scholarly journals Smoking Cessation in Stroke Survivors in the United States: A Nationwide Analysis

Stroke ◽  
2021 ◽  
Author(s):  
Neal S. Parikh ◽  
Melvin Parasram ◽  
Halina White ◽  
Alexander E. Merkler ◽  
Babak B. Navi ◽  
...  
Keyword(s):  
United States ◽  
Smoking Cessation ◽  
Cancer Survivors ◽  
The United States ◽  
Stroke Recurrence ◽  
Stroke Survivors ◽  
Related Condition ◽  
Cross Sectional ◽  
Quit Smoking ◽  
History Of

Background and Purpose: Continued smoking after stroke is associated with a high risk of stroke recurrence and other cardiovascular disease. We sought to comprehensively understand the epidemiology of smoking cessation in stroke survivors in the United States. Furthermore, we compared smoking cessation in stroke and cancer survivors because cancer is another smoking-related condition in which smoking cessation is prioritized. Methods: We performed a cross-sectional analysis of data from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System, an annual, nationally representative health survey. Using pooled data from 2013 to 2019, we identified stroke and cancer survivors with a history of smoking. We used survey procedures to estimate frequencies and summarize quit ratios with attention to demographic and geographic (state-wise and rural-urban) factors for stroke survivors. The quit ratio is conventionally defined as the proportion of ever smokers who have quit. Then, we used multivariable logistic regression to compare quit ratios in stroke and cancer survivors while adjusting for demographics and smoking-related comorbidities. Results: Among 4 434 604 Americans with a history of stroke and smoking, the median age was 68 years (interquartile range, 59–76), and 45.4% were women. The overall quit ratio was 60.8% (95% CI, 60.1%–61.6%). Quit ratios varied by age group, sex, race and ethnicity, and several geographic factors. There was marked geographic variation in quit ratios, ranging from 48.3% in Kentucky to 71.5% in California. Furthermore, compared with cancer survivors, stroke survivors were less likely to have quit smoking (odds ratio, 0.72 [95% CI, 0.67–0.79]) after accounting for differences in demographics and smoking-related comorbidities. Conclusions: There were considerable demographic and geographic disparities in smoking quit ratios in stroke survivors, who were less likely to have quit smoking than cancer survivors. A targeted initiative is needed to improve smoking cessation for stroke survivors.

Abstract MP28: Nationwide Racial Disparities in Smoking Cessation After Stroke in the United States

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Neal S Parikh ◽  
Melvin Parasram ◽  
Yongkang Zhang ◽  
Saad Mir ◽  
Halina White ◽  
...  
Keyword(s):  
United States ◽  
Smoking Cessation ◽  
Racial Disparities ◽  
Race And Ethnicity ◽  
Recurrent Stroke ◽  
The United States ◽  
Smoking History ◽  
Behavioral Risk ◽  
Stroke Survivors ◽  
Cross Sectional

Introduction: Black Americans face a higher risk of recurrent stroke than White Americans, and the reasons are unclear. Smoking after stroke is associated with a higher risk of recurrence. We investigated whether there are racial disparities in smoking cessation among stroke survivors in the United States. Methods: We performed a cross-sectional analysis of data from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System, an annual, nationally representative health survey. Respondents are asked about medical conditions and health-related behaviors. We pooled data from 2013-2018, during which race and ethnicity were uniformly reported. We included respondents with prior stroke and any smoking history. The exposure was self-reported race, and the outcome was smoking cessation. We calculated the quit ratio, defined as the proportion of former smokers among ever smokers; this is a standard measure in population-based studies of smoking cessation. Survey procedures were used to estimate frequencies and summarize quit ratios by race. Multiple logistic regression was used to assess the association of Black race with smoking cessation, as compared to White race, while adjusting for age, gender, Hispanic ethnicity, education, income, health insurance, and the number of smoking-related health conditions (heart disease, lung disease, cancer) that may prompt cessation. Results: Among 4,374,011 Americans with a history of stroke and any smoking, the median age was 67 years (IQR, 58-76), and 45.7% were women; 15.4% were Black, 74.8% were White, and 9.8% reported other race. The crude quit ratio was 51.4% (95% CI, 49.0-53.7) in Black and 63.2% (95% CI, 62.4-64.1) in White stroke survivors. In unadjusted analyses, Black stroke survivors were less likely to have quit smoking than White stroke survivors (OR, 0.61; 95% CI, 0.55-0.68). This remained the case after accounting for differences in demographics and smoking-related comorbidities (OR, 0.85; 95% CI, 0.74-0.98). Conclusion: In this nationwide study, Black stroke survivors had lower smoking quit rates than White stroke survivors, even after accounting for group differences. Expanding access to smoking-cessation interventions may reduce disparities in recurrent stroke.

Is cancer history associated with asset ownership, debt, and net worth in the United States?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18085-e18085
Author(s):  
Maryam Doroudi ◽  
Diarmuid Coughlan ◽  
Matthew P. Banegas ◽  
K Robin Yabroff
Keyword(s):  
United States ◽  
Cancer Survivors ◽  
The United States ◽  
Medical Expenditure ◽  
Age Group ◽  
Asset Ownership ◽  
Cancer History ◽  
Net Worth ◽  
History Of ◽  
History Of Cancer

e18085 Background: Financial hardships experienced by cancer survivors in the United States have become significant social and public health issues. Few studies have assessed the underlying financial holdings, including ownership and values of assets and debts, of individuals following a cancer diagnosis. This study assessed the association between a cancer history and asset ownership, debt, and net worth. Methods: We identified 1,603 cancer survivors and 34,915 individuals without a history of cancer aged 18-64 from the nationally representative Medical Expenditure Panel Survey (MEPS) Household Component and Asset sections (years 2008-2011). Descriptive statistics were used to assess demographic characteristics, cancer history, asset ownership, debt, and net worth by cancer history. Regression analysis was conducted to assess the association between cancer history and net worth, stratified by age group (18-34, 35-44, 45-54, and 55-64 years) to reflect stages of the life-course. Results: Asset ownership was least common for cancer survivors and individuals without a cancer history in the 18-34 age group and most common in the 55-64 age group. Cancers survivors aged 45-54 had a lower proportion of home ownership than individuals without a cancer history (59% vs 67%; p = 0.001). Nearly 20% of all respondents reported at least some debt. The proportion of cancer survivors with debt was higher than individuals without a history of cancer, especially in the 18-34 age group (41% vs 27%; p < 0.001), although it did not vary by age group. When asset and debt values were combined to assess net worth, cancer survivors aged 45-54 were significantly more likely to have a negative net worth and significantly less likely to have a positive net worth than those individuals without a history of cancer in fully adjusted models. Findings on net worth were similar in the 18-34 age group, although only statistically significant in unadjusted and partially adjusted models. Conclusions: We found that cancer history is associated with asset ownership, debt, and net worth, especially in those aged 45-54 years. Longitudinal studies to assess patterns of financial holdings throughout the cancer experience are warranted.

Depression and self-reported memory problems in adult-onset cancer survivors.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9586-9586
Author(s):  
Pascal Jean-Pierre ◽  
Paul Winters
Keyword(s):  
United States ◽  
Cancer Survivors ◽  
The United States ◽  
Adult Onset ◽  
Memory Impairments ◽  
Memory Problems ◽  
History Of ◽  
Nationally Representative ◽  
Brain Insults ◽  
History Of Depression

9586 Background: Memory impairments are debilitating adverse effects of cancer and its treatments. Depression may predispose or exacerbate memory problems. We examined the relationship between depression and memory problems in adult-onset cancer survivors. Methods: We included data from individuals who completed the National Health and Nutrition Examination Survey, a nationally representative, stratified, multistage probability sample of the civilian, non-institutionalized population of the United States from 2005 to 2010. We excluded individuals with a history of brain cancer or stroke since these conditions are expected to cause cognitive problems because of direct brain insults. We determined the prevalence of depression and its relationship to memory problems in cancer survivors by weighting our results proportionally. We controlled for demographic predictors of memory problems. Results: The sample included 14249 adults (6875 men and 7274 women) age 20 years and older. There were 6959 Whites, 2792 Blacks, 3903 Hispanics, and 589 other race/multiracial. Overall, individuals in the United States with a history of depression were 8.4 times more likely to report memory problems (Odds Ratio (OR), 8.406; 95%CI, 6.73 to 10.64). We further explored the depression-memory relationship in a subsample of cancer survivors. Adjusting for age, sex, race-ethnicity, education, income, and general health, cancer survivors with a history of depression were approximately 5 times more likely to report memory problems (N=1283; OR, 4.921; 95%CI, 2.141 to 11.313) than those without a history of depression. Other predictors of memory problems were age (≥ 60 years old, OR = 4.756, 95%CI, 1.957 to 11.560) and lower income (OR, 3.721; 95%CI, 1.951 to 7.098). Conclusions: The likelihood of memory problems is higher in cancer survivors with a history of depression. Future studies are needed to systematically delineate the depression-memory problems relationship, and to inform the development of interventions to treat these conditions for cancer survivors.

Characterizing Husbandry Risk Factors Associated with Metastatic Soft Tissue Mineralization in Zoo-Housed Komodo Dragons (Varanus komodoensis) in the United States

2021 ◽  
Author(s):  
Dawn Zimmerman ◽  
Jennifer H. Yu ◽  
Willem Schaftenaar ◽  
Laura Debnar ◽  
Drury Reavill ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Soft Tissue ◽  
Multinomial Logistic Regression ◽  
The United States ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Difference ◽  
History Of ◽  
Univariate Analyses

Metastatic soft tissue mineralization has emerged as a major cause of death in captive Komodo dragons ( Varanus komodoensis ). A cross-sectional survey-based study was performed to evaluate husbandry-related risk factors for metastatic mineralization in zoo-housed Komodo dragons in the United States. Nineteen institutions participated, nine of which (47.4%) had a history of metastatic mineralization within their collections. Husbandry at participating institutions varied in temperature gradients, outdoor exposure, artificial lighting, and diet items offered. Differences in husbandry were tested between institutions with and without a history of mineralization using univariate analyses, and variables resulting in a significance level ≤0.10 were entered into a multinomial logistic regression model. The only variable demonstrating a significant difference during univariate analyses was the number of dragons per enclosure ( p =0.036), while the only significant predictive variable after modeling was humidity approximation. Zoos that approximated rather than measured humidity were 12.0 times as likely to have a history of mineralization in their Komodo dragons (OR 12.0, p =0.045). These variables likely reflect the under- or overestimation of exhibit humidity levels, and the tendency to house males and females together. Based on post-mortem findings for 27 dragon mortalities from these institutions, the presence of mineralization at necropsy was significantly associated with female dragons (OR 18.2, p =0.0044) and yolk coelomitis or embolism (OR 6.76, p =0.046). Although this study did not identify definitive links between husbandry and the prevalence of mineralization at the institutional level, the survey revealed high variation in husbandry conditions, and potential

Factors associated with self-reported history of depression diagnosis among cancer survivors aged 18 years and over in the United States

2018 ◽  
Vol 27 (8) ◽  
pp. 2039-2044 ◽  
Author(s):  
Gemechu B. Gerbi ◽  
Stranjae Ivory ◽  
Elaine Archie-Booker ◽  
Mechelle D. Claridy ◽  
Stephanie Miles-Richardson
Keyword(s):  
United States ◽  
Cancer Survivors ◽  
The United States ◽  
Depression Diagnosis ◽  
Factors Associated ◽  
History Of ◽  
History Of Depression

scholarly journals Comparison of comorbidities and treatment between ankylosing spondylitis and non-radiographic axial spondyloarthritis in the United States

Rheumatology ◽  
2019 ◽  
Vol 58 (11) ◽  
pp. 2025-2030 ◽  
Author(s):  
Sizheng Steven Zhao ◽  
Joerg Ermann ◽  
Chang Xu ◽  
Houchen Lyu ◽  
Sara K Tedeschi ◽  
...  
Keyword(s):  
United States ◽  
Chart Review ◽  
The United States ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Academic Hospitals ◽  
Biologic Dmard ◽  
History Of ◽  
Icd Codes ◽  
The Mean

Abstract Objectives This study aimed to compare comorbidities and biologic DMARD (bDMARD) use between AS and non-radiographic axial SpA (nr-axSpA) patients, using a large cohort of patients from routine clinical practice in the United States. Methods We performed a cross-sectional study using electronic medical records from two academic hospitals in the United States. Data were extracted using automated searches (⩾3 ICD codes combined with text searches) and supplemented with manual chart review. Patients were categorized into AS or nr-axSpA according to classification criteria. Disease features, comorbidities (from a list of 39 chronic conditions) and history of bDMARD prescription were compared using descriptive statistics. Results Among 965 patients identified, 775 (80%) were classified as having axSpA. The cohort was predominantly male (74%) with a mean age of 52.5 years (s.d. 16.8). AS patients were significantly older (54 vs 46 years), more frequently male (77% vs 64%) and had higher serum inflammatory markers than those with nr-axSpA (median CRP 3.4 vs 2.2 mg/dl). Half of all patients had at least one comorbidity. The mean number of comorbidities was 1.5 (s.d. 2.2) and similar between AS and nr-axSpA groups. A history of bDMARD-use was seen in 55% of patients with no difference between groups. The most commonly prescribed bDMARDs were adalimumab (31%) and etanercept (29%). Ever-prescriptions of individual bDMARDs were similar between AS and nr-axSpA. Conclusion Despite age differences, nr-axSpA patients had similar comorbidity burdens as those with AS. Both groups received comparable bDMARD treatment in this United States clinic-based cohort.

Influenza Vaccination of Healthcare Workers in the United States, 1989-2002

2006 ◽  
Vol 27 (3) ◽  
pp. 257-265 ◽  
Author(s):  
Frances J. Walker ◽  
James A. Singleton ◽  
Pengjun Lu ◽  
Karen G. Wooten ◽  
Raymond A. Strikas
Keyword(s):  
United States ◽  
Influenza Vaccination ◽  
Healthcare Workers ◽  
Pneumococcal Vaccination ◽  
The United States ◽  
Hepatitis B Vaccination ◽  
Cross Sectional ◽  
Factors Associated ◽  
The Past ◽  
History Of

Objectives.We sought to estimate influenza vaccination coverage among healthcare workers (HCWs) in the United States during 1989-2002 and to identify factors associated with vaccination in this group. The Advisory Committee on Immunization Practices (ACIP) recommends annual influenza vaccination for HCWs to reduce transmission of influenza to patients at high risk for serious complications of influenza.Design.Analysis of cross-sectional data from 1989-2002 surveys conducted by the National Health Interview Survey (NHIS). The outcome measure was self-reported influenza vaccination in the past 12 months. Bivariate and multivariate analysis of 2002 NHIS data.Setting.Household interviews conducted during 1989-2002, weighted to reflect the noninstitutionalized, civilian US population.Participants.Adults aged 18 years or older participated in the study. A total of 2,089 were employed in healthcare occupations or settings in 2002, and 17,160 were employed in nonhealthcare occupations or settings.Results.The influenza vaccination rate among US HCWs increased from 10.0% in 1989 to 38.4% in 2002, with no significant change since 1997. In a multivariate model that included data from the 2002 NHIS, factors associated with a higher rate of influenza vaccination among HCWs aged 18-64 years included age of 50 years or older (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.1-2.1), hospital employee status (OR, 1.5; 95% CI, 1.2-1.9), 1 or more visits to the office of a healthcare professional in the past 12 months (OR, 1.5; 95% CI, 1.1-2.2), receipt of employer-provided health insurance (OR, 1.5; 95% CI, 1.1-2.1), a history of pneumococcal vaccination (OR, 3.9; 95% CI, 2.5-6.1), and history of hepatitis B vaccination (OR, 1.9; 95% CI, 1.4-2.4). Non-Hispanic black persons were less likely to be vaccinated (OR, 0.6; 95% CI, 0.5-0.9) than non-Hispanic white persons. There were no significant differences in vaccination levels according to HCW occupation category.Conclusions.Influenza immunization among HCWs reached a plateau during 1997-2002. New strategies are needed to encourage US HCWs to receive influenza vaccination to prevent influenza illness in themselves and transmission of influenza to vulnerable patients.

scholarly journals Smoking Cessation Using Wearable Sensors: Protocol for a Microrandomized Trial

10.2196/22877 ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. e22877
Author(s):  
Laura M Hernandez ◽  
David W Wetter ◽  
Santosh Kumar ◽  
Steven K Sutton ◽  
Christine Vinci
Keyword(s):  
United States ◽  
Smoking Cessation ◽  
Real Time ◽  
Trial Design ◽  
Wearable Sensors ◽  
Ethnically Diverse ◽  
The United States ◽  
Feasibility Trial ◽  
Quit Attempt ◽  
Quit Smoking

Background Cigarette smoking has numerous health consequences and is the leading cause of morbidity and mortality in the United States. Mindfulness has the ability to enhance resilience to stressors and can strengthen an individual’s ability to deal with discomfort, which may be particularly useful when managing withdrawal and craving to smoke. Objective This study aims to evaluate feasibility results from an intervention that provides real-time, real-world mindfulness strategies to a sample of racially and ethnically diverse smokers making a quit attempt. Methods This study uses a microrandomized trial design to deliver mindfulness-based strategies in real time to individuals attempting to quit smoking. Data will be collected via wearable sensors, a study smartphone, and questionnaires filled out during the in-person study visits. Results Recruitment is complete, and data management is ongoing. Conclusions The data collected during this feasibility trial will provide preliminary findings about whether mindfulness strategies delivered in real time are a useful quit smoking aid that warrants additional investigation. Trial Registration Clinicaltrials.gov NCT03404596; https://clinicaltrials.gov/ct2/show/NCT03404596 International Registered Report Identifier (IRRID) DERR1-10.2196/22877

Abstract WMP111: Trends in Active Tobacco Smoking Among Stroke Survivors in The United States: An Analysis of the National Health and Nutrition Examination Survey, 1999-2016

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Neal S Parikh ◽  
Abhinaba Chatterjee ◽  
Alexander E Merkler ◽  
Mackenzie P Lerario ◽  
Costantino Iadecola ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
National Health ◽  
The United States ◽  
Self Report ◽  
Stroke Survivors ◽  
Nutrition Examination Survey ◽  
Active Smoking ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
Prior Stroke

Background: Active smoking after stroke is associated with worse outcomes. Since several smoking cessation drugs have become available during the last two decades, we sought to determine whether the rate of active smoking among stroke survivors has decreased. Methods: We performed a trends analysis using cross-sectional data from all nine available consecutive cycles of the continuous phase of the National Health and Nutrition Examination Survey from 1999 to 2016. Participants in each cycle were asked about their medical history and health-related behaviors. We included participants 20 years of age and older who answered questions regarding smoking. Patients with prior stroke were identified based on self-report, which has been validated against expert chart review. Active smoking was defined based on self-report. We used multivariable logistic regression methods for survey data to assess for trends in active smoking among all participants and those with prior stroke. Models were adjusted for demographics. Results: We included 49,440 participants in our analysis, of whom 1,921 (2.7%) reported a prior stroke. The mean age of stroke survivors was 64.8 (standard error, 0.5) years, and 57% were women. The average prevalence of active smoking over 1999-2016 was 22.2% for the whole sample and 24.3% among stroke survivors. In the overall population, the adjusted prevalence of active smoking decreased over the study period (odds ratio [OR] per cycle, 0.96; 95% confidence interval [CI], 0.94-0.97). The rate did not decrease among stroke survivors (OR, 1.01; 95% CI, 0.93-1.09) (Fig). Conclusion: Despite the availability of several effective smoking cessation therapies, the rate of active smoking among stroke survivors has not decreased in the past two decades. Effective strategies for smoking cessation for secondary stroke prevention are needed.

Determinan perilaku berhenti merokok pada penderita hipertensi di Kabupaten Sleman

2017 ◽  
Vol 33 (3) ◽  
pp. 135 ◽  
Author(s):  
Nurvita Wikansari ◽  
Nyoman Kertia ◽  
Fatwa Sari Tetra Dewi
Keyword(s):  
Smoking Cessation ◽  
Economic Status ◽  
Total Sample ◽  
Sample Population ◽  
Chi Square ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Professional Advice ◽  
Quit Smoking ◽  
History Of

Purpose: This study aimed to determine the factors associated with smoking cessation behavior in patients with hypertension in Sleman district.Methods: This quantitative study used a cross-sectional design. The subjects of this study were all patients with hypertension with a history of smoking. There were those subjects who had stopped smoking and those still smoking totaling 120 respondents. The sample population was the total sample that met the inclusion and exclusion criteria. Data analysis was done by bivariate and multivariate analysis using chi square and logistic regression tests.Results: This study found that factors related to smoking cessation behavior in hypertensive patients in Sleman district were education with PR 1.56 (95% CI 1.111-2.274; p=0.004) and history of other disease with PR 2.7 (95% CI 1.209-6.031; p=0.007). Age, occupation, marital status, economic status, and health professional advice were not related to smoking cessation behavior in hypertensive patients in Sleman district.Conclusion: Health and community institutions are expected to support hypertensive patients to quit smoking by advising them of the health risks. This study showed people who quit smoking, may start smoking again.

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