Chest Image Staging and Prevalence of Current Smoking Among Hospitalized COVID-19 Patients in Turkey

Abstract Background Tobacco use accounts for half the difference in life expectancy across groups of low and high socioeconomic status. The objective was to assess whether social inequalities in smoking in Canada-born young adults are also apparent among same-age immigrants, a group often viewed as disadvantaged and vulnerable to multiple health issues. Methods Data were drawn from the Interdisciplinary Study of Inequalities in Smoking, a longitudinal investigation of social inequalities in smoking in Montreal, Canada. The sample included 2,077 young adults age 18-25 (56.6% female; 18.9% immigrants). Immigrants had been in Canada 11.6 (SD 6.4) years on average. The association between level of education and current smoking was examined separately in immigrants and non-immigrants in multivariate logistic regression analyses controlling for covariates. Results Twenty percent of immigrants were current smokers compared to 24% of non-immigrants. In immigrants, relative to those who were university-educated, the adjusted odds ratio (OR) (95% confidence interval) for current smoking was 1.2 (0.6, 2.3) among those with pre-university or vocational training, and 1.5 (0.7, 2.9) among those with high school education only. In non-immigrants, the adjusted ORs were 1.9 (1.4, 2.5) among those with pre-university or vocational training and 4.0 (2.9, 5.5) among those with high school education. Conclusions Despite a mean of over 10 years in Canada, young adults who immigrated to Canada did not manifest the strong social gradient in smoking apparent in non-immigrants. Identification of factors that protect immigrants from manifesting marked social inequalities in smoking could inform the development of smoking preventive intervention sensitive to social inequalities in smoking. Key messages A social gradient in smoking apparent in Canada-born young adults was not observed in same-age immigrants. Factors that protect immigrants against social inequalities in smoking should be identified.

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Socio-economic differences in smoking among adolescents in a school-based smoking intervention: The X:IT II study

Scandinavian Journal of Public Health ◽

10.1177/14034948211007683 ◽

2021 ◽

pp. 140349482110076

Author(s):

Lotus S. Bast ◽

Lisbeth Lund ◽

Stine G. LauemØller ◽

Simone G. Kjeld ◽

Pernille Due ◽

...

Keyword(s):

Preventive Intervention ◽

First Year ◽

Difference In Difference ◽

Current Smoking ◽

Smoking Intervention ◽

School Time ◽

School Based ◽

Inequality In Health ◽

Baseline Response

Aims: Socio-economic inequalities in health behaviour may be influenced by health interventions. We examined whether the X:IT II intervention, aiming at preventing smoking in adolescence, was equally effective among students from different occupational social classes (OSC). Methods: We used data from the multi-component school-based smoking preventive intervention X:IT II, targeting 13- to 15-year-olds in Denmark. The intervention was tested in 46 schools with 2307 eligible students at baseline (response rate=86.6%) and had three main intervention components: smoke-free school time, smoke-free curriculum and parental involvement. We used a difference-in-difference design and estimated the change in current smoking after the first year of implementation in high versus low OSC. Analyses were based on available cases ( N=1190) and imputation of missing data at follow-up ( N=1967). Results: We found that 1% of the students from high OSC and 4.9% from low OSC were smokers at baseline (imputed data), and 8.2% of the students from high OSC and 12.2% from low OSC were smokers at follow-up. Difference-in-difference estimates were close to zero, indicating no differential trajectory. Conclusions: As intended, the X:IT II intervention, designed to apply equally to students from all socio-economic groups, did not seem to create different trajectories in current smoking among adolescents in high and low socio-economic groups. To diminish social inequality in health, future studies should carefully consider the ability to affect all socio-economic groups equally, or even to appeal mainly to participants from lower socio-economic groups, as they are often the ones most in need of intervention.

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Social Determinants of Cigarette Smoking among American Women during Pregnancy

Women ◽

10.3390/women1030012 ◽

2021 ◽

Vol 1 (3) ◽

pp. 128-136

Author(s):

Shervin Assari ◽

Shanika Boyce

Keyword(s):

Cigarette Smoking ◽

Educational Attainment ◽

Protective Effect ◽

Pregnant Women ◽

Ethnic Minority ◽

Current Smoking ◽

Smoking During Pregnancy ◽

American Women ◽

Poverty Status ◽

Racial And Ethnic Minority

Educational attainment is among the most substantial protective factors against cigarette smoking, including during pregnancy. Although Minorities’ Diminished Returns (MDRs) of educational attainment, defined as weaker protective effect of education for racial and ethnic minority groups compared to Non-Hispanic Whites, has been demonstrated in previous studies; such MDRs are not tested for cigarette smoking during pregnancy. To better understand the relevance of MDRs to tobacco use during pregnancy, this study had three aims: firstly, to investigate the association between educational attainment and cigarette smoking in pregnant women; secondly, to compare racial and ethnic groups for the association between educational attainment and cigarette smoking; and thirdly, to explore the mediating effect of poverty status on such MDRs, among American adults during pregnancy. This cross-sectional study explored a nationally representative sample of pregnant American women (n = 338), which was taken from the Population Assessment of Tobacco and Health (PATH; 2013). Current smoking was the outcome. Educational attainment was the independent variable. Region and age were the covariates. Poverty status was the mediator. Race and ethnicity were the effect modifiers. Overall, a higher level of educational attainment (OR = 0.54, p < 0.05) was associated with lower odds of current smoking among pregnant women. Race (OR = 2.04, p < 0.05) and ethnicity (OR = 2.12, p < 0.05) both showed significant interactions with educational attainment on smoking, suggesting that the protective effect of educational attainment against smoking during pregnancy is smaller for Blacks and Hispanics than Non-Hispanic Whites. Poverty status fully mediated the above interactions. In the United States, highly educated pregnant Black and Hispanic women remain at higher risk of smoking cigarettes, possibly because they are more likely to live in poverty, compared to their White counterparts. The results suggest the role that labor market discrimination has in explaining lower returns of educational attainment in terms of less cigarette smoking by racial and ethnic minority pregnant women.

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Abatacept in rheumatoid arthritis-associated interstitial lung disease: short-term outcomes and predictors of progression

Clinical Rheumatology ◽

10.1007/s10067-021-05854-w ◽

2021 ◽

Author(s):

Marika Tardella ◽

Marco Di Carlo ◽

Marina Carotti ◽

Andrea Giovagnoni ◽

Fausto Salaffi

Keyword(s):

Rheumatoid Arthritis ◽

Interstitial Lung Disease ◽

Lung Disease ◽

Multivariate Regression ◽

Clinical Laboratory ◽

Smoking Habit ◽

Concomitant Treatment ◽

Current Smoking ◽

Modifiable Factors ◽

Aba Response

Abstract Introduction Interstitial lung disease in rheumatoid arthritis (RA-ILD) is an extra-articular involvement that impairs the prognosis and for which there is still no well-coded treatment. The aim of this study was to evaluate abatacept (ABA) effectiveness and safety in patients with RA-ILD. Methods RA-ILD patients who started ABA treatment were consecutively enrolled. Chest high-resolution computed tomography (HRCT), clinical, laboratory and respiratory function variables were collected at baseline and after 18 months of ABA treatment. HRCT abnormalities were evaluated using a computer-aided method (CaM). ABA response was established based on the change in the percentage of fibrosis evaluated at HRCT-CaM, dividing patients into “worsened” (progression ≥ 15%), “improved” (reduction ≥ 15%), and “stable” (changes within the 15% range). The multivariate regression model was used to assess the associations between RA characteristics and ABA response. Results Forty-four patients (81% women, mean age 59.1 ± 8.0, mean disease duration of 7.5 ± 3.1 years) were studied. Five patients (11.4%) showed RA-ILD progression, 32 patients (72.6%) were considered stable, and 7 patients (16.0%) showed an RA-ILD improvement. The proportion of current smokers was significantly different between “worsened” patients, respect to those defined as "improved/stable” (p = 0.01). Current smoking habit (p = 0.005) and concomitant methotrexate treatment (p = 0.0078) were the two variables related to RA-ILD progression in multivariate regression analysis. Conclusion Treatment with ABA is associated with a RA-ILD stability or improvement in the 88.6% of patients. Current smoking habit and concomitant treatment with methotrexate are the modifiable factors associated with RA-ILD worsening. Key Points• Abatacept plays a favourable role in the control of RA-ILD, with a significant worsening in only 11.4% of patients during a 18-month follow-up period.• The predictive variables related to RA-ILD progression during abatacept therapy are the concomitant treatment with methotrexate and current smoking habit.

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ASSOCIATIONS BETWEEN SERUM ANTIBODIES TO PERIODONTAL PATHOGENS AND PRECLINICAL PHASES OF RHEUMATOID ARTHRITIS

Rheumatology ◽

10.1093/rheumatology/keab097 ◽

2021 ◽

Author(s):

Daniel Manoil ◽

Delphine S Courvoisier ◽

Benoit Gilbert ◽

Burkhard Möller ◽

Ulrich A Walker ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Primary Outcome ◽

Signs And Symptoms ◽

Serum Levels ◽

Study Cohort ◽

Periodontal Pathogens ◽

Serum Antibodies ◽

Current Smoking ◽

Clinical Arthritis ◽

Citrullinated Protein

Abstract Objectives To examine whether serum antibodies against selected periodontal pathogens are associated with early symptoms of rheumatoid arthritis (RA) development in healthy individuals at risk of developing the disease. Methods Within an ongoing study cohort of first-degree relatives of patients with RA (RA-FDRs), we selected four groups corresponding to specific preclinical phases of RA development (n = 201). (1) RA-FDR controls without signs and symptoms of arthritis nor RA-related autoimmunity (n = 51); (2) RA-FDRs with RA-related autoimmunity (n = 51); (3) RA-FDRs with inflammatory arthralgias without clinical arthritis (n = 51); (4) RA-FDRs who have presented at least one swollen joint (“unclassified arthritis”) (n = 48). Groups were matched for smoking, age, sex and shared epitope status. The primary outcome was IgG serum levels against five selected periodontal pathogens and one commensal oral species assessed using validated-in-house ELISA assays. Associations between IgG measurements and preclinical phases of RA development were examined using Kruskal-Wallis or Mann-Whitney tests (α = 0.05). Results None of the IgGs directed against individual periodontal pathogens significantly differed between the four groups of RA-FDRs. Further analyses of cumulated IgG levels into bacterial clusters representative of periodontal infections, revealed significantly higher IgG titers against periodontopathogens in anti-citrullinated protein antibodies (ACPA)-positive RA-FDRs (p = 0.015). Current smoking displayed a marked trend towards reduced IgG titers against periodontopathogens. Conclusion Our results do not suggest an association between serum IgG titers against individual periodontal pathogens and specific preclinical phases of RA development. However, associations between cumulative IgG titers against periodontopathogens and the presence of ACPAs suggest a synergistic contribution of periodontopathogens to ACPA development.

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Combined effect of hypertension and hyperuricemia on ischemic stroke in a rural Chinese population

BMC Public Health ◽

10.1186/s12889-021-10858-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Peng Sun ◽

Mengqi Chen ◽

Xiaofan Guo ◽

Zhao Li ◽

Ying Zhou ◽

...

Keyword(s):

Ischemic Stroke ◽

Missing Data ◽

Chinese Population ◽

Joint Effect ◽

Cross Sectional Study ◽

Combined Effect ◽

Sectional Study ◽

Cross Sectional ◽

Current Smoking ◽

Positive Correlations

Abstract Background To investigate the combined effect of hypertension and hyperuricemia to the risk of ischemic stroke in a rural Chinese population. Methods The cross-sectional study was conducted from 2012 to 2013 in a rural area of China. After exclusion for missing data, we finally included 11,731 participants into analysis. Results After adjusting for age, current smoking, current drinking, BMI, TG, HDL-C and eGFR, hypertension was significantly associated with ischemic stroke in men (OR: 2.783, 95% CI: 1.793, 4.320) and in women (OR: 4.800, 95% CI: 2.945, 7.822). However, hyperuricemia was significantly associated with ischemic stroke only in women (OR: 1.888, 95% CI: 1.244, 2.864). After full adjustment, participants with both hypertension and hyperuricemia had 8.9 times higher risk than those without them. Finally, the interaction between hypertension and hyperuricemia was statistically significant only in women rather than in men after full adjustment. Conclusions This study demonstrated the positive correlations between hypertension, hyperuricemia and ischemic stroke. Our study also demonstrated the joint effect between hypertension and hyperuricemia towards ischemic stroke only in women, not in men.

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