| 1. |
- Baba, Sachiko, et al.
(author)
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Influence of Snuff and Smoking Habits in Early Pregnancy on Risks for Stillbirth and Early Neonatal Mortality
- 2014
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In: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 16:1, s. 78-83
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Journal article (peer-reviewed)abstract
- Prenatal exposure to Swedish snuff (including nicotine and other components in grinded tobacco) is reported to increase stillbirth risk, but the effect of snuff on early neonatal mortality is unknown. Prenatal smoking exposure is associated with risks for both stillbirth and early neonatal mortality. We aimed to study if women who quit using snuff or quit smoking before first antenatal visit reduce their risks. In a nationwide study of 851,371 singleton births in Sweden from 1999 to 2010, we used multiple logistic regression models to examine associations between cessation or continuation of snuff use or smoking and risks for stillbirth (at 28 weeks or later) and early neonatal mortality (death during the first week of life). Compared with nontobacco users, snuff users and smokers in early pregnancy had increased risks for stillbirths, and adjusted odds ratios (ORs), with 95% confidence intervals (CI), were 1.43 (1.021.99) and 1.59 (1.401.80), respectively. Women who stopped using snuff or stopped smoking before first visit to antenatal care had no increased risks. Compared with nontobacco users, smokers had an increased risk for early neonatal mortality (adjusted OR 1.37 [95% CI 1.111.71]). Women who stopped smoking and snuff users in early pregnancy had no increased risks of early neonatal mortality. Both snuff and smoking influence risk for stillbirth, and women who stop using snuff or smoking have a similar stillbirth risk as nontobacco users. Smoking but not snuff use influences risk for early neonatal mortality.
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| 2. |
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| 3. |
- Cederblad, Lena, et al.
(author)
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The Combined Effects of Single-Nucleotide Polymorphisms, Tobacco Products, and Ethanol on Normal Resting Blood Mononuclear Cells
- 2013
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In: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 15:5, s. 890-895
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Journal article (peer-reviewed)abstract
- Introduction: Tobacco and ethanol consumption are crucial factors in the development of various diseases including cancer. In this investigation, we evaluated the combined effects of a number of single nucleotide polymorphisms (SNPs), with ethanol and tobacco products on healthy individuals. Methods: Pure nicotine, cigarette smoke extract, and Swedish snuff (snus) extract were used. The effects were examined by means of in vitro cell cycle progression and cell death of peripheral blood mononuclear cells (PBMCs) obtained from healthy donors. Results: After 3 days, in vitro, resting PBMCs entered the S and G2 stage in the presence of 100 mu M nicotine. The PBMCs only proceeded to S stage, in the presence of 0.2% ethanol. The nicotine- and ethanol-induced normal cell cycle progression correlated to a number of SNPs in the IL12RB2, Rad 52, XRCC2, P53, CCND3, and ABCA1 genes. Certain SNPs in Caspases 8, IL12RB2, Rad 52, MMP2, and MDM2 genes appeared to significantly influence the effects of EtOH-, snus-, and snus + EtOH-induced cell death. Importantly, the highest degree of cell death was observed in the presence of smoke + EtOH. The amount of cell death under this treatment condition also correlated to specific SNPs, located in the MDM2, ABCA1, or GASC1 genes. Conclusions: Cigarette smoke in combination with ethanol strongly induced massive cell death. Long-term exposure to smoke and ethanol could provoke chronic inflammation, and this could be the initiation of disease including the development of cancer at various sites.
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| 4. |
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| 5. |
- Digard, Helena, et al.
(author)
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Determination of Nicotine Absorption from Multiple Tobacco Products and Nicotine Gum
- 2013
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In: Nicotine & Tobacco Research. - : Oxford University Press (OUP). - 1469-994X .- 1462-2203. ; 15:1, s. 255-261
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Journal article (peer-reviewed)abstract
- Snus is a smokeless tobacco product traditionally used in Scandinavia and available in pouched or loose forms. The objective of this study was to determine nicotine absorption for current pouched and loose snus products in comparison with a cigarette and an over-the-counter nicotine gum. We conducted an open-label, randomized, 6-way, crossover study involving 20 healthy snus and cigarette users. One of 6 products (2 pouched snus, 2 weights of loose snus, a cigarette, and a nicotine gum) was administered at each of 6 visits. Blood samples were taken at intervals over 120 min and sensory perception assessed by questionnaire. For the 4 smokeless tobacco products and the nicotine gum, blood plasma levels of nicotine were ranked according to total nicotine content as follows: loose snus (27.1 mg nicotine) > pouched snus (14.7 mg nicotine) > loose snus (10.8 mg nicotine) = pouched snus (10.7 mg nicotine) > nicotine gum (4.2 mg nicotine). The area under the plasma concentration-time curve (AUC) and maximum plasma concentration (C-max) of nicotine ranged from 26.9 to 13.1 ng.h/ml and 17.9 to 9.1 ng.h/ml, respectively across all the products. Nicotine was absorbed more rapidly from the cigarette but systemic exposure was within the range of the smokeless tobacco products (AUC = 14.8 ng.h/ml; C-max = 12.8 ng.h/ml). This study has generated new information on comparative nicotine absorption from a cigarette, loose snus, and pouched snus typical of products sold in Scandinavia. The similar nicotine absorption for 1 g portions of loose and pouched snus with approximately 11 mg of nicotine indicate that absorption kinetics were dependent on quantity of tobacco by weight and total nicotine content rather than product form.
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| 6. |
- Durazzo, T. C., et al.
(author)
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Interaction of Cigarette Smoking History With APOE Genotype and Age on Amyloid Level, Glucose Metabolism, and Neurocognition in Cognitively Normal Elders
- 2016
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In: Nicotine & Tobacco Research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 18:2, s. 204-211
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Journal article (peer-reviewed)abstract
- Introduction: Chronic cigarette smoking is associated with increased risk for Alzheimer's disease (AD). The goal of this study was to determine if smoking history moderated the associations of age and APOE genotype (the most robust risk factors for AD) on brain amyloid deposition, glucose metabolism, and neurocognition in cognitively-normal elders. Methods: Participants (n = 264) were grouped according to their APOE epsilon 4 carrier status (epsilon 4 carrier: APOE4+; non-epsilon 4 carrier: APOE4-) and smoking status (smokers: at least 1 year of smoking during lifetime; never-smokers: no history of smoking). Approximately 89% of the smoking sample was former-smokers. We specifically tested for interactions of smoking status with APOE epsilon 4 carrier status and age on measures of cortical amyloid deposition, glucose metabolism, and neurocognition. Results: (1) smoking status interacted with APOE epsilon 4 carrier status, where smoker APOE4+ showed lower glucose metabolism and poorer auditory-verbal learning and memory than never-smoking APOE4-, never-smoking APOE4+, and smoking APOE4-; (2) smoking status interacted with age on measures of semantic fluency, processing speed/set-shifting and global neurocognition; smokers, irrespective of APOE epsilon 4 carrier status, demonstrated poorer performance with increasing age than never-smokers; and (3) smoking APOE4+ and never-smoking APOE4+ showed greater cortical amyloid deposition than never-smoking APOE4-and smoking APOE4-. Conclusions: The findings indicate consideration of smoking history is essential to both better understand the factors associated with neurobiological and neurocognitive abnormalities in elders, and the risk for development of AD-related neuropathology.
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| 7. |
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| 8. |
- Eliasson, Björn, 1959, et al.
(author)
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Effect of smoking reduction and cessation on cardiovascular risk factors.
- 2001
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In: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. - : Informa UK Limited. - 1462-2203. ; 3:3, s. 249-55
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Journal article (peer-reviewed)abstract
- This open study examined the effect of smoking reduction and smoking cessation on established cardiovascular risk factors. Fifty-eight healthy adult smokers (smoking >or=15 cigarettes/day for at least 3 years) were provided with nicotine nasal spray (to be used ad libitum) and asked to stop smoking. The primary goal during the first 8 weeks, however, was to reduce their daily smoking by at least 50%. Subjects were then followed for another 8 weeks; at this point, 33 participants had successfully stopped smoking. Cardiovascular risk factors including fibrinogen, hemoglobin, hematocrit, triglycerides, and cholesterol were measured at baseline and at 9 and 17 weeks. After 8 weeks of smoking reduction, the mean number of cigarettes smoked per day had decreased from 21.5 +/- 0.6 (baseline) to 10.8 +/- 0.6 (p < 0.001). This was accompanied by significant improvements in fibrinogen (from 2.9 +/- 0.1 g/l at baseline to 2.6 +/- 0.1 g/l, p = 0.011), white blood cells (from 7.0 +/- 0.4 to 6.2 +/- 0.3 x 10(9)/l, p = 0.005) and the high-density/low-density lipoprotein (HDL/LDL) ratio (0.33 +/- 0.03 to 0.37 +/- 0.03, p < 0.005). Following 8 weeks of abstinence from smoking, the mean white blood cell count was further reduced (to 6.1 +/- 0.3 x 10(9)/l, p = 0.026 vs. baseline) and there were also significant improvements in HDL (from 1.16 +/- 0.06 mmol/l at baseline to 1.32 +/- 0.06, p < 0.001) and LDL (from 3.78 +/- 0.16 mmol/l at baseline to 3.52 +/- 0.17, p = 0.015). In conclusion, 8 weeks of smoking reduction resulted in clinically significant improvements in established cardiovascular risk factors. These improvements were even greater after an additional period of abstinence from smoking.
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| 9. |
- Footman, Katharine, et al.
(author)
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Smoking cessation and desire to stop smoking in nine countries of the former soviet union
- 2013
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In: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 15:9, s. 1628-1633
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Journal article (peer-reviewed)abstract
- Introduction: Smoking rates and corresponding levels of premature mortality from smoking-related diseases in the former Soviet Union (fSU) are among the highest in the world. To reduce this health burden, greater focus on smoking cessation is needed, but little is currently known about rates and characteristics of cessation in the fSU. Methods: Nationally representative household survey data from a cross-sectional study of 18,000 respondents in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine were analyzed to describe patterns of desire and action taken to stop smoking, quit ratios (former ever-smokers as a percent of ever-smokers, without a specified recall period), and help used to stop smoking. Multivariate logistic regression was used to analyze characteristics associated with smoking cessation and desire to stop smoking. Results: Quit ratios varied from 10.5% in Azerbaijan to 37.6% in Belarus. About 67.2% of respondents expressed a desire to quit, and 64.9% had taken action and tried to stop. The use of help to quit was extremely low (12.6%). Characteristics associated with cessation included being female, over 60, with higher education, poorer health, lower alcohol dependency, higher knowledge of tobacco's health effects, and support for tobacco control. Characteristics associated with desire to stop smoking among current smokers included younger age, poorer health, greater knowledge of tobacco's health effects, and support for tobacco control. Conclusions: Quit ratios are low in the fSU but there is widespread desire to stop smoking. Stronger tobacco control and cessation support are urgently required to reduce smoking prevalence and associated premature mortality.
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| 10. |
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| 11. |
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| 12. |
- Gebreslassie, Mihretab, et al.
(author)
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Should Nicotine Replacement Therapy be Provided Free of Charge? : A Cost-Utility Analysis in Sweden
- 2023
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In: Nicotine & tobacco research. - : Oxford University Press. - 1462-2203 .- 1469-994X. ; 25:11, s. 1762-1769
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Journal article (peer-reviewed)abstract
- Introduction Treatment with nicotine replacement therapy (NRT) during an attempt to quit smoking increases the likelihood of success by about 55%. However, out-of-pocket payment for NRT can hinder its use. Aims and Methods This study aims therefore to assess the cost-effectiveness of subsidizing NRT in Sweden. A homogeneous cohort-based Markov model was used to assess the lifetime costs and effects of subsidized NRT from a payer and societal perspective. Data to populate the model were retrieved from the literature, and selected parameters were varied in deterministic and probabilistic sensitivity analyses to assess robustness of model outputs. Costs are presented in USD, year 2021. Results A 12-week treatment with NRT was estimated to cost USD 632 (474-790) per person. From a societal perspective, subsidized NRT was a cost-saving alternative in 98.5% of the simulations. NRT is cost-saving across all ages, but the health and economic gains are somewhat larger among younger smokers from a societal perspective. When a payer perspective was used, the incremental cost-effectiveness ratio was estimated at 14 480 (11 721-18 515) USD per QALY which was cost-effective at a willingness to pay of 50 000 USD per QALY in 100 % of the simulations. Results were robust with realistic changes in the inputs during scenario and sensitivity analyses. Conclusions Subsidizing NRT is potentially a cost-saving smoking cessation strategy from a societal perspective and cost-effective from a payer perspective. Implications This study found that subsidizing NRT is potentially a cost-saving smoking cessation policy alternative compared to current practice from a societal perspective. From a healthcare payer perspective, subsidizing NRT is estimated to cost USD 14 480 to gain an extra QALY. NRT is cost-saving across all ages, but the health and economic gains are somewhat larger among younger smokers from a societal perspective. Moreover, subsidizing NRT removes the financial barriers that are mostly faced by socioeconomically disadvantaged smokers which might reduce health inequalities. Thus, future economic evaluations should further investigate the health inequality impacts with methods that are more suitable for this.
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| 13. |
- Grill, Kalle, 1976-
(author)
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E-cigarettes : The Long-Term Liberal Perspective
- 2021
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In: Nicotine & Tobacco Research. - : Oxford University Press. - 1462-2203 .- 1469-994X. ; 23:1, s. 9-13
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Journal article (peer-reviewed)abstract
- The debate for and against making e-cigarettes available to smokers is to a large extent empirical. We do not know the long-term health effects of vaping and we do not know how smokers will respond to e-cigarettes over time. In addition to these empirical uncertainties, however, there are difficult moral issues to consider. One such issue is that many smokers in some sense choose to smoke. Though smoking is addictive and though many start young, it does not seem impossible to plan for and implement cessation. Yet many choose not to do so and we arguably have some reason to respect this choice. I propose that liberal opposition to strict tobacco control, based on respect for choice, is mitigated when e-cigarettes are available, since they are such a close substitute. Making e-cigarettes available to smokers might therefore not only enable switching in practice, but may make tougher tobacco control more justified. Another moral issue is that making e-cigarettes widely available might induce many people to vape, who would otherwise have neither vaped nor smoked. If this is so, the price of using e-cigarettes to accelerate smoking cessation may be a long-term vaping epidemic. Since vaping is less harmful than smoking, both individuals and society will have less reason to end this epidemic and so it may endure longer than the smoking epidemic would otherwise have done. This raises further questions around the weighing of reduced harm to current smokers against increased harm to future vapers.
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| 14. |
- Hansson, Anna, et al.
(author)
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Single-Dose and Multiple-Dose Pharmacokinetics of Nicotine 6 mg Gum
- 2017
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In: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. - : Oxford University Press (OUP). - 1469-994X. ; 19:4, s. 477-483
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Journal article (peer-reviewed)abstract
- Introduction: Under-dosing is a recognized problem with current nicotine replacement therapy (NRT). Therefore, a new 6mg nicotine gum has been developed. To compare the nicotine uptake from the 6mg gum versus currently available NRT products, two pharmacokinetic studies were performed.Methods: In one randomized crossover study, 44 healthy adult smokers received single doses of 6, 4, and 2mg nicotine gum, and 4mg nicotine lozenge on separate occasions. In a separate randomized crossover multiple-dose study over 11 hours, 50 healthy adult smokers received one 6mg gum every hour and 90 minutes, respectively, one 4mg gum every hour, and one 4mg lozenge every hour. In both studies, blood samples were collected over 12 hours to determine single-dose and multiple-dose pharmacokinetic variables.Results: In the single-dose study, the amount of nicotine released from the 2, 4, and 6mg gums (1.44, 3.36, and 4.94mg) as well as the resulting maximum concentration and area under the curve (5.9, 10.1, and 13.8ng/mL, and 17.1, 30.7, 46.2ng/mL × h, respectively) increased with dose. The maximum concentration and area under the curve of the 6mg gum were 44% and 30% greater, respectively, than those for 4mg lozenge. Upon hourly administration, the steady-state average plasma nicotine concentration with 6mg gum (37.4ng/mL) was significantly higher than those for 4mg lozenge (28.3ng/mL) and 4mg gum (27.1ng/mL).Conclusions: Nicotine delivery via the 6mg gum results in higher plasma nicotine concentrations after a single dose and at steady state than with currently available oral NRT.Implications: Under-dosing is a recognized problem with current NRT. Therefore, a new 6mg nicotine gum has been developed. Our studies show that upon single-dose and multiple-dose administration, the 6mg gum releases and delivers more nicotine to the systemic circulation than 2mg gum, 4mg gum, and 4mg lozenge. Thus, each 6mg nicotine gum provides a higher degree of nicotine substitution and/or lasts for a longer period of time than currently available nicotine gums and lozenges.
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| 15. |
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| 16. |
- Jamil, Hikmet, et al.
(author)
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Do Household Smoking Behaviors Constitute a Risk Factor for Hookah Use?
- 2011
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In: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 13:5, s. 384-388
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Journal article (peer-reviewed)abstract
- Introduction: Much research has focused on the role played by families in cigarette smoking behavior. However, there is a lack of such research for hookah (waterpipe) smoking. This study focuses on the role of family members' hookah smoking behaviors as a possible risk factor for hookah smoking. Methods: Eight hundred and one adults in southeast Michigan responded to an anonymous self-administered survey regarding personal and family members' hookah smoking behavior and perceptions of health risks related to hookah smoking. Multinomial logistic regression modeling was used to examine risk factors for hookah use. Results The prevalence of current hookah smoking in the study population was 26%. The odds ratio for an individual to smoke hookah were 9.5 (95% CI = 2.37-38.47, p < .01), 8.6 (95% CI = 3.92-19.02, p < .001), and 1.2 (95% CI = 1.14-1.41, p < .05) if the father, mother, or sibling, respectively, smoked hookah at home. Male gender and younger age were also significantly associated with hookah smoking. Household hookah smoking behaviors were also significant risk factors among former hookah smokers compared with nonsmokers, but there were no significant risk factors when comparing former hookah smokers with current hookah smokers. Conclusions: Having a father, mother, or sibling smoking hookah at home, male gender and younger age are significant risk factors for current hookah smoking.
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| 17. |
- Jamil, Hikmet, et al.
(author)
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Sociodemographic risk indicators of hookah smoking among White Americans : A pilot study
- 2010
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In: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 12:5, s. 525-529
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Journal article (peer-reviewed)abstract
- Background: Despite the sustained public health efforts to decrease cigarette smoking, there is an increasing trend in the use of alternative tobacco products that are perceived by some as less harmful. One example is hookah smoking. This study aimed to assess hookah trends among White Americans. Methods: Two hundred and forty-five White American adults residing in southeast Michigan answered a self-administered standardized questionnaire that included basic demographics, socioeconomic status, and questions related to hookah smoking behavior. Logistic regression was used to determine risk indicators for hookah smoking. Results: The combined prevalence of hookah smoking in the White American study population was 19%, with 10% of the sample smoking hookah only and 9% smoking both hookah and cigarettes. Approximately 19% of respondents believed that smoking hookah was less harmful than smoking cigarettes. Significant risk indicators for smoking hookah were being younger than 22 years and living with a family member who used tobacco. Discussion: In addition to reporting the prevalence of use in this important group of potential users, we outline important sociodemographic risk factors for hookah use in a non-Arab American population. More research is needed with a larger population to better understand this new tobacco trend in order to curb a new potential health threat.
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| 18. |
- Kendler, Kenneth S., et al.
(author)
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Evidence for a Causal Relationship between Academic Achievement and Cigarette Smoking
- 2021
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In: Nicotine and Tobacco Research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 23:2, s. 334-340
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Journal article (peer-reviewed)abstract
- Introduction: Academic achievement (AA) is associated with smoking rates. Can we determine the degree to which this relationship is likely a causal one? Methods: We predict smoking in male conscripts (mean age 18.2) assessed from 1984 to 1991 (N = 233 248) and pregnant females (mean age 27.7) receiving prenatal care 1972-1990 (N = 494 995) from AA assessed in all students at 16. Instrumental variable (IV) analyses used the instrument month-of-birth as in each school year, older children have high AA. Co-relative analyses used AA-smoking associations in the population, cousins and siblings to predict the AA-smoking relationship in MZ twins, thereby controlling for familial confounding. Results: In males, higher AA was associated with a substantial decrease in risk for smoking (odds ratio [OR] [95% confidence intervals [CIs]] per standard deviation [SD] = 0.41 [0.40-0.41]) while the parallel figures obtain from our IV and co-relative analyses were 0.47 (0.39-0.57) and 0.51 (0.43-0.60), respectively. In females, these figures for pre-pregnancy smoking were, respectively, 0.39 (0.39-0.39), 0.50 (0.46-0.54) and 0.54 (0.51-0.58). Results for heavy versus light smoking suggested a causal effect but were inconsistent across methods. However, among females smoking prior to pregnancy, AA predicted a reduced risk for continued smoking with ORs for uncontrolled, IV, and co-relative analyses equaling, respectively, were 0.54 (0.53-0.55) 0.68 (0.56-0.82) and 0.78 (0.66-0.91), respectively. Conclusions: Two different methods produced consistent evidence that higher AA has a causal effect on reducing smoking rates and increasing cessation rates in smoking pregnant females. Improving AA may result in meaningful gains in population health through reduced smoking. Implications: This study provides consistent evidence across two different methods that high AA is causally related to reduced rates of smoking and increasing rates of smoking cessation among pregnant women. Our results suggest that interventions that improve educational achievement in adolescence would reduce tobacco consumption, thereby improving public health.
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| 19. |
- Kulik, MC, et al.
(author)
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Educational inequalities in three smoking-related causes of death in 18 European populations
- 2014
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In: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 16:5, s. 507-518
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Journal article (peer-reviewed)abstract
- Introduction: Smoking is an important determinant of socioeconomic inequalities in mortality in many countries. As the smoking epidemic progresses, updates on the development of mortality inequalities attributable to smoking are needed. We provide estimates of relative and absolute educational inequalities in mortality from lung cancer, aerodigestive cancers, and chronic obstructive pulmonary disease (COPD)/asthma in Europe and assess the contribution of these smoking-related diseases to inequalities in all-cause mortality.Methods: We use data from 18 European populations covering the time period 1998–2007. We present age-adjusted mortality rates, relative indices of inequality, and slope indices of inequality. We also calculate the contribution of inequalities in smoking-related mortality to inequalities in overall mortality.Results: Among men, relative inequalities in mortality from the 3 smoking-related causes of death combined are largest in the Czech Republic and Hungary and smallest in Spain, Sweden, and Denmark. Among women, these inequalities are largest in Scotland and Norway and smallest in Italy and Spain. They are often larger among men and tend to be larger for COPD/asthma than for lung and aerodigestive cancers. Relative inequalities in mortality from these conditions are often larger in younger age groups, particularly among women, suggesting a possible further widening of inequalities in mortality in the coming decades. The combined contribution of these diseases to inequality in all-cause mortality varies between 13% and 32% among men and between −5% and 30% among women.Conclusion: Our results underline the continuing need for tobacco control policies, which take into account socioeconomic position.
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| 20. |
- Lind, Lars, et al.
(author)
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The effect of smoking on endothelial vasodilatory function evaluated by local infusion of metacholine in the forearm is dependent on the duration of smoking
- 2003
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In: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 5:1, s. 125-130
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Journal article (peer-reviewed)abstract
- The objective of the study was to evaluate if endothelial vasodilatory function in the human forearm is impaired by regular cigarette smoking. The setting was a tertiary university hospital. Subjects were 56 apparently healthy subjects from a population screening (mean age 50) and 52 young healthy volunteers (mean age 25) who were investigated regarding endothelial-dependent (EDV) and endothelial-independent vasodilation (EIDV) by means of local infusion of metacholine (MCh; 2 and 4 mg/min) and sodium nitroprusside (SNP; 5 and 10 mg/min) in the forearm. Forearm blood flow (FBF) was measured by venous occlusion plethysmography. The MCh to SNP FBF ratio was denoted the endothelial function index. In the young subjects, no differences between smokers (n = 12) and non-smokers regarding EDV or EIDV were seen. In the population sample, however, the smokers (n = 8) showed an attenuated endothelial function index when compared with non-smokers (1.0 +/- 0.1 vs. 1.3 +/- 0.3, p = .02). The EDV showed a significant inverse relationship to the duration of smoking (r = -0.52, p < .05), independent of age, when the smokers in both groups were analyzed together. A similar, although not significant, relation was found between the endothelial function index and the duration of smoking (p = -.44). The present study showed that endothelial vasodilatory function was impaired in middle-aged, but not young, smokers, suggesting that the duration of smoking is of major importance for the deleterious effects of smoking on endothelial vasodilatory function.
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| 21. |
- Lindblad, Frank, et al.
(author)
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ADHD after fetal exposure to maternal smoking
- 2010
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In: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 12:4, s. 408-15
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Smoking during pregnancy has been reported to be associated with a twofold to fourfold increased risk of attention-deficit hyperactivity disorder (ADHD) in the offspring. Genetic and socioeconomic confounders may contribute to this association. The aim of this study was to investigate the association between fetal exposure to maternal smoking during pregnancy and ADHD, taking such potential confounders into consideration. METHODS: A register study in a population of 982,856 children, 6-19 years of age, born at term, and residents in Sweden in 2006 was conducted. Logistic regression was used to calculate odds ratios (ORs) of maternal smoking habits during pregnancy on ADHD medication in the 927,007 study subjects where maternal smoking habits were available from the Medical Birth Register in the presence of socioeconomic and parental psychiatric morbidity confounders. To adjust the analysis also for genetic confounding, we used a within-mother between-pregnancy approach in offspring of 26,292 mothers with inconsistent smoking habits (smoking/non-smoking) between pregnancies. RESULTS: The OR for ADHD medication in offspring of mothers who smoked >or=10 cigarettes/day was 2.86 (2.66-3.07) in the entire study population after adjustment for sex and age, while this same exposure yielded an OR of only 1.26 (0.95-1.58) when two pregnancies of the same mother were analyzed in a within-subjects design. DISCUSSION: Smoking during pregnancy has a strong association with ADHD in the offspring in the general Swedish population, but this risk is primarily explained by genetic and socioeconomic confounding.
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| 22. |
- Lindström, Martin, et al.
(author)
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Changes in social capital and cigarette smoking behavior over time : A population-based panel study of temporal relationships
- 2016
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In: Nicotine & Tobacco Research. - : Oxford University Press (OUP). - 1469-994X .- 1462-2203. ; 18:11, s. 2106-2114
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Journal article (peer-reviewed)abstract
- Introduction: Identifying factors that influence individuals' smoking behavior remains a huge public health concern. This study aimed to investigate changes in individuals' cigarette smoking while considering well-known smoking determinants, including social capital, its presence being postulated to reduce smoking. Methods: From British Household Panel Survey data, two baseline smoking cohorts were created ("smoking" and "not smoking"). The same individuals from this nationally representative sample (NT = 8114, aged 16-91 years) were interviewed on four occasions between years 2000 and 2007 to investigate changes in cigarette smoking behavior. Logistic regression models with random effects compensated for within-individual behavior over time. Temporal pathways were investigated by lagging independent variables (t - 1) in relation to our cigarette-use outcome at time (t). Results: Active social participation at (t - 1) was positively associated with smoking cessation at (t) (odds ratio [OR] = 1.39; 95% confidence interval [CI] [1.07-1.82]). Separating from one's spouse at (t - 1) increased risk for smoking relapse/initiation at (t) (OR = 6.63; 95% CI [1.70-28.89]). Conversely, being married protected against smoking cigarettes (OR = 1.87; 95% CI [1.15-3.04]). These associations held in our robustness checks. Conclusions: Initial marital breakdown predicted a high risk of smoking relapse/initiation. The timing of this life event provides a critical window where adverse smoking behavior might occur. Conversely, the positive effects of active social participation on cigarette cessation remained consistent, its absence further predicting smoking relapse/initiation. Robustness of results confirms the important role that active participation has on cigarette smoking behavior. Group smoking cessation interventions could harness participatory elements to better achieve their goals. Implications: By investigating temporal relationships between well-known smoking determinants and cigarette smoking outcomes, we identified that being "separated" (not "divorced") at time (t) predicted a higher risk of smoking relapse/initiation at (t). Tailored health messages could be employed to highlight the increased risk of cigarette smoking relapse/initiation during this stressful life event. Conversely, active social participation (a common social capital proxy) consistently predicted smoking cessation over time. Future group smoking cessation interventions could be designed explicitly to harness participatory elements to better achieve their goals.
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| 23. |
- Lunell, Erik, et al.
(author)
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Pharmacokinetic Comparison of a Novel Non-tobacco-Based Nicotine Pouch (ZYN) With Conventional,Tobacco-Based Swedish Snus and American Moist Snuff
- 2020
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In: Nicotine & tobacco research. - OXFORD ENGLAND : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 22:10, s. 1757-1763
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Journal article (peer-reviewed)abstract
- Introduction: The single-dose pharmacokinetics (PK) of a novel, non-tobacco-based nicotine pouch, ZYN, 3 and 6 mg, were compared with 8 mg General snus (part 1) and ZYN 8 mg was compared with 18 mg Longhorn moist snuff (part 2). The present study demonstrates the characteristics of three strengths of a novel tobacco-free oral snus, ZYN, viz. the extraction of nicotine from the oral cavity and its uptake into the systemic blood circulation. Comparison is made to Swedish General snus and American Longhorn moist snuff and from literature 4 mg Nicorette gum and mean of 13 brands of e-cigarettes. Aims and Methods: A single-dose randomized crossover design was used. In vivo extraction and PK parameters were determined. Results: Part 1. The AUC(inf) of ZYN 3 mg was 27% smaller than that of 8 mg General and the AUC(inf) of ZYN 6 mg was 34% larger than that of 8 mg General. Less nicotine was extracted from ZYN 3 mg (1.5 mg) and more from ZYN 6 mg (3.5 mg) than from 8 mg General (2.4 mg).The extracted fractions of nicotine for both ZYN products (56% and 59%) were significantly larger than for 8 mg General (32%). Results: Part 2. Close to identical plasma nicotine curves, AUC(inf) and C-max were found for ZYN 8 mg and Longhorn Natural 18 mg moist snuff. The extracted amount of nicotine from ZYN 8 mg (3.8 mg) was larger than the amount extracted from Longhorn Natural 18 mg (3.0 mg), but smaller than the extracted amount of nicotine from General 2 x 8 mg snus pouches (5.0 mg).The extracted fraction of nicotine for ZYN 8 mg (50%) was larger than for Longhorn Natural (19%) and General 2 x 8 mg snus pouches (33%). Conclusions: The two higher doses of ZYN (6 and 8 mg) deliver nicotine as quickly and to a similar extent as existing smokeless products, with no significant adverse effects.
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| 24. |
- Lunell, Erik, et al.
(author)
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Steady-state nicotine plasma levels following use of four different types of Swedish snus compared with 2-mg Nicorette chewing gum: A crossover study
- 2005
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In: Nicotine & Tobacco Research. - : Oxford University Press (OUP). - 1469-994X .- 1462-2203. ; 7:3, s. 397-403
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Journal article (peer-reviewed)abstract
- The present study evaluated nicotine plasma levels achieved following 1 day's regular use of four commonly used brands of Swedish portion snus and 2-mg Nicorette chewing gum. The study also estimated the amount of sodium chloride extracted from each snus sachet to identify potential risks for exacerbation of heart failure and hypertension with the use of Swedish snus. Extracted dose of nicotine, area under the venous plasma concentration-time curve (AUC), maximum plasma nicotine concentration (C-max) of the last (12th) dosing interval, and the Cm,, and AUC ratios versus Nicorette were calculated. Relative brioavailable dose was calculated using AUC of 2-mg Nicorette gum as the reference. The mean extracted nicotine doses were 2.74 +/- 0.80, 1.55 +/- 0.68, 2.00 +/- 0.56, and 1.08 +/- 0.94 mg/sachet for General, Catch Licorice, Catch Mini, and Catch Dry Mini snus, respectively. The approximate bioavailable dose of nicotine from snus was 40%-60% of the extracted dose. The steady-state nicotine plasma concentration-time curve for the weakest brand, Catch Dry Mini portion snus, did not differ significantly from that of the 2-mg Nicorette gum. The AUC and C-max for Catch Licorice I g and Catch Mini 0.5 g portion snus were twice those for the 2-mg Nicorette gum; for the strongest brand, General, these values were 21/2 times those for Nicorette gum. The differences in AUC and C-max versus the 2-mg Nicorette gum were statistically significant (p=.020). Nicotine plasma levels with General portion snus were sustained at higher levels than current nicotine replacement therapy products, peaking at 29.0 +/- 8.5 ng/ml, and more closely mimicking cigarette smokers' nicotine plasma levels. The risks of aggravation of heart failure and hypertension with respect to increased salt load from the use of snus appeared to be negligible.
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| 25. |
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| 26. |
- Maes, Hermine H., et al.
(author)
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Modeling Etiology of Smoking During Pregnancy in Swedish Twins, Full-, and Half-Siblings, Reared Together and Apart
- 2020
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In: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. - : Oxford University Press (OUP). - 1469-994X. ; 22:10, s. 1736-1743
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Using Swedish nationwide registry data, we investigated the contribution of genetic and environmental risk factors to the etiology of smoking status across stages of pregnancy with increasing degrees of social and psychological pressure to reduce or quit smoking, by twin and sibling modeling. AIMS AND METHODS: Smoking status was available before, and during early and late pregnancy from the Medical Birth Register. Twin, full-, and half-sibling pairs, both reared together and apart, born between 1960 and 1990 were obtained from national twin and genealogical registers. Genetic structural equation modeling in OpenMx was applied to the population-based data to estimate shared genetic and/or environmental covariance across stages of pregnancy, accounting for maternal birth cohort and age at pregnancy. RESULTS: Analyses of paired data on 258 749 individuals suggested that risk factors for smoking status changed across stages of pregnancy. Results predicted substantial heritability (60-70%) and moderate contributions of shared environmental factors (10-15%) for smoking status. Whilst the same shared environmental factors were amplified from before pregnancy to late pregnancy, new primarily unique environmental factors explained ~10% of the variance during early pregnancy which was carried forward to late pregnancy. CONCLUSIONS: Using registry data on women across pregnancy, we replicated that smoking status is highly heritable. Furthermore, we found support for increased impact of shared environmental factors during pregnancy of factors already present prior to pregnancy, and an independent set of mostly new unique environmental factors that may be triggered by increased social pressure to reduce or quit smoking during pregnancy. IMPLICATIONS: As new factors partially explain smoking status during pregnancy and the effects of familial factors increase across pregnancy, efforts to prevent or reduce smoking during pregnancy should receive continued attention, with a focus on both the individual and the family unit.
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| 27. |
- Mariscalco, Giovanni, et al.
(author)
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Are current smokers paradoxically protected against atrial fibrillation after cardiac surgery?
- 2009
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In: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 11:1, s. 58-63
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Journal article (peer-reviewed)abstract
- BACKGROUND: The hyperadrenergic condition following surgical stress and inotropic drugs have been identified as leading causes for postoperative atrial fibrillation (AF). Smokers are characterized by higher catecholamine levels and tolerance. We tested the hypothesis that smoking patients are less prone to develop postoperative AF. METHODS: A total of 3,245 coronary artery bypass and valvular procedures were reviewed. Predictors of AF and interaction between variables were explored by multivariable logistic regression. AF-predictive scores were created and validated for goodness of fit, and receiver operating characteristic curves were created. RESULTS: Postoperative AF occurred in 26% of patients. Smokers accounted for 15% of the study population and demonstrated a reduced incidence of postoperative AF compared with nonsmoking individuals (20% vs. 27%, p < .001). Multivariate analysis revealed a significant interaction between smoking status and inotropic support requirement. The AF-protective effect of smoking was confounded by inotropic drugs. However, when we excluded from analysis the patients with inotropic support, smoking conferred a 46% risk reduction of AF (odds ratio [OR] = 0.54, 95% CI = 0.34-0.87, p = .011). In addition, age, valvular surgery, and hypertension were independently associated with AF. Postoperative AF increased the length of hospitalization, without affecting hospital mortality. AF was associated with an increased 1-year mortality (p = .002). DISCUSSION: Current smokers are less prone to develop AF after cardiac surgery. Our data support the hypothesis that hyperadrenergic state and catecholamines are key mechanisms in the pathophysiology of postoperative AF.
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| 28. |
- Mattsson, Kristina, et al.
(author)
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Cotinine validation of self-reported smoking during pregnancy in the Swedish Medical Birth Register.
- 2015
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In: Nicotine & Tobacco Research. - : Oxford University Press (OUP). - 1469-994X .- 1462-2203.
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Journal article (peer-reviewed)abstract
- Self-reported data on smoking during pregnancy from the Medical Birth Register of Sweden (MBR) are widely used. However, underreporting of such behaviour may occur, leading to biases. It is of importance to validate the smoking data in the MBR. The main objective was to investigate the agreement between self-reported smoking data from the MBR and cotinine levels in maternal serum among women from the general population in the region of Skåne, Sweden. We also estimated the transfer of cotinine from mother to fetus.
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| 29. |
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| 30. |
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| 31. |
- Nohlert, Eva, et al.
(author)
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Comparison of the cost-effectiveness of a high- and a low-intensity smoking cessation intervention in Sweden : A randomized trial
- 2013
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In: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 15:9, s. 1519-1527
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Journal article (peer-reviewed)abstract
- OBJECTIVE:To assess the relative cost-effectiveness of a high-intensity treatment (HIT) and a low-intensity treatment (LIT) for smoking cessation.METHODS:The societal and health care perspective economic evaluation was based on the reported number of quitters at 12-month follow-up (point prevalence) from a randomized controlled trial of 2 smoking cessation programs in Sweden. Future disease-related costs (in Swedish kronor [SEK] 2004; SEK7.35 = USD1) and health effects (in quality-adjusted life-years [QALYs]) were estimated via a Markov model comprising lung cancer, chronic obstructive pulmonary disease, and cardiovascular disease including stroke with costs and QALYs discounted 3% annually.RESULTS:HIT was more effective than LIT (23% vs. 16% quitters), but at a considerably higher intervention cost: SEK26,100 versus 9,100 per quitter. The model-estimated societal costs avoided did not balance the higher intervention costs, so the incremental cost-effectiveness ratio (ICER) amounted to SEK100,000 per QALY for HIT versus LIT. All sensitivity analyses indicated an ICER below SEK300,000 and that HIT is the preferred option if the decision maker willingness-to-pay exceeds SEK50,000 per QALY. Compared with no intervention, LIT was cost saving, whereas HIT was estimated at SEK8,400 per QALY.CONCLUSIONS:Compared with no smoking cessation program, it is a societal waste not to implement the LIT as it is estimated to result in lower societal costs. The incremental cost per QALY gained of SEK100,000 for HIT is considered very cost-effective in Sweden. Thus, if smoking cessation programs are judged in the same manner as other Swedish health care measures, the high-intensity program should be chosen before the low-cost program.
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| 32. |
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| 33. |
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| 34. |
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| 35. |
- Reitan, Therese, 1965-, et al.
(author)
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Changes in Smoking Rates Among Pregnant Women and the General Female Population in Australia, Finland, Norway, and Sweden
- 2017
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In: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 19:3, s. 282-289
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Journal article (peer-reviewed)abstract
- Introduction:Smoking rates have dropped substantially in most developed countries in recent decades. This general trend has, however, not always been evident among women—particularly younger women. Smoking habits do, however, often change in connection with pregnancy and the aim of this study is to determine whether smoking during pregnancy follows general trends in smoking rates in the general female population in four countries with active anti-tobacco policies and decreasing population smoking rates.Methods:Changes in rates of persistent smoking, that is, smoking in late pregnancy or daily smoking among all women of childbearing age were described according to age groups. Data were retrieved from the Australian Household Drug Surveys during 2000–2013 and from registries and surveys in Finland, Norway, and Sweden between 1995 and 2014.Results:In general, persistent smoking has decreased and late-pregnancy smoking rates are lower than daily smoking rates among all women. However, younger women are more likely to be persistent smokers regardless of pregnancy status. In Norway and Finland, persistent smoking was most common among young pregnant women and in Sweden there was an increased polarization between age groups. In Australia, a steady decrease in smoking rates appears to have stalled in younger pregnant women.Conclusion:Although smoking has declined substantially in recent decades, there are groups lagging behind this general trend. Young pregnant women are of particular concern in this respect. The possibility that these findings reflect the changing characteristics of younger pregnant women is discussed.Implications:This study puts recent trends in maternal smoking into a broader context by relating developments to changes in smoking rates among women in general. By using similar data from four countries we were able to follow changes in smoking rates “within” groups of women within the four countries without being limited by methodological problems related to cross-country or inter-group comparisons. We were above all able to show that aggregate data disclose the strong age gradient in maternal smoking habits.
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| 36. |
- Roberts, Bayard, et al.
(author)
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Prevalence and Psychosocial Determinants of Nicotine Dependence in Nine Countries of the Former Soviet Union
- 2013
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In: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 15:1, s. 271-276
-
Journal article (peer-reviewed)abstract
- Introduction: Despite the high prevalence of smoking in the former Soviet Union (fSU), particularly among men, there is very little information on nicotine dependence in the region. The study aim was to describe the prevalence of nicotine dependence in 9 countries of the fSU and to examine the psychosocial factors associated with nicotine dependence. Methods: Cross-sectional, nationally representative surveys using multistage random sampling were conducted in 2010 with men and women aged 18 years and over in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine. The main outcome of interest was nicotine dependence using the Fagerstrom Test for Nicotine Dependence. Multivariate regression analysis was then used to explore the influence of a range of psychosocial factors on higher nicotine dependence. Results: Mean nicotine dependence among men in the region as a whole was 3.96, with high dependence ranging from 17% in Belarus to 40% in Georgia. Among women, mean dependence was 2.96, with a prevalence of high dependence of 11% for the region. Gender (men), younger age of first smoking, lower education level, not being a member of an organization, bad household economic situation, high alcohol dependence, and high psychological distress showed significant associations with higher nicotine dependence. Conclusions: High nicotine dependence among men was recorded in a number of study countries. Findings highlight the need for tobacco programmes to target early age smokers and less educated and poorer groups and suggest common ground for programmes seeking to reduce nicotine dependence, harmful alcohol use, and psychological distress.
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| 37. |
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| 38. |
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| 39. |
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| 40. |
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| 41. |
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| 42. |
- Urquia, Marcelo L., et al.
(author)
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Smoking During Pregnancy Among Immigrant Women With Same-Origin and Swedish-Born Partners
- 2021
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In: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 23:2, s. 349-356
-
Journal article (peer-reviewed)abstract
- Introduction: Although ethnically mixed couples are on the rise in industrialized countries, their health behaviors are poorly understood. We examined the associations between partner's birthplace, age at immigration, and smoking during pregnancy among foreign-born women.Methods: Population-based register study including all pregnancies resulting in a livebirth or stillbirth in Sweden (1991-2012) with complete information on smoking and parental country of birth. We compared the prevalence of smoking during pregnancy between women in dual same-origin foreign-born unions (n = 213 111) and in mixed couples (immigrant women with a Swedish-born partner) (n = 111 866) using logistic regression. Swedish-born couples were used as a benchmark.Results: The crude smoking rate among Swedish women whose partners were Swedish was 11%. Smoking rates of women in dual same-origin foreign-born unions varied substantially by birthplace, from 1.3% among women from Asian countries to 23.2% among those from other Nordic countries. Among immigrant groups with prevalences of pregnancy smoking higher than that of women in dual Swedish-born unions, having a Swedish-born partner was associated with lower odds of smoking (adjusted odds ratios: 0.72-0.87) but with higher odds among immigrant groups with lower prevalence (adjusted odds ratios: 1.17-5.88). These associations were stronger among women immigrating in adulthood, whose smoking rates were the lowest.Conclusions: Swedish-born partners pull smoking rates of immigrant women toward the level of smoking of Swedish-born women, particularly among women arrived during adulthood. Consideration of a woman's and her partner's ethnic background and life stage at migration may help understand smoking patterns of immigrant women.
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| 43. |
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| 44. |
- Zhao, Xiang, PhD, 1987-, et al.
(author)
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Smoking Beliefs Among Chinese Secondary School Students : A Theory-Based Qualitative Study
- 2018
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In: Nicotine & tobacco research. - : Oxford University Press. - 1462-2203 .- 1469-994X. ; 20:3, s. 321-331
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Journal article (peer-reviewed)abstract
- Introduction: China has the world's greatest number of smokers but theory-based smoking interventions are rare. To develop an effective intervention, understanding the determinants of Chinese adolescent smoking is crucial. The Theory of Planned Behavior (TPB) is empirically supported to predict and assist in informing intervention strategies to change health-related behaviors. Based on the TPB, the elicitation of shared smoking beliefs among adolescents can inform future intervention designs among this at-risk population.Methods: We investigated the beliefs from six focus groups (N = 30) of one senior secondary school in Kunming, Yunnan Province, China. We used semi-structured questions based on the TPB framework, including prompts about behavioral (advantages and disadvantages), normative (important referents), and control (barriers and facilitators) beliefs. Following the Consensual Qualitative Research (CQR) methodology, data were discussed until consensus was reached. Auditing was undertaken by an external researcher.Results: Seven domains (advantages, disadvantages, approvers, disapprovers, facilitators, barriers, and smoker images) were examined. Smoking as a gendered behavior, smoking as influenced by cultural and environmental contexts, smoking as a strategy to cope with stress, and awareness of the harm of smoking, are highlighted themes across domains. Data suggested an extended-TPB framework as an appropriate approach to adopt when addressing smoking beliefs among the target population.Conclusions: These beliefs can be utilized to inform future school-based interventions and public health campaigns targeting smoking among Chinese adolescents.Implications: A modified TPB approach has potential for future smoking interventions among Chinese adolescents. Beliefs elicited in this study form a strong basis for designing a location- and population-specific antismoking programme.
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