America’s Choice: Reducing Tobacco Addiction and Disease

Background:Smoking is one of the most significant modifiable exosomes risk factors for rheumatoid arthritis (RA) (1). Studies suggest that 25-30% of people with RA in Denmark smoke (2). This is almost twice as many as in the background population in Denmark. People with RA have a significant increased risk of severe comorbidity including cardiovascular disease. In addition, there are indications that smokers with RA have a poorer effect of the medical inflammatory treatment compared to non-smokers, and consequently more difficult to achieve remission of the disease activity (3). Tobacco addiction is complex and can be a challenge in smoking cessation. In addition to physiological dependence, habits and social and environmental factors may influence addiction. Tobacco smoking is associated with an addiction to nicotine and it is unexplored how this addiction appears in people with RA.Objectives:The aim of this study was to examine from the patient’s perspective how tobacco addiction appears in people with rheumatoid arthritis.Methods:We conducted a qualitative study based on a hermeneutics approach. People with RA who previously had participated in a randomized controlled study (4) about smoking cessation conducted at the Center for Rheumatology and Spine Diseases at Rigshospitalet, Denmark were recruited for semi-structured interviews.Results:In total, 12 people with RA (50% female) were included in the study. The median age was 62 years and median RA disease duration was 12 years. The degree of physical dependence measured by Fagerströms Test for Nicotine dependence (FTND) was on average: 4.9 (score: 0-10, 0=nonphysical dependence).Three categories of how tobacco addiction appeared emerged during the analysis: 1)It develops into ingrown habitsreferring to the fact that smoking already in adolescence contributes to the development of specific physical, mental and social smoking behavior. Not all individuals considered themselves addicted to nicotine as they did not necessarily connect the nicotine to the ingrown habits. 2)The body craves for nicotinereferring to nicotine proved calming, while a lacking or insufficient dose caused withdrawal symptoms. Furthermore, smoking became a habit where a craving for smoking occurred in certain situations. 3)Ambivalence – for and againstreferring to the physical dependence and smoking habits making a smoking cessation difficult. Dependency to nicotine and challenges to quit smoking led to a feeling of ambivalence and a lack of control.Conclusion:Tobacco addiction appeared as a physical dependence and a habit, which, during a smoking cessation, led to ambivalent feelings. Therefore, based on this study, there is still a need for health professionals to talk to patients about smoking. But also, a need to articulate the complexity of addiction in order to support for smoking cessations. Information should be strengthened in the clinical practice in relation to nicotine’s implication in tobacco addiction as well as the consequences of tobacco smoking for individuals with RA.References:[1]Scott DL, Wolfe F, Huizinga TW. Lancet. 2010 ###[2]Loppenthin K, Esbensen BA, Jennum P, Ostergaard M, Tolver A, Thomsen T, et al. Clin Rheumatol. 2015. ###[3]Roelsgaard IK, Ikdahl E, Rollefstad S, Wibetoe G, Esbensen BA, Kitas GD, et al. Rheumatology (Oxford). 2019. ###[4]Roelsgaard IK, Thomsen T, Ostergaard M, Christensen R, Hetland ML, Jacobsen S, et al. Trials. 2017;18(1):570.###Disclosure of Interests:None declared

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The Sociopharmacology of Tobacco Addiction: Implications for Understanding Health Disparities

Nicotine & Tobacco Research ◽

10.1093/ntr/ntv084 ◽

2015 ◽

Vol 18 (2) ◽

pp. 110-121 ◽

Cited By ~ 22

Author(s):

Adam M. Leventhal

Keyword(s):

Health Disparities ◽

Tobacco Addiction

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Electronic Cigarette: Role in the Primary Prevention of Oral Cavity Cancer

Clinical Medicine Insights Ear Nose and Throat ◽

10.4137/cment.s40364 ◽

2016 ◽

Vol 9 ◽

pp. CMENT.S40364 ◽

Cited By ~ 15

Author(s):

Teresa Franco ◽

Serena Trapasso ◽

Lidia Puzzo ◽

Eugenia Allegra

Keyword(s):

Primary Prevention ◽

Oral Cavity ◽

Oral Cavity Cancer ◽

Electronic Cigarettes ◽

Micronucleus Assay ◽

Electronic Cigarette ◽

Cytologic Examination ◽

Oral Cavity Carcinoma ◽

Gender And Age ◽

Tobacco Addiction

Background Cigarette smoke has been identified as the main cause of oral cavity carcinoma. Recently, the electronic cigarette, a battery-operated device, was developed to help smokers stop their tobacco addiction. This study aimed to evaluate the safety of electronic cigarettes and to establish the possible role of such device in the primary prevention of oral cavity cancer. Subjects and Methods This study included 65 subjects who were divided into three groups (smokers, e-cigarette smokers, and nonsmokers). All subjects were submitted to cytologic examination by scraping of oral mucosa. The slides were microscopically evaluated through a micronucleus assay test. Results The prevalence of micronuclei was significantly decreased in the e-cigarette smoker group. There were no statistically significant differences in micronuclei distribution according to the type of cigarette, gender, and age. Conclusions The use of electronic cigarettes seems to be safe for oral cells and should be suggested as an aid to smoking cessation.

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COMPARISON OF CLINICO-SOCIAL PROFILE OF PULMONARY AND EXTRA PULMONARY TUBERCULOSIS IN TERTIARY CARE HOSPITAL IN A RURALAREA: A RETROSPECTIVE STUDY

10.36106/ijsr/4605295 ◽

2021 ◽

pp. 70-72

Author(s):

Gaurav Santosh Nemade ◽

Sumit Nitin Dhus ◽

Arushi Ramesh Shetty ◽

Neha Dhananjay Firake

Keyword(s):

Tertiary Care ◽

Care Hospital ◽

Female Ratio ◽

Extra Pulmonary Tuberculosis ◽

Younger Age ◽

Tobacco Addiction ◽

History Of ◽

Early Case ◽

Male To Female ◽

Clinical Characteristic

BACKGROUND AND OBJECTIVES: The burden of tuberculosis (TB) in India is the highest accounting for 26% of the global incidence. A total of 1.4 million people died from TB in 2019 (including 208 000 people with HIV). India accounts for a fourth of the global burden of TB and 29% of global mortality. Therefore, we carried out this study to compare demographic, lifestyle and clinical characteristic between pulmonary TB (PTB) and extrapulmonary TB (EPTB). MATERIALS AND METHODOLOGY:Aretrospective analysis was carried of 348 patients diagnosed in DOTS centre, Pravara Rural Hospital, Loni. Characteristics of demographic and clinical characteristics were obtained from medical case records. RESULTS:Among the 348 cases, 71.3% were PTB and 28.7% were EPTB including, pleural (36%), meningeal (27%) and lymphatic (20%) cases. The male to female ratio in PTB and EPTB are 1.99 and 1.22 respectively. EPTB was more common at younger age (<25 years). Tobacco addiction (10.9%), diabetes mellitus (4.03%), HIV positivity (12.1%) and history of contact with Tb patients (17.7%) were more likely to be associated with PTB. CONCLUSION:Increased awareness of the risk factors may facilitate early case nding and better management outcomes for these patients.

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