Smoking status on subsequent readmission to hospital: The impact of inpatient brief interventions for smokers

Abstract Research shows that over 80% of smokers start their habit under the age of 18. A few years ago young people undertook risky behaviors related to nicotine initiation mainly by smoking cigarettes. Today, next to traditional tobacco products, electronic cigarettes are becoming more and more popular. Due to the prevalence of new forms of nicotine addiction, modification of anti-tobacco prevention programs is required. The purpose of the research was exploration - learning the opinions and attitudes of young people towards e-cigarettes. The qualitative study was conducted using the FGI method (focus group interview). The meetings were modereted by specially trained psychologists. 48 students participated in the meetings of six focus groups, divided by gender and smoking status (smokers/non-smokers). The participants are young people aged 15-19, attending high schools in Warsaw, Kielce and Lublin. In conversations, young people emphasized the impact of e-cigarettes in smoking initiation - it usually occurs at the age of 12-14. E-cigarettes are perceived as cigarettes “for younger”, non-addictive, less serious, providing more entertainment. 'Cloud chasing' is particularly popular. They perform social functions - they are helpful in establishing relationships. Teenagers do not see the harmfulness of e-cigarettes. Participants mentioned their advantages over traditional tobacco products - they can be smoked everywhere and do not leave an unpleasant smell. Some of the respondents admit to the simultaneous use of electronic and traditional cigarettes. Moreover, many parents allow children to smoke electronic cigarettes. Vaping have become a natural way to relaxation and socialization for adolescents. E-cigarettes do not have such a negative connotation as traditional tobacco products. Young people do not see them as harmful, which is a challenge for effective preventive measures. Key messages Adolescents do not see e-cigarettes as harmful, which is a challenge for effective preventive measures. Vaping have become more and more popular - it's natural way to relaxation and socialization for young people.

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Nonunion Rates After Anterior Cervical Discectomy and Fusion: Comparison of Polyetheretherketone vs Structural Allograft Implants

Neurosurgery ◽

10.1093/neuros/nyab079 ◽

2021 ◽

Author(s):

Won Hyung A Ryu ◽

Dominick Richards ◽

Mena G Kerolus ◽

Adewale A Bakare ◽

Ryan Khanna ◽

...

Keyword(s):

Smoking Status ◽

Posterior Instrumentation ◽

Patient Reported Outcome ◽

Anterior Cervical Discectomy ◽

Successful Outcome ◽

Cervical Discectomy ◽

Structural Allograft ◽

Modifiable Factors ◽

Patient Reported ◽

The Impact

Abstract BACKGROUND Although advances in implant materials, such as polyetheretherketone (PEEK), have been developed aimed to improve outcome after anterior cervical discectomy and fusion (ACDF), it is essential to confirm whether these changes translate into clinically important sustained benefits. OBJECTIVE To compare the radiographic and clinical outcomes of patients undergoing up to 3-level ACDF with PEEK vs structural allograft implants. METHODS In this cohort study, radiographic and symptomatic nonunion rates were compared in consecutive patients who underwent 1 to 3 level ACDF with allograft or PEEK implant. Prospectively collected clinical data and patient-reported outcome (PRO) scores were compared between the allograft and PEEK groups. Regression analysis was performed to determine the predictors of nonunion. RESULTS In total, 194 of 404 patients met the inclusion criteria (79% allograft vs 21% PEEK). Preoperative demographic variables were comparable between the 2 groups except for age. The rate of radiographic nonunion was higher with PEEK implants (39% vs 27%, P = .0035). However, a higher proportion of nonunion in the allograft cohort required posterior instrumentation (14% vs 3%, P = .039). Patients with multilevel procedures and PEEK implants had up to 5.8 times the risk of radiographic nonunion, whereas younger patients, active smokers, and multilevel procedures were at higher risk of symptomatic nonunion. CONCLUSION Along with implant material, factors such as younger age, active smoking status, and the number of operated levels were independent predictors of fusion failure. Given the impact of nonunion on PRO, perioperative optimization of modifiable factors and surgical planning are essential to ensure a successful outcome.

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The Impact of Smoking on Clinical Results Following the Rotator Cuff and Biceps Tendon Complex Arthroscopic Surgery

Journal of Clinical Medicine ◽

10.3390/jcm10040599 ◽

2021 ◽

Vol 10 (4) ◽

pp. 599

Author(s):

Jan Zabrzyński ◽

Gazi Huri ◽

Maciej Gagat ◽

Łukasz Łapaj ◽

Alper Yataganbaba ◽

...

Keyword(s):

Rotator Cuff ◽

Functional Outcomes ◽

Shoulder Arthroscopy ◽

Smoking Status ◽

Biceps Tendon ◽

Arthroscopic Surgery ◽

Rotator Cuff Tears ◽

Shoulder Injuries ◽

The Impact

The purpose of this study was to investigate the association of smoking and functional outcomes after arthroscopic treatment of complex shoulder injuries: rotator cuff tears (RCTs) with biceps tendon (LHBT) tears. This retrospective case-control study has been conducted on a cohort of patients who underwent shoulder arthroscopy between 2015 and 2017 due to complex injury treatment. The outcomes were assessed using the American Shoulder and Elbow Surgeons Score (ASES), the University of California at Los Angeles (UCLA) Shoulder Score, need for non-steroid anti-inflammatory drugs (NSAIDs) consumption and the visual analog scale (VAS). Complications and changes in smoking status were also noted. A cohort of 59 patients underwent shoulder arthroscopy, due to complex LHBT pathology and RCTs, and were enrolled in the final follow-up examination; with mean duration of 26.03 months. According to smoking status, 27 of patients were classified as smokers, and the remaining 32 were non-smokers. In the examined cohort, 36 patients underwent the LHBT tenotomy and 23 tenodesis. We observed a relationship between smoking status and distribution of various RCTs (p < 0.0001). The mean postoperative ASES and UCLA scores were 80.81 and 30.18 in the smoker’s group and 84.06 and 30.93 in the non-smoker’s group, respectively. There were no statistically significant differences in pre/postoperative ASES and postoperative UCLA scores between smokers and non-smokers (p > 0.05). The VAS was significantly lower in the non-smokers’ group (p = 0.0021). Multi-tendon injuries of the shoulder are a serious challenge for surgeons, and to obtain an excellent functional outcome, we need to limit the negative risk factors, including smoking. Furthermore, there is a significant association between smoking and the occurrence of massive rotator cuff tears, and the pain level measured by the VAS. Simultaneous surgical treatment of RC and LHBT lesions in the smoker population allowed us to obtain the functional outcomes approximated to non-smokers in the long-term follow-up. Of course, we cannot assert that smoking is the real cause of all complications, however, we may assume that this is a very important, negative factor in shoulder arthroscopy.

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DEFINING ELIGIBILITY CRITERIA FOR FUNDING POLICIES AROUND IN VITRO FERTILIZATION

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462315000628 ◽

2015 ◽

Vol 31 (6) ◽

pp. 426-433 ◽

Cited By ~ 1

Author(s):

Devidas Menon ◽

Alexa A. Nardelli ◽

Tarek Motan ◽

Kristin Klein ◽

Tania Stafinski

Keyword(s):

Maternal Age ◽

Smoking Status ◽

Cochrane Collaboration ◽

Assessment Tools ◽

Paternal Age ◽

Eligibility Criteria ◽

Vitro Fertilization ◽

Funding Policies ◽

The Impact

Objectives: This review aims to assess the state of the science around the potential impact of certain patient characteristics on the safety and effectiveness of in vitro fertilization (IVF).Methods: Following Cochrane Collaboration guidelines and the PRISMA statement, a comprehensive systematic review of reviews and recent primary studies examining the impact of paternal age and maternal age, smoking, and body mass index (BMI) on the safety and effectiveness of IVF was performed. Papers, published between January 2007 and June 2014, were independently reviewed and critically appraised by two researchers using published quality assessment tools for reviews and primary studies. Due to heterogeneity across papers (different study designs and patient selection criteria), a qualitative analysis of extracted information was performed.Results: Seventeen papers (ten systematic reviews and seven primary studies) were included. They comprised evidence from retrospective observational studies in which maternal age, BMI, and smoking status were explored as part of secondary analyses of larger studies. The majority of papers found that the likelihood of achieving a pregnancy was lower among women who were >40 years, had a BMI ≥ 25 and smoked. Advanced maternal age and BMI were also associated with higher rates of preterm birth and low birth weight.Conclusions: Based on available evidence, it may be appropriate to consider “maternal age” and “morbid obesity” in public funding policies that aim to maximize the effectiveness of IVF. However, given inconsistencies in the effect of smoking across different pregnancy-related outcomes, support for incorporating it into funding conditions appears weak.

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Impact of flavours, device, nicotine levels and price on adult e-cigarette users’ tobacco and nicotine product choices

Tobacco Control ◽

10.1136/tobaccocontrol-2021-056599 ◽

2021 ◽

pp. tobaccocontrol-2021-056599

Author(s):

Yong Yang ◽

Eric N. Lindblom ◽

Ramzi G. Salloum ◽

Kenneth D. Ward

Keyword(s):

Open System ◽

Closed System ◽

Smoking Status ◽

Discrete Choice Experiments ◽

User Characteristics ◽

Product Attributes ◽

Product Choices ◽

Nicotine Level ◽

The Difference ◽

The Impact

IntroductionTo understand the impact of e-cigarette devices, flavours, nicotine levels and prices on adult e-cigarette users’ choices among closed-system and open-system e-cigarettes, cigarettes and heated tobacco products (HTPs).MethodsOnline discrete choice experiments were conducted among adult (≥18 years) e-cigarette users (n=2642) in August 2020. Conditional logit regressions were used to assess the relative impact of product attributes and the interactions between product attributes and user characteristics, with stratified analyses to examine differences by smoking status and primarily used e-cigarette device and flavour.ResultsOn average, participants preferred non-tobacco and non-menthol flavours most, preferred open-system over closed-system e-cigarettes and preferred regular nicotine level over low nicotine level. However, the preference varied by demographics, smoking status and the primarily used e-cigarette device and flavour. The differences in preference among products/devices were larger than the difference among flavours or nicotine levels. Participants who primarily used closed-system e-cigarettes exhibited similar preferences for closed-system and open-system e-cigarettes, but those who primarily used open-system e-cigarettes preferred much more open-system over closed-system e-cigarettes. HTP was the least preferred product, much lower than cigarettes in general, but participants living in states where IQOS is being sold had similar preferences to cigarettes and HTPs.ConclusionsPeople are unlikely to switch to another product/device because of the restriction of flavour or nicotine level. If non-tobacco and non-menthol flavours were banned from open-system e-cigarettes, users may switch to menthol flavour e-cigarettes. Intervention strategies should be tailored to specific groups.

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Support for cigarette filter waste policies among US adults

Tobacco Control ◽

10.1136/tobaccocontrol-2020-056451 ◽

2021 ◽

pp. tobaccocontrol-2020-056451

Author(s):

Minal Patel ◽

Alison F Cuccia ◽

Shanell Folger ◽

Adam F Benson ◽

Donna Vallone ◽

...

Keyword(s):

Smoking Status ◽

Population Based ◽

Tobacco Product ◽

Cross Sectional ◽

Cigarette Filter ◽

Logistic Regression Models ◽

Knowledge And Beliefs ◽

Cigarette Butts ◽

Using Data ◽

The Impact

IntroductionLittle is known on whether cigarette filter-related knowledge or beliefs are associated with support for policies to reduce their environmental impact.MethodsA cross-sectional, population-based sample of US adults aged 18–64 years (n=2979) was used to evaluate filter-related knowledge and beliefs by smoking status using data collected between 24 October 2018 and 17 December 2018. Multivariate logistic regression models explored whether these knowledge and belief items were associated with support for two policies, a US$0.75 litter fee and a ban on sales of filtered cigarettes, controlling for demographic characteristics and smoking status.ResultsRegardless of smoking status, 71% did not know plastic was a cigarette filter component and 20% believed filters were biodegradable. Overall, 23% believed filters reduce health harms and 60% believed filters make it easier to smoke; 90% believed cigarette butts are harmful to the environment. Individuals believing cigarette butts harmed the environment were more likely to support a litter fee (adjusted OR (aOR)=2.33, 95% CI: 1.71 to 3.17). Individuals believing that filters are not biodegradable had higher odds of supporting a litter fee (OR=1.47, 95% CI: 1.15 to 1.88). Respondents believing that filters do not make cigarettes less harmful were more likely to support a litter fee (aOR=1.50, 95% CI: 1.20 to 1.88) and filter ban (aOR=2.03, 95% CI: 1.64 to 2.50). Belief that filters make it easier to smoke was associated with decreased support for a filter ban (aOR=0.69, 95% CI: 0.58 to 0.83).ConclusionsComprehensive efforts are needed to educate the public about the impact of cigarette filters in order to build support for effective tobacco product waste policy.

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Smoking Cessation during Pregnancy and Relapse after Childbirth: The Impact of the Grandmother’s Smoking Status

Maternal and Child Health Journal ◽

10.1007/s10995-007-0258-4 ◽

2007 ◽

Vol 12 (4) ◽

pp. 525-533 ◽

Cited By ~ 14

Author(s):

Sakari Lemola ◽

Alexander Grob

Keyword(s):

Smoking Cessation ◽

Smoking Status ◽

The Impact

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Abstract TP196: New Zealand Workforce Stroke Incidence: Urban and Rural Risk Factor Evaluation

Stroke ◽

10.1161/str.44.suppl_1.atp196 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Hope E Buell ◽

Patricia Metcalf ◽

Daniel Exeter

Keyword(s):

Risk Factors ◽

New Zealand ◽

Stroke Risk ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Smoking Status ◽

Prior History ◽

Stroke Incidence ◽

Stroke Outcomes ◽

The Impact

This analysis aims to assess the impact of urban and rural risk factors on a model of stroke incidence in a New Zealand workforce population. The New Zealand study consisted of 4,926 subjects prospectively enrolled at 46 worksites. The subjects were aged 40-78 years at baseline and had no prior history of stroke. This prospective study defines stroke events experienced by the study subjects during follow-up between 1988 and 2012 based on hospital admission coding. Proportional hazards regression models were fit using baseline characteristics. The difference in stroke outcomes for urban and rural worksites was also evaluated. Results demonstrate that baseline demographic, physical exam, and behavioural measures impact stroke outcomes. While the baseline distribution of stroke risk factors such as Pacific Island ethnicity, smoking status, and increased blood pressure indicates a potentially higher risk of stroke in the rural population, the proportional hazards model does not identify increased stroke risk for rural workers. Additional analysis of the diet, exercise and Quality of Life measures for these subjects may provide further information into the stroke risk profiles of individuals working in different locales.

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Abstract 15844: Plasma Parathyroid Hormone is Independently Related to 24-Hour Pulse Wave Velocity in Patients With Primary Hyperparathyroidism - Insights fFom The EPATH Study

Circulation ◽

10.1161/circ.130.suppl_2.15844 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Julia Wetzel ◽

Nicolas Verheyen ◽

Evgeny Belyavskiy ◽

Albrecht Schmidt ◽

Caterina Colantonio ◽

...

Keyword(s):

Parathyroid Hormone ◽

Primary Hyperparathyroidism ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Vascular Function ◽

Pulse Wave ◽

Smoking Status ◽

Strong Predictor ◽

Double Blind ◽

The Impact

Introduction: Accumulating evidence indicated that high parathyroid hormone (PTH) is associated with increased cardiovascular risk. The impact of PTH on vascular structure and function is, however, still unclear. We evaluated the relationship between pulse wave velocity (PWV) as a novel index of arterial stiffness and circulating levels of PTH in patients with PTH-excess (primary hyperparathyroidism (pHPT)). Methods and Results: We analyzed baseline data of the ongoing randomized, double-blind, placebo-controlled “Effect of Eplerenone on Parathyroid Hormone Levels in Patients with Primary Hyperparathyroidism” (EPATH) study. Inclusion criteria were age of at least 18 years and a diagnosis of pHPT according to international guidelines. Standardized blood sampling was performed after an overnight fast and 24h PWV was measured by a validated non-invasive device for ambulatory hemodynamic monitoring (Mobil O Graph, I.E.M., Stolberg, Germany). Our analysis comprised 92 pHPT patients with a mean age of 68.5 +/- 9.7 years (71 % females) and a median PTH of 102 (IQR 81 - 132) pg/ml. Mean 24h PWV was 9.8 +/- 1.8 m/s, mean daytime and mean nighttime PWV were 10.0 +/- 1.7 m/s and 9.6 +/- 1.8 m/s, respectively. In multivariate linear regression analyses adjusted for age, sex, body mass index, smoking status, mean systolic and mean diastolic 24h blood pressure, antihypertensive medication, type 2 diabetes, 25-hydroxyvitamin D, serum calcium, intake of cinacalcet and fasting serum cholesterol PTH emerged as a strong predictor of mean 24h PWV (ß=0.30, p=0.012), daytime PWV and nighttime PWV (ß=0.30, p=0.011 and ß=0.30, p=0.019, respectively). Conclusion: In a selective cohort of patients with pHPT plasma PTH was strongly related to 24h PWV. These data strengthen the notion that PTH may impact on vascular function. Interventional and mechanistic trials are needed to evaluate modulatory effects on vasculature in patients with high PTH.

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Abstract P260: Can Metabolic Syndrome Predict the Incidence of Silent Myocardial Infarction? An Analysis From the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽

10.1161/circ.137.suppl_1.p260 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Yong Shen ◽

Stephanie Filipp ◽

Matthew J Gurka ◽

Mark D DeBoer ◽

Thomas A Pearson

Keyword(s):

Myocardial Infarction ◽

Metabolic Syndrome ◽

Severity Score ◽

Smoking Status ◽

Heart Diseases ◽

Significant Risk ◽

Predictive Tool ◽

Aric Study ◽

The Impact ◽

Silent Myocardial Infarction

Introduction: Diabetes patients are at risk for clinical Myocardial Infarction (MI) and have a larger proportion being silent Myocardial Infarction. However, less is known about the impact of Metabolic Syndrome (MetS, also known as prediabetes) on the incidence of silent MI. Here, we studied whether the degree of MetS severity can be predictive for future risk of silent MI. Methods: 12,527 ARIC study participants who are free of coronary heart diseases (CHD) and diabetes at baseline (1987-1989) were included for the analysis. Silent MI was determined by ECG serial changes of MI without prior clinical history of MI. A continuous MetS severity score was formulated from the integration of MetS components to assess its prediction for future silent MI and clinical MI. Results and Conclusions: 458 participants (3.7%, 458 of 12,527) developed clinical MI and 87 (0.7%, 87 of 12,527) were diagnosed with silent MI until ARIC visit 4 (1996-1998). Within the 10 years follow-up period, gender, smoking status, MetS components (waist circumference, blood pressure, HDL cholesterol) and the integrated MetS severity score were identified as significant risk factors for the incidence of both silent MI and clinical MI. Participants with MetS had a significant adjusted HR for incident silent MI (HR = 1.98, 95% CI: [1.30, 3.02], p=0.0015) as compared to clinical MI (HR = 1.67, 95% CI: [1.39, 2.00], p<0.0001). The 10-year risk scoring equations of silent MI and clinical MI were constructed as a multivariate predictive tool based on MetS severity score. In conclusion, higher MetS severity score is associated with further risk of both clinical and silent MI, identifying the potential clinical application of MetS severity score in MI prevention.

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