Adolescent Light Cigarette Smoking Patterns and Adult Cigarette Smoking

Purpose. Light cigarette smoking has had limited research. The purpose of this study was to examine the relationship between light smoking in adolescence with smoking in adulthood. Methods. National Longitudinal Study of Adolescent Health data, Waves I and IV, were analyzed. Previous month adolescent smoking of 1–5 cigarettes/day (cpd) (light smoking); 6–16 cpd (average smoking); 17 or more cpd (heavy smoking); and nonsmoking were compared with the outcome of adult smoking. Results. At baseline, 15.9% of adolescents were light smokers, 6.8% were average smokers, and 3.6% were heavy smokers. The smoking patterns were significantly related to adult smoking. In logistic regression analyses, adolescent light smokers had an adjusted odds ratio (AOR) of 2.45 (95% CI: 2.00, 3.00) of adult smoking; adolescent average or heavy smokers had AOR of 5.57 (95% CI: 4.17, 7.43) and 5.23 (95% CI: 3.29, 8.31), respectively. Conclusion. Individuals who initiate light cigarette smoking during adolescence are more likely to smoke as young adults. Practical Implications. When screening for tobacco use by adolescents, there is a need to verify that the adolescents understand that light smoking constitutes smoking. There is a need for healthcare providers to initiate interventions for adolescent light smoking.

Association between Perceived Built Environment and Prevalent Hypertension among South African Adults

Introduction. The association between perceived built environmental attributes and hypertension among adults has received little attention in an African context. We investigated the association between the perceived built environment and prevalent hypertension in adult South Africans. Method. A cross-sectional study was conducted using 2008-2009 Prospective Urban Rural Epidemiology data among South African (n=671) adults aged ≥35 years. Perceived built environment was assessed using the neighborhood environment walkability scale questionnaire. Prevalent hypertension was defined as previously diagnosed by a physician, screen-detected hypertension as ≥140/90 mmHg, and a combination of both as any hypertension. Logistic regressions were applied for analyses. Results. In crude logistic regressions, self-reported hypertension was associated with land use mix-diversity, street connectivity, infrastructure for walking/cycling, aesthetics, traffic, and crime. In adjusted model, land use mix-diversity was significantly associated with self-reported hypertension. In similar multivariable models, the direction and magnitude of the effects were mostly similar to the outcomes of “screen-detected hypertension” which was further predicted by perceived lack of safety from traffic. Conclusion. Perceived built environment attributes were significantly associated with hypertension. This has relevance to population-based approaches to hypertension prevention and control.

Smoking and Heberden Nodes: Analysis of Data from the Osteoarthritis Initiative

Purpose. Dental hygienists, dentists, and other workforce providers who depend upon their hands for employment are acutely aware of the need to protect their hands to ensure a successful career. Recent research has suggested that smoking may be protective of hand osteoarthritis. The purpose of this study is to determine the association between smoking and Heberden’s nodes. Methods. Data from the Osteoarthritis Initiative were used in a cross-sectional, secondary data analysis of self-reported current smoking/never smoking and the presence/absence of Heberden’s nodes, the hard enlargements of the joints nearest the fingertips (distal interphalangeal joints). Analyses included descriptive statistics, Chi-square associations with Heberden’s nodes, and logistic regressions. Results. In adjusted analysis, smoking had an adjusted odds ratio for Heberden’s nodes of 0.832 [95% confidence interval: 0.60, 1.14] which failed to reach significance (P=.2488). In the selected model, females were more likely than males to have Heberden’s nodes; non-Hispanic Blacks were less likely than non-Hispanic Whites to have Heberden’s nodes; and older age groups were more likely than the youngest age group to have Heberden’s nodes. Conclusion. Smoking did not provide protection against Heberden’s nodes in this study of US participants in the Osteoarthritis Initiative.

Trajectories of Body Mass Index from Young Adulthood to Middle Age among Canadian Men and Women

Knowledge regarding the heterogeneity of BMI trajectories is limited for the Canadian population. Using latent class growth modelling, four distinct BMI trajectories of individuals from young adulthood to middle age were identified for both women and men from the longitudinal data of the National Population Health Survey. The associations between BMI trajectories and the individuals’ sociodemographic characteristics and behavioural factors were also examined. Aboriginal women were found more likely to be in the long-term overweight or obese groups. It reveals that increased years of smoking, drinking, and being physically active were associated with lowering the BMI trajectory in all groups for both women and men, with some exceptions in the long-term normal weight group for men. Increased years of rural living, being employed, and living with low income were associated with raising the BMI trajectory in all groups for women and in some groups for men. Food insecurity was associated with raising the BMI trajectory in each group for both women and men.

Survival of Preterm Singleton Deliveries: A Population-Based Retrospective Study

Aim. To identify sociodemographic and medical characteristics associated with preterm birth survival. Methods. A retrospective study of singleton births was performed using Missouri linked data for the years 1978 to 2005. We computed hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazards model. Results. High rates of infant, neonatal, and postneonatal mortality were observed among preterm as compared to term births. White are at low risk for postneonatal (HR = 0.77, CI: 0.65, 0.90) and infant mortality (HR = 0.90, CI: 0.81, 0.99) compared to blacks. We observed increased risks of all mortality types for preterm deliveries by caesarean section (neonatal HR = 1.53, CI: 1.40, 1.68; postneonatal HR = 1.39, CI: 1.22, 1.58; infant HR = 1.37, CI: 1.27, 1.48). As compared to nonsmokers, preterm singletons born to smoking mothers are 69% more likely to experience postneonatal mortality and have a 17% increased risk for infant death. Conclusions. Caesarean section is associated with increased risk of all types of mortality. Racial disparity is still a concern. Further research is required to identify the detailed differences in structure and procedures that result in the disadvantage associated with preterm birth especially with respect to caesarean section and race.

Previous Preterm Birth and Current Maternal Complications as a Risk Factor of Subsequent Stillbirth

Purpose. To examine the association between previous preterm birth and the risk of stillbirth. Methods. This population-based retrospective cohort study analyzed live births and stillbirth records in Missouri (1989–1997). The main outcome of interest was stillbirth occurrence while the exposures were prior preterm birth. Adjusted odds ratios and 95% confidence intervals were computed using logistic regression. Results. Women who had a previous preterm birth have 63% increased odds of stillbirth in singleton pregnancies and 75% increased odds in twins as compared to those who did not have a preterm birth in a prior pregnancy (AOR = 1.63, 95% CI = 1.41–1.88 and AOR = 1.75, 95% CI = 1.20–2.56), respectively. The most significant risk factor for stillbirth in singleton pregnancies was uterine bleeding (AOR = 5.89, 95% CI = 5.13–6.76). In twin pregnancies, it was the condition hydramnios/oligohydramnios (AOR = 4.72, 95% CI = 3.70–6.02). Eclampsia was associated with a heightened risk of stillbirth in singletons (AOR = 2.45, 95% CI = 1.41–4.12), but not in twins (AOR = 0.96, 95% CI = 0.13–7.00). Black mothers were more likely than white to experience stillbirth (AOR = 2.10, 95% CI = 1.99–2.22 for singletons and AOR = 1.51, 95% CI = 1.27–1.79 for twins). Conclusion. Stillbirth is a vital public health issue and its etiology is not well understood. Previous history of preterm birth was found to be associated with future stillbirth. Targeted early medical and obstetric care and interventions among women with preterm birth history may potentially reduce the likelihood of stillbirth.

Using the Negative Exponential Model to Describe Changes in Risk of Smoking-Related Diseases following Changes in Exposure to Tobacco

Recently published analyses for four smoking-related diseases show that the declining excess relative risk by time quit is well fitted by the negative exponential model. These analyses estimated the half-life of this excess, that is, the time after quitting when the excess relative risk reaches half that for continuing smokers. We describe extensions of the simple model. One quantifies the decline following an exposure reduction. We show that this extension satisfactorily predicts results from studies investigating the effect of reducing cigarette consumption. It may also be relevant to exposure reductions following product-switching. Another extension predicts changes in excess relative risk occurring following multiple exposure changes over time. Suitable published epidemiological data are unavailable to test this, and we recommend its validity to be investigated using large studies with data recorded on smoking habits at multiple time points in life. The basic formulae described assume that the excess relative risk for a continuing smoker is linearly related to exposure and that the half-life is invariant of age. We describe model adaptations to allow for nonlinear dose-response and for age-dependence of the half-life. The negative exponential model, though relatively simple, appears to have many potential uses in epidemiological research for summarizing variations in risk with exposure changes.

Prevalence of Out-of-Hospital Sudden Cardiac Death in Moscow in 2005–2009

Background. The sudden out-of-hospital cardiac death (SOHCD) in Russia is poorly investigated. The aim of study was to determine structure of SOHCD in Moscow. Methods. SOHCD were analyzed according to data for 2005–2009 from the 2nd Thanatology Department of Forensic Medicine of Moscow that serves 2502836 citizens in Moscow. Results. Prevalence of SOHCD was 49.1% of autopsies for all age groups and in 8.9% in the group aged 1–45 (22.3 cases per 100000 population/year). The frequency of SOHCD progressively increased with age. Most SOHCD victims (82%) were males. The diagnosis of cardiomyopathy was prevalent (80–96%) in the age 1–45 group; in 11–15 more 30% had normal heart; after 35 years of age, the role of ischaemic heart disease increased. In 67% of the people aged 19–25 SOHCD was associated with traces of alcohol (0.3–3.0 promile). Conclusion. The proportion of SOHCD in the Moscow population over all age groups has reached 123.2 per 100000 citizens annually. In the age group 1–45, the prevalence of SOHCD was 22.3 cases per 100000 citizens per year. The risk of SOHCD was greater in males. Possibly the role of alcohol in SOHCD in people older than 20 increased.

Epidemiological Investigations on Cystic Echinococcosis in North-West (Sidi Kacem Province) Morocco: Infection in Ruminants

Despite alarming statistics on cystic echinococcosis (CE) in humans and the importance of dog and ruminant populations, no epidemiological investigations have been performed on CE in Sidi Kacem Province (North-West of Morocco). A part of large research project was devoted to determine the status of CE in ruminants. This paper reports the results of the investigations carried out in the 10 abattoirs of this region, over four successive years (April 2009–March 2013). A total of 1,302 sheep, 652 head of cattle, and 136 goats were postmortem examined and hydatid cysts were collected and examined. The overall CE prevalence of infection was 42.9% in cattle, 11.0% in sheep, and 1.5% in goats. The prevalence shows significant association with age in sheep and cattle; sheep above 3 years and cattle above 5 years are highly infected (64.0% and 72.2%, resp.). Only liver and lungs are found to be infected. Molecular analyses identified G1, G2, and G3 of E. granulosus sensu stricto in liver and lung samples. Cyst fertility was significantly higher in sheep (54.9%) than in cattle (50.3%). These findings suggest that control measures should target not only sheep but also cattle.

Prevalence and Predictors of Undiagnosed Hypertension in an Apparently Healthy Western Indian Population

This epidemiological study was designed to evaluate the prevalence of undetected hypertension in an apparently healthy western Indian population having no history of major illness. 3629 individuals of ≥18 years of age were included in the study. Hypertension (HTN) was defined as systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg and prehypertension (PHTN) as SBP ≥ 120–139 mmHg or DBP ≥ 80–89 mmHg, but without HTN. The prevalence of undiagnosed HTN in the total population was 26% and was 11% and 40% in the young (≤40-year) and old (>40-year) populations, respectively. The prevalence of PHTN, 40% in the overall population, was nearly the same in the young (39%) and the old population (42%). The risk factor most strongly associated with PHTN and HTN was obesity, showing the highest odds ratio in the overall (PHTN 2.14; 95% CI 1.20–3.81; HTN 2.72; 95% CI 1.53–4.85), the young (PHTN 2.29; 95% CI 1.25–4.21; HTN 2.92; 95% CI 1.59–5.35), and the old (PHTN 1.13; 95% CI 0.65–1.96; HTN 1.38; 95% CI 0.79–2.4) populations. Hypertension is a major risk factor for cardiovascular diseases which must not be ignored, especially in the western Indian population.