Making smoking history: temporal changes in support for a future smoking ban and increasing taxes in the general population of Denmark

2021 ◽  
pp. tobaccocontrol-2020-056067
Author(s):  
Cecilie Goltermann Toxværd ◽  
Charlotta Pisinger ◽  
Maja Bülow Lykke ◽  
Cathrine Juel Lau
Keyword(s):  
Policy Making ◽  
Smoking Status ◽  
Public Support ◽  
Temporal Changes ◽  
Smoking History ◽  
Smoking Ban ◽  
Tobacco Taxes ◽  
The World ◽  
Never Smokers ◽  
Almost All

BackgroundAn end date for smoking has been adopted in several countries and is now being discussed by governments all over the world. However, little is known about temporal changes in citizens’ support for a future smoking ban.AimTo examine temporal changes in support for a future smoking ban and for increasing taxes on tobacco in Denmark, and to explore whether these changes differ across sex, age, educational attainment, smoking status and between smokers with/without intention to quit.MethodThe study was based on two waves of ‘The Danish Capital Region Health Survey’ conducted in 2013 and 2017. The pooled study sample included 96 521 citizens aged ≥16 years old.ResultsPublic support for a future smoking ban increased from 30.6% in 2013 to 50.3% in 2017, whereas support for increasing tobacco taxes remained unchanged at 59%. Support for a future smoking ban increased significantly in almost all subgroups from 2013 to 2017: Support among daily smokers increased by 27% between 2013 and 2017. Support among never smokers was almost 2.63 times higher than among smokers in 2013 and increased further in 2017 (OR: 2013=2.63; 2017=5.13).ConclusionThis study indicates a readiness to support a future smoking ban and increasing tobacco taxes. Support for a future smoking ban has increased from 2013 to 2017 among both young people and adults. By 2017, about half of the population supported a future smoking ban and increasing tobacco taxes. Findings may help inform policy-making related to endgame strategies.

Effect of smoking on the efficacy of immune checkpoint inhibitors in advanced cancers: A systematic review and meta-analysis.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14109-e14109
Author(s):  
Chia Ching Lee ◽  
Ivan Weng Keong Tham ◽  
Yu Yang Soon ◽  
Jeremy Chee Seong Tey
Keyword(s):  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Smoking Status ◽  
Meta Analysis ◽  
Random Effect ◽  
Standard Of Care ◽  
Smoking History ◽  
P Value ◽  
Never Smokers

e14109 Background: The association between smoking history and benefit from treatment with immune checkpoint inhibitors (ICIs) was unclear. We performed a meta-analysis to assess the efficacy of ICIs in advanced cancers according to smoking status (never-smokers vs ever-smokers). Methods: We searched MEDLINE and EMBASE for randomized controlled trials (RCTs) comparing immunotherapy with standard-of-care in the treatment of advanced cancers which reported overall survival (OS) as the outcome, stratified by smoking status. We calculated pooled hazard ratios (HRs) and 95% confidence interval (CIs) for OS using random-effect models and assessed the differences in OS between the two estimates (never smoker (vs) ever smoker). using a test of heterogeneity. We also performed prespecified subgroup analyses based on disease site, line of therapy, proportion of never-smokers in the trials and trial conclusion to assess the potential association of oncologic and methodologic factors in effect modification of smoking status with the efficacy of ICIs. Results: We identified ten RCTs on non-small cell lung cancer, head and neck, and urothelial cancers, including 4,245 ever-smokers and 972 never-smokers. The difference in the effects of ICIs on OS between ever-smokers (HR, 0.74; 95% CI, 0.66-0.84) and never-smokers (HR, 0.79; 95% CI, 0.61-1.02) was not statistically significant (interaction P-value = 0.69). There were no significant differences in the effects of ICIs on OS between ever-smokers and never smokers in the pre-specified subgroups. Conclusions: There was no significant association between smoking status and improved survival outcome with ICIs in the treatment of advanced cancers. Smoking status should not be used as a biomarker for guiding treatment with immunotherapy.

scholarly journals The multifunctionality of urban horticulture and its integration with the city ecosystem: a brief review of concepts and the case of São Luís

2019 ◽  
Vol 37 (3) ◽  
pp. 252-259
Author(s):  
João Flávio B Gomes ◽  
Renata SB Gomes ◽  
Alex O Souza
Keyword(s):  
Urban Agriculture ◽  
Rural Areas ◽  
Urban Areas ◽  
Technical Assistance ◽  
Public Support ◽  
Urban Ecosystem ◽  
The World ◽  
Belo Horizonte ◽  
Almost All ◽  
The City

ABSTRACT Urban agriculture is currently carried out all over the world. The activity is characterized by its multifunctionality, contributing to food security, preservation of biodiversity, better use of urban spaces, and proper management of soil and water, in addition to contributing to increasing income and improving the quality of life of farmers who live in the cities. In the 1980s and 1990s, urban agriculture gained momentum on the international scene and, from 2005, in Brazil. Some successful experiences in the world (Detroit, Havana, and St. Petersburg) and in Brazil (Teresina, Sao Paulo, and Belo Horizonte) are briefly reported here. Then, we describe in more detail the case of the city of São Luís. The municipality is situated on an island and its rural spaces have characteristics of peri-urban areas. Agricultural production has low expression in municipal GDP (Gross Development Product). The main products are papaya, cassava, beans, bananas, coconut, and passion fruit and, among the vegetables, roselle, chives, coriander, and West Indian gherkin, traditional regional species of Maranhão cuisine. The activity has two primary groups of actors: producers and intermediaries, with 83 and 41% of them, respectively, living in rural areas. Almost all producers (92%) use their area, 79% use some sustainable fertilization practice, and 69% do not use pesticides. Production areas are small and producers need technical assistance. Transport and poor road conditions are the main challenges to bring products to the markets. The reality that came out from our study indicates the lack of public support to urban farmers in São Luís. On the contrary, successful experiences of urban agriculture have in common the convergence of public policies of urban planning, agriculture and supply, education, and health. Urban agriculture is dynamic and must be integrated into the urban ecosystem to make it possible to unveiling new perspectives on the countryside-city relationship.

Smoking history and adherence to cancer-related recommendations in a primary care setting

2021 ◽  
Author(s):  
Roger J Zoorob ◽  
Maria C Mejia ◽  
Jennifer Matas ◽  
Haijun Wang ◽  
Jason L Salemi ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Screening ◽  
Pap Smear ◽  
Task Force ◽  
Smoking Status ◽  
The United States ◽  
Smoking History ◽  
Former Smokers ◽  
Never Smokers ◽  
Primary Care Practices

Abstract Public health prevention efforts have led to overall reductions in mortality from screening-preventable cancers. We explored cancer screening behaviors of smokers, former smokers, and nonsmokers among patients of large primary care practices to discover the relationship between smoking status and previous adherence to the United States Preventive Services Task Force breast, cervical, and colorectal cancer screening recommendations. Our descriptive study of electronic medical record data included 6,029 established primary care patients. Multi-predictor log-binomial regression models yielded prevalence ratios (PRs) and 95% confidence intervals (CIs) to determine associations between smoking status and the likelihood of nonadherence. All models were adjusted for race/ethnicity, age, insurance, primary care specialty, number of comorbidities, and sex. Smoking history was obtained from all participants in January 2020. Current smokers accounted for 4.8%, while 22.7% were former smokers, and 72.5% were never smokers. Current smokers (compared to never smokers) were 63% more likely to be mammogram nonadherent (PR: 1.63, 95% CI: 1.31 to 2.02), 26% more likely to be Pap smear nonadherent (PR: 1.26, 95% CI: 1.04 to 1.53), and 39% more likely to be colonoscopy nonadherent (PR: 1.39, 95% CI: 1.16 to 1.66). Current smokers and former Powered by Editorial Manager and ProduXion Manager from Aries Systems Corporation smokers had on average 2.9 comorbidities while never smokers had on average 2.1 comorbidities. Our findings showed that current smokers experienced significantly lower rates of cancer screening compared to never smokers. Further research is needed to investigate and identify best practices for increasing cancer screening uptake in this population.

Family History of Crohn’s Disease (CD) May Be a Risk Factor for Developing de novo CD following Ileal Pouch Anal Anastomosis (IPAA) for Ulcerative Colitis (UC)

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S150-S150
Author(s):  
H Li ◽  
M Arslan ◽  
Z Fu ◽  
H Lee ◽  
M Mikula
Keyword(s):  
Family History ◽  
De Novo ◽  
Smoking Status ◽  
Smoking History ◽  
Current Smoking Status ◽  
Current Smoking ◽  
History Of ◽  
Former Smokers ◽  
Never Smokers

Abstract Introduction/Objective A subset of patients with an established diagnosis of UC develops signs of CD (de novo CD) following IPAA. While the etiology and risk factors of de novo CD remain largely unknown, preliminary studies have shown controversial results regarding family history of inflammatory bowel disease (IBD) and smoking history. Methods Patients that underwent IPAA for UC, with at least 1 year of follow-up, were identified (n=161; 1996 to 2018). We retrospectively reviewed the electronic medical records. Patients that were diagnosed with de novo CD during the follow-up period were further identified. Smoking history and family history of IBD were evaluated. Chi square test was performed to compare the frequencies. Odds ratio (OR) and 95% confidence intervals (CIs) were estimated by logistic regression model. P<0.05 was considered statistically significant. Results 29 de novo CD were identified. At the time of proctocolectomy, the family history of IBD and smoking history was documented in 152 UC patients including 27 that subsequently developed de novo CD. 23 of 152 had a family history of IBD (12 UC, 9 CD and 2 IBD, NOS). 19/129 (14.7%) UC patients without a family history of any type of IBD, 4/9 (44.4%) with a family history of CD, and 4/12 (33.3%) with a family history of UC developed de novo CD. Patients with a family history of CD were more likely to develop de novo CD post IPAA than those without a family history of any type of IBD (OR 4.63, 95% CI 1.14-18.82, p=0.03). Family history of UC did not correlate with development of de novo CD (OR 2.90; 95% CI 0.79-10.57, p=0.108). At the time of proctocoletomy, 11 were current smokers, 25 were former smokers, and 116 never smoked. In de novo CD group, there were 4/27 (14.8 %) former smokers and 23/27 (85.2 %) never smokers. No de novo CD patient was current smoker. In the UC group that remained as UC following IPAA, 11/125 (8.8%) were current smokers, 21/125 (16.8 %) former smokers, and 93/125 (74.4 %) were never smokers. Current smoking status was not associated with development of de novo CD (p = 0.214). Conclusion Family history of CD may be a risk factor for developing de novo CD following IPAA for UC. Current smoking status was not associated with development of de novo CD following IPAA for UC.

scholarly journals Smoking and Breast Cancer Recurrence after Breast Conservation Therapy

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Jennifer D. Bishop ◽  
Brigid K. Killelea ◽  
Anees B. Chagpar ◽  
Nina R. Horowitz ◽  
Donald R. Lannin
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
African American Women ◽  
Smoking Status ◽  
Breast Conservation ◽  
Tumor Stage ◽  
Partial Mastectomy ◽  
Smoking History ◽  
Never Smokers

Background. Prior studies have shown earlier recurrence and decreased survival in patients with head and neck cancer who smoked while undergoing radiation therapy. The purpose of the current study was to determine whether smoking status at the time of partial mastectomy and radiation therapy for breast cancer affected recurrence or survival.Method. A single institution retrospective chart review was performed to correlate smoking status with patient demographics, tumor characteristics, and outcomes for patients undergoing partial mastectomy and radiation therapy.Results. There were 624 patients who underwent breast conservation surgery between 2002 and 2010 for whom smoking history and follow-up data were available. Smoking status was associated with race, patient age, and tumor stage, but not with grade, histology, or receptor status. African American women were more likely to be current smokers (22% versus 7%,P<0.001). With a mean follow-up of 45 months, recurrence was significantly higher in current smokers compared to former or never smokers (P=0.039). In a multivariate model adjusted for race and tumor stage, recurrence among current smokers was 6.7 times that of never smokers (CI 2.0–22.4).Conclusions. Although the numbers are small, this study suggests that smoking may negatively influence recurrence rates after partial mastectomy and radiation therapy. A larger study is needed to confirm these observations.

The predictive factors and patient-selection associated with the survival benefits of gefitinib in patients with advanced non-small cell lung cancer (NSCLC)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 17020-17020
Author(s):  
Y. Funada ◽  
M. Satouchi ◽  
T. Miyagawa ◽  
Y. Urata ◽  
T. Shimada ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Survival Benefit ◽  
Smoking Status ◽  
Performance Status ◽  
Univariate Analysis ◽  
Growth Factor Receptor ◽  
Smoking History ◽  
Potential Factors ◽  
Never Smokers ◽  
Histological Factors

17020 Background: Gefitinib, an inhibitor of epidermal growth factor receptor (EGFR) tyrosine kinase, has shown meaningful antitumor activity for advanced NSCLC. Survival benefit of treatment with gefitinib has not been shown in unselected patients, however heterogeneity in survival outcomes between sub-group (histological types, gender, smoking status and ethnicity) of patients has been observed. The aim of this study was to identify the potential predictive features associated with the survival benefit of treatment with gefitinib. Methods: All NSCLC patients who began taking gefitinib during the period from July 2002 until July 2005 in our institute were retrospectively reviewed. Potential factors analyzed included age, gender, smoking history, performance status (PS), histology, stage, and prior chemotherapy. Results: Overall 221 patients were analyzed. The overall response rate of gefitinib was 26.7%. Median survival time (MST) was 8.0 months. MST of patients whose tumor response was partial response (PR) was 34.5 months. Univariate analysis revealed that the predictive factors of favorable survival were female (p = 0.001), never-smoker (p < 0.0001), good PS (p < 0.0001) and adenocarcinoma (p < 0.0001). Multivariate analysis showed that never-smoking history (p = 0.005), adenocarcinoma (p = 0.004), and better PS (P < 0.001) were significant independent predictors of long survival. The Brinkman index (BI), number of cigarettes per day multiplied by number of years smoked, was associated with survival benefit. MST was 17.6 months in the BI = 0 group (never-smokers), 9.7 months in 1 ≤BI <500, 6.9 months in 500 ≤BI <1000, 4.4 months in 1000 ≤BI <1500, and 4.0 months in BI ≥1500. Conclusion: Never-smokers and adenocarcinoma are predictive factors for prolonged survival. As for smoking status, lower BI is associated with better prognosis after treatment with gefitinib. Therefore, histological factors and smoking status must be considered when treating with gefitinib. No significant financial relationships to disclose.

Smoking history and PD-1/PDL-1 pathway blockade: Predicting response to treatment in metastatic cancer.

2019 ◽  
Vol 37 (8_suppl) ◽  
pp. 95-95 ◽  
Author(s):  
Caitlin Marie Sullivan ◽  
Jonathan Lu ◽  
John Ross Kucharczyk ◽  
Diana Vesselinovitch ◽  
Neharika Khurana ◽  
...  
Keyword(s):  
Treatment Response ◽  
Smoking Status ◽  
Metastatic Cancer ◽  
Post Treatment ◽  
Inhibitor Therapy ◽  
Response To Treatment ◽  
Smoking History ◽  
Heavy Smoking ◽  
Never Smokers ◽  
Heavy Smokers

95 Background: Identifying patients who will benefit from immune-checkpoint inhibitor therapy is a challenge as proven predicative indicators remain to be elucidated. High tumor mutational burden (TMB) represents a possible biomarker for response to PD1 blockade such as in nivolumab or pembrolizumab. Genomic analyses have shown that patients with heavy smoking history are more likely to have high TMB. However smoking status alone has not been examined independently in relation to treatment response. We sought to determine whether a relationship existed between smoking history and response to treatment in metastatic non-small cell lung cancer (NSCLC), metastatic renal cell carcinoma (mRCC) and metastatic melanoma (mMelanoma). Methods: A retrospective analysis was conducted of Ochsner Health System patients with mRCC, mMelanoma, and NSCLC receiving a minimum of two cycles of nivolumab or pembrolizumab between 12/2014 and 01/2018. Pre- and post-treatment target lesions were analyzed using RECIST criteria to calculate best response to treatment. Patient demographic information was gathered including age, sex, smoking history, and performance status pre and post treatment. Kaplan-Meier method was used to estimate progression free survival (PFS) and overall survival (OS) outcomes. Results: Heavy smokers (>10 pack-years) had a higher response to immunotherapy than light (< 10 years) and never smokers (p = 0.0500). Heavy smokers with NSCLC treated with immuno-therapy also had significantly improved OS compared to light smokers with NSCLC (p=0.003). mRCC immuno-therapy patients with heavy smoking history showed increased PFS compared to light/never smokers (p=0.026). Conclusions: In summary, in response to PD-1 blockade heavy smokers showed improved survival compared to light and never smokers suggesting smoking history may represent a potential predictor of treatment response to PD-1 inhibitor therapy.[Table: see text]

scholarly journals Sex Difference and Smoking Effect of Lung Cancer Incidence in Asian Population

Cancers ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 113
Author(s):  
Boyoung Park ◽  
Yeol Kim ◽  
Jaeho Lee ◽  
Nayoung Lee ◽  
Seung Hun Jang
Keyword(s):  
Lung Cancer ◽  
Sex Difference ◽  
Cancer Incidence ◽  
Screening Program ◽  
Smoking Status ◽  
Asian Population ◽  
Smoking History ◽  
Lung Cancer Incidence ◽  
Male And Female ◽  
Never Smokers

This study analyzed the sex difference in the effect of smoking exposure on lung cancer in terms of absolute and relative risks despite the increasing lung cancer incidence in Asian female never smokers. A retrospective cohort study was conducted on individuals aged 40–79 years who participated in the national health screening program in 2007 and 2008 with linkage to the Korea Central Cancer Registry records. We evaluated sex differences in the age-standardized incidence rate (ASR) of lung cancer by smoking history and the hazard ratio (HR) after adjusting for potential confounders. ASRs for male and female never smokers were 92.5 and 38.3 per 100,000 person-years, respectively (rate ratio (RR) = 2.4; 95% confidence interval (CI) = 2.3–2.5). ASRs for male and female current smokers with a 30 pack-year smoking history were 305.3 and 188.4 per 100,000 person-years, respectively (RR = 1.6; 95% CI = 1.3–2.0). Smoking was significantly associated with lung cancer risk for both sexes. HRs for former smokers versus never smokers were 1.27 (95% CI = 1.23–1.33) for men and 1.43 (95% CI = 1.16–1.81) for women. HRs for current smokers versus never smokers were 2.71 (95% CI = 2.63–2.79) for men and 2.70 (95% CI = 2.48–2.94) for women. HRs for lung cancer increased similarly in both men and women according to smoking status. However, among Korean individuals with comparable smoking statuses, lung cancer incidence is higher in men than in women. Sex should be considered in combination with smoking history in the selection of a lung cancer screening target population.

scholarly journals Lung Cancer Characteristics in the World Trade Center Environmental Health Center

2021 ◽  
Vol 18 (5) ◽  
pp. 2689
Author(s):  
Nedim Durmus ◽  
Sultan Pehlivan ◽  
Yian Zhang ◽  
Yongzhao Shao ◽  
Alan A. Arslan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Environmental Health ◽  
Health Center ◽  
World Trade ◽  
World Trade Center ◽  
Smoking History ◽  
Community Members ◽  
The World ◽  
Trade Center ◽  
Never Smokers

The destruction of the World Trade Center (WTC) towers on 11 September 2001 resulted in acute and chronic dust and fume exposures to community members, including local workers and residents, with well-described aerodigestive adverse health effects. This study aimed to characterize lung cancer in the WTC Environmental Health Center (WTC EHC) focusing on gender and smoking history. WTC EHC patients undergo an initial evaluation that includes WTC exposure information, demographics, and tobacco use. Detailed cancer characteristics are recorded from pathology reports. As of 31 December 2019, 248 WTC EHC patients had a diagnosis of lung cancer. More patients with lung cancer were women (57%) compared to men (43%). Many cases (47% women, 51% men) reported acute dust cloud exposure. Thirty-seven percent of lung cancer cases with available smoking history were never-smokers (≤1 pack-years) and 42% had a ≤5 pack-year history. The median age of cancer diagnosis in never-smoking women was 61 years compared to 66 years in men. Adenocarcinoma was more common in never-smokers compared to ever-smokers (72% vs. 65%) and in women compared to men (70% vs. 65%). We provide an initial description of lung cancers in local community members with documented exposure to the WTC dust and fumes.

Cancer patient (pt) attitudes and preferences towards smoking status assessment.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 177-177
Author(s):  
Lawson Eng ◽  
Sophia Liu ◽  
Qihuang Zhang ◽  
Delaram Farzanfar ◽  
Robin Milne ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Smoking Status ◽  
Clinic Visit ◽  
Smoking History ◽  
Second Hand Smoke ◽  
Logistic Regression Models ◽  
Second Hand Smoke Exposure ◽  
Status Assessment ◽  
Never Smokers ◽  
Routine Assessment

177 Background: Continued smoking after a cancer diagnosis is associated with poorer outcomes. Understanding pt attitudes towards smoking status assessment will help with integrating smoking cessation programs into survivorship care. Methods: Cancer pts were surveyed on their smoking history, assessment rates and attitudes/preferences towards smoking status assessment. Multivariate logistic regression models assessed for factors associated with screening preferences. Results: Among 501 pts, 115 smoked at diagnosis, 60% quit after; 53% had a tobacco related (lung/head and neck) cancer (TRC); 40% reported that their smoking status was assessed only on their first clinic visit, while 12% were assessed at all visits. Most felt smoking status should be assessed at the first visit (95%), while half (58%) felt it should be assessed each visit. Most felt comfortable with being assessed (96%), felt it was important for clinicians to be aware of tobacco use (98%) and that smoking cessation discussions should occur at the first visit (87%). Most preferred being assessed by their oncologist (88%); less preferred being asked by another healthcare provider (44%), on paper (29%) or e-surveys (32%). Compared to ex/never smokers, current smokers were assessed more often at most/every visit (36% vs 20%) and were less comfortable being assessed (88% vs 98%). Among current smokers, lung cancer pts were more agreeable being assessed each visit compared to head/neck (aOR 2.48 95% CI [0.9-6.5] P = 0.06) and non TRCs (aOR 2.63 [1.0-6.8] P = 0.05). Among all, pts who are older (aOR 1.03 [1.0-1.1]), curative (aOR 1.92 [1.1-3.2]) and smoked less (aOR 0.98 per pkyr [0.97-0.99]) were more agreeable to routine assessment. Most pts also felt oncologists should screen for second hand smoke exposure (92%), felt its assessment was important (93%) and should help others who smoke to quit (68%). Many felt that tobacco cessation programs for both pts (75%) and others who around them who smoke (65%) should be routine cancer care. Conclusions: Most cancer pts felt that assessment of smoking status was important, were comfortable being assessed and preferred direct assessment by their oncologist. Routine screening of those currently smoking is recommended to help with cessation.

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