Young Adult
4.Prenatal tobacco exposure and ADHD symptoms at pre-school age: the Hokkaido Study on Environment and Children's Health.
Machiko MINATOYA ; Atsuko ARAKI ; Sachiko ITOH ; Keiko YAMAZAKI ; Sumitaka KOBAYASHI ; Chihiro MIYASHITA ; Seiko SASAKI ; Reiko KISHI
Environmental Health and Preventive Medicine 2019;24(1):74-74
BACKGROUND:
There have been inconsistent findings reported on maternal passive smoking during pregnancy and child risk of ADHD. In this study, ADHD symptoms at pre-school age children in association with prenatal passive and active tobacco smoke exposure determined by maternal plasma cotinine levels in the third trimester were investigated.
METHODS:
This was a follow-up study of the birth cohort: the Hokkaido Study on Environment and Children's Health. Children whose parents answered Strengths and Difficulties Questionnaire (SDQ) to identify child ADHD symptoms (hyperactivity/inattention and conduct problems) and total difficulties at age 5 years with available maternal plasma cotinine level at the third trimester were included (n = 3216). Cotinine levels were categorized into 4 groups; ≦ 0.21 ng/ml (non-smoker), 0.22-0.51 ng/ml (low-passive smoker), 0.52-11.48 ng/ml (high-passive smoker), and ≧ 11.49 ng/ml (active smoker).
RESULTS:
Maternal cotinine levels of active smokers were significantly associated with an increased risk of total difficulties (OR = 1.67) and maternal low- and high-passive smoking also increased the risk (OR = 1.11, 1.25, respectively) without statistical significance. Similarly, maternal cotinine levels of active smokers were associated with an increased risk of hyperactivity/inattention (OR = 1.49). Maternal low- and high-passive smoking and active smoking increased the risk of hyperactivity/inattention (OR = 1.45, 1.43, and OR = 1.59, respectively) only in boys.
CONCLUSION
Our findings suggested that maternal active smoking during pregnancy may contribute to the increased risk of child total difficulties and hyperactivity/inattention at pre-school age. Pregnant women should be encouraged to quit smoking and avoid exposure to tobacco smoke.
Adult
;
Attention Deficit Disorder with Hyperactivity
;
epidemiology
;
etiology
;
physiopathology
;
psychology
;
Child, Preschool
;
Cotinine
;
blood
;
Female
;
Follow-Up Studies
;
Humans
;
Japan
;
epidemiology
;
Male
;
Maternal Exposure
;
adverse effects
;
Mothers
;
Pregnancy
;
Pregnancy Trimester, Third
;
Prenatal Exposure Delayed Effects
;
epidemiology
;
etiology
;
Risk
;
Sex Factors
;
Tobacco Smoking
;
adverse effects
;
epidemiology
5.Association between exposure to household smoking and dental caries in preschool children: a cross-sectional study.
Yuko GOTO ; Keiko WADA ; Kie KONISHI ; Takahiro UJI ; Sachi KODA ; Fumi MIZUTA ; Michiyo YAMAKAWA ; Kaori WATANABE ; Kyoko ANDO ; Jun UEYAMA ; Takaaki KONDO ; Chisato NAGATA
Environmental Health and Preventive Medicine 2019;24(1):9-9
BACKGROUND:
We aimed to examine the association of exposure to environmental tobacco smoke with dental caries among preschool children. Exposure to environmental tobacco smoke was assessed in terms of urinary cotinine concentrations and pack-years of exposure to smoking by parents and other family members at home.
METHODS:
This cross-sectional study included 405 preschool children aged 3-6 years from two preschools in Japan in 2006. Information on the smoking habits of family members living with the child was obtained from parent-administered questionnaires. Dental examination was conducted to assess dental caries, that is, decayed and/or filled teeth. Urinary cotinine levels were measured using first-void morning urine samples.
RESULTS:
Overall, 31.1% of the children had dental caries, and 29.5% had decayed teeth. Exposure to current maternal and paternal smoking was positively associated with the presence of dental caries after controlling for covariates. More than three pack-years of exposure to maternal smoking and more than five pack-years of exposure to smoking by all family members were significantly associated with the presence of dental caries as compared with no exposure (odds ratio [OR] = 5.55, 95% confidence interval [CI] = 2.17-14.22, P for trend < 0.001 and OR = 2.00, 95% CI = 1.12-3.58, P for trend = 0.004, respectively). These exposure variables were similarly associated with the presence of decayed teeth (OR = 2.92, 95% CI = 1.23-6.96, P for trend = 0.01 and OR = 1.75, 95% CI = 0.96-3.20, P for trend = 0.03, respectively). As compared with lowest tertile of the urinary cotinine level, the highest tertile of the urinary cotinine level was significantly associated with the presence of dental caries as well as decayed teeth; the ORs for the highest vs. lowest tertile of urinary cotinine levels were 3.10 (95% CI = 1.71-5.63, P for trend = 0.012) and 2.02 (95% CI = 1.10-3.70, P for trend = 0.10), respectively.
CONCLUSIONS
These data suggest that exposure to tobacco smoke may have a dose-dependent influence on the development of caries.
Child
;
Child, Preschool
;
Cotinine
;
urine
;
Cross-Sectional Studies
;
Dental Caries
;
epidemiology
;
etiology
;
Female
;
Humans
;
Japan
;
epidemiology
;
Logistic Models
;
Male
;
Maternal Exposure
;
adverse effects
;
Parents
;
Paternal Exposure
;
adverse effects
;
Risk Factors
;
Surveys and Questionnaires
;
Tobacco Smoke Pollution
;
adverse effects
;
Tobacco Smoking
;
adverse effects
;
epidemiology
6.Adverse health effects of asbestos: solving mysteries regarding asbestos carcinogenicity based on follow-up survey of a Chinese factory.
Environmental Health and Preventive Medicine 2018;23(1):35-35
The present review summarizes the results of several follow-up studies assessing an asbestos product manufacturing plant in Chongqing, China, and discusses three controversial issues related to the carcinogenicity of asbestos. The first issue is the amphibole hypothesis, which asserts that the carcinogenicity of asbestos is limited to amphiboles, such as crocidolite, but not serpentines, such as chrysotile. However, considering the possible multiple component of asbestos carcinogenicity in the presence of tobacco smoke or other carcinogens, chrysotile cannot be regarded as non-carcinogenic. Additionally, in a practical sense, it is not possible to assume "pure" chrysotile due to its ubiquitous contamination with tremolite, which is a type of amphibole. Thus, as the International Agency for Research on Cancer (IARC) assessed, all forms of asbestos including chrysotile should be regarded carcinogenic to humans (Group 1). The second issue is the chrysotile/tremolite paradox, which is a phenomenon involving predominant levels of tremolite in the lung tissues of individuals who worked in locations with negligible levels of tremolite due to the exclusive use of chrysotile. Four possible mechanisms to explain this paradox have been proposed but this phenomenon does not support the claim that amphibole is inert. The final issue discussed is the textile mystery, i.e., the higher incidence of cancer in asbestos textile plants compared to asbestos mines where the same asbestos was produced and the exposure levels were comparable. This phenomenon was first reported in North America followed by UK and then in the present observations from China. Previously, levels of fiber exposure were calculated using a universal converting coefficient to estimate the mass concentration versus fiber concentration. However, parallel measurements of fiber and mass concentrations in the workplace and exposed air indicated that there are wide variations in the fiber/mass ratio, which unjustifies the universal conversion. It is possible that contamination by airborne non-fibrous particles in mines with mass fiber conversion led to the overestimation of fiber concentrations and resulted in the textile mystery. Although the use and manufacturing of asbestos has been banned in Japan, more than 10 million tons of asbestos had been imported and the majority remains in existing buildings. Thus, efforts to control asbestos exposure should be continued.
Asbestos
;
classification
;
toxicity
;
Asbestos, Amphibole
;
toxicity
;
Asbestos, Serpentine
;
toxicity
;
Carcinogens
;
China
;
Follow-Up Studies
;
Humans
;
Lung Neoplasms
;
chemically induced
;
epidemiology
;
Manufacturing and Industrial Facilities
;
statistics & numerical data
;
Mining
;
statistics & numerical data
;
Occupational Diseases
;
epidemiology
;
Occupational Exposure
;
adverse effects
;
Textiles
;
Tobacco Smoking
;
epidemiology
7.Impact of Smoking on Anal Abscess and Anal Fistula Diseases.
Li-Hua ZHENG ; Ao-Zhe ZHANG ; Yu-Ying SHI ; Xin LI ; Lan-Si JIA ; Cong-Cong ZHI ; Qiu-Xiang YU ; Wen ZHANG ; Yan-Jun LIU ; Luan WANG ; Dan XIAO ; Chen WANG
Chinese Medical Journal 2018;131(9):1034-1037
BackgroundSeveral studies have investigated the association between smoking and anal abscess and anal fistula (AA/F) diseases. However, the relationship between cigarette smoking and AA/F remains unclear. This study sought to assess the role of smoking in anorectal male patients in a Chinese population.
MethodsIn this retrospective study, a questionnaire, including smoking history, was completed over a 3-month period by male inpatients in the Proctology Department of China-Japan Friendship Hospital. "Cases" were patients who had AA/F, and "controls" were patients with other anorectal complaints. Mann-Whitney U-test and Chi-square test were carried out to examine differences in baseline characteristics between groups. Subsequently, multivariate logistic regression was used to explore any related factors.
ResultsA total of 977 patients aged from 18 to 80 years were included, excluding those diagnosed with inflammatory bowel disease or diabetes mellitus. Out of this total, 805 patients (82.4%) completed the entire questionnaire. Among the 805 patients, 334 (41.5%) were cases and 471 (58.5%) were controls. Results showed significant differences between cases and controls (χ = 205.2, P < 0.001), with smoking found to be associated with the development of AA/F diseases (odds ratio: 12.331, 95% confidence interval: 8.364-18.179, P < 0.001).
ConclusionsThis study suggested smoking to be a potential risk factor for the development of AA/F diseases in a Chinese population. Consequently, current smoking patients should be informed of this relationship, and further research should be conducted to explore and investigate this further.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anus Diseases ; epidemiology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Rectal Fistula ; epidemiology ; Retrospective Studies ; Risk Factors ; Smoking ; adverse effects ; Surveys and Questionnaires ; Young Adult
8.Sex-specific associations between tobacco smoking and risk of cardiovascular diseases in Chinese adults.
Qian SHEN ; Nan Bo ZHU ; Can Qing YU ; Yu GUO ; Zheng BIAN ; Yun Long TAN ; Pei PEI ; Jun Shi CHEN ; Zheng Ming CHEN ; Jun LYU ; Li Ming LI
Chinese Journal of Epidemiology 2018;39(1):8-15
Objective: To examine the sex-specific associations between tobacco smoking and risk of cardiovascular diseases in Chinese adults. Methods: The present analysis included 487 373 participants from the China Kadoorie Biobank after excluding those with cancer, heart diseases, stroke at baseline survey. The baseline survey was conducted from June 2004 to July 2008. The number of follow-up years was calculated from the time that the participants completed baseline survey to the time of any event: CVD incidence, death, loss of follow-up, or December 31, 2015, whichever occurred first. We used Cox proportional hazards regression models to estimate the HRs and 95%CI of incident cardiovascular diseases with tobacco smoking. Results: During a median follow-up of 8.9 years(a total of 4.1 million person years), we documented 33 947 cases of ischemic heart diseases, 6 048 cases of major coronary diseases, 7 794 cases of intracerebral hemorrhage, and 31 722 cases of cerebral infarction. The prevalence of smoking was much higher in men (67.9%) than in women (2.7%). Smoking increased risk of all subtypes of cardiovascular diseases. Compared with nonsmokers, the multivariable-adjusted HRs (95% CI) for current smokers were 1.54 (1.43-1.66) for major coronary event, 1.28 (1.24-1.32) for ischemic heart disease, 1.18 (1.14-1.22) for cerebral infarction, and 1.07 (1.00-1.15) for intracerebral hemorrhage, respectively. Female smokers tended to have greater risk of developing major coronary event associated with amount of tobacco smoked daily (interaction P=0.006) and age when smoking started (interaction P=0.011). There was no sex difference in these two effects for ischemic heart diseases, intracerebral hemorrhage and cerebral infarction (all interaction P>0.05). Conclusions: This prospective study confirmed increased risk of all subtypes of cardiovascular diseases in current smokers. Smoking was more harmful to women than to men for major coronary event.
Adult
;
Asian People/statistics & numerical data*
;
Cardiovascular Diseases/epidemiology*
;
China/epidemiology*
;
Female
;
Humans
;
Incidence
;
Male
;
Neoplasms/epidemiology*
;
Prevalence
;
Prospective Studies
;
Risk Factors
;
Smoking/ethnology*
;
Smoking Cessation
;
Stroke/epidemiology*
;
Tobacco Smoking/adverse effects*
9.A cross-sectional study on the status of tobacco use among junior middle school students in Shaanxi province.
Y GUO ; A H WANG ; C Y LIU ; C N MU ; B WANG
Chinese Journal of Epidemiology 2018;39(2):184-187
Objective: To understand the rate on tobacco use and associated factors in junior middle school students in Shaanxi province. Methods: We used a multi-stage stratified random sampling method to select students from 30 junior middle schools in 10 areas of Shaanxi province in 2013. All the participants completed a self-administered questionnaire. Results: A total of 4 633 questionnaires were dispatched and 4 298 were qualified for further analysis. The current smoking rate of junior middle school students in Shaanxi was 6.5%, with rate in male (11.1%) higher than that of female students (1.7%). The current smoking rate of students in grade three (9.3%) was higher than those of students in grade one (3.5%) or in grade two (7.0%). The smoking rate of students with pocket money more than 31 Yuan per week was (10.0%) higher than those of students with pocket money less than 10 Yuan (4.6%) or 10-30 Yuan (6.3%) per week. Results from the logistic regression analysis showed that factors as: male, school located in the city, older age, with more pocket money, having smokers in the family and exposure to second hand smoking were high risk factors for current smoking. Conclusion: Rate on current smoking was high in junior middle schools students in Shaanxi, suggesting that comprehensive intervention programs be developed to reduce the rate of tobacco use in junior middle school students.
China/epidemiology*
;
Cities
;
Cross-Sectional Studies
;
Female
;
Humans
;
Male
;
Prevalence
;
Schools
;
Smoking/epidemiology*
;
Students/statistics & numerical data*
;
Surveys and Questionnaires
;
Tobacco Smoke Pollution/adverse effects*
;
Tobacco Use/epidemiology*
10.Study on the current status of smoking, intention of tobacco concession and related risk factors among 18-65-year olds patients with chronic diseases in Beijing.
B JIANG ; A J MA ; H LI ; K FANG ; J DONG ; J XIE ; K QI ; C XIE ; Y ZHOU ; Y ZHAO ; Z DONG
Chinese Journal of Epidemiology 2018;39(4):505-509
Objective: To understand the status, attitude and related risk factors on smoking among 18-65 years old patients with hypertension, diabetes, dyslipidemia, chronic obstructive pulmonary disease (COPD) or asthma in Beijing. Methods: Data was gathered from the 2014 Beijing Non-communicable and Chronic Disease Surveillance Program. Multiple classified cluster sampling method was used and 19 815 participants aged 18-65 were sampled from 16 districts in Beijing. Results: Among all the 18 405 participants, male hypertensive patients showed a higher rate on current smoking than the other groups (χ(2)=17.695, P<0.001). Male patients with dyslipidemia had higher current smoking rate than the other groups (χ(2)=39.292, P<0.001). However, female patients with COPD or with asthma showed higher rate on current smoking than the other groups (χ(2)=6.276, P=0.012), (χ(2)=8.245, P=0.004). Among the smokers, hypertensive patients presented lower rate (χ(2)=20.487, P<0.001) on intention of smoking concession, than the other groups. Patients with COPD showed greater intention in quitting smoking (χ(2)=6.085, P=0.048), than the other groups. Male patients with diabetes (χ(2)=9.219, P=0.010) or dyslipidemia (χ(2)=13.513, P=0.001) who had stopped smoking tobacco appeared having higher rates in keeping the current status. Results from logistic regression analyses showed that smoking was the risk factor for hypertension (OR=1.17), dyslipidemia (OR=1.25), COPD (OR=1.78), and asthma (OR=1.57). Conclusions: Patients with certain kinds of chronic diseases showed higher rate of current smoking and lower rate of quitting. Cigarette consumption appeared an important risk factor for patients with hypertension, dyslipidemia, COPD, or asthma in Beijing.
Adolescent
;
Adult
;
Aged
;
Asthma/epidemiology*
;
Beijing/epidemiology*
;
Chronic Disease/epidemiology*
;
Diabetes Mellitus/epidemiology*
;
Female
;
Humans
;
Hypertension/epidemiology*
;
Intention
;
Male
;
Middle Aged
;
Pulmonary Disease, Chronic Obstructive/epidemiology*
;
Risk Factors
;
Smokers
;
Smoking/psychology*
;
Smoking Cessation
;
Nicotiana/adverse effects*

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