scholarly journals What differs former, light and heavy smokers? Evidence from a post-conflict setting

2021 ◽  
Vol 21 (1) ◽  
pp. 112-22
Author(s):  
Tatjana Gazibara ◽  
Marija Milic ◽  
Milan Parlic ◽  
Jasmina Stevanovic ◽  
Nebojsa Mitic ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Smoking Status ◽  
Smoking Prevention ◽  
Second Hand Smoke ◽  
Tobacco Prevention ◽  
Conflict Setting ◽  
Heavy Smoking ◽  
Post Conflict ◽  
Former Smokers ◽  
Heavy Smokers

Background: Evidence suggests that people who live in regions affected by the armed conflict are more likely to smoke. Objective: The purpose of this study was to assess factors associated with smoking status in a sample of students in the northern Kosovo province. Materials and methods: A total of 514 students enrolled in University in Kosovska Mitrovica, Kosovo, were recruited be- tween April to June 2015 at Student Public Health Center during mandatory health checks. Participants filled in socio-demo- graphic and behavioral questionnaire and Beck Depression Inventory (BDI). Based on responses about smoking, students were categorized in non-smokers, former smokers, light smokers (1-13 cigarettes/day) and heavy smokers (> 13 cigarettes/ day). Results: Of 514 students, 116 (22.6%) classified themselves as smokers. Higher education level of fathers (Odds ra- tio [OR]=2.89, 95% confidence interval [CI] 1.30-6.44, p=0.009), not living with smokers (OR=0.42, 95%CI 0.15-0.97, p=0.017) and longer exposure to second hand smoke (OR=1.07, 95%CI 1.01-1.13, p=0.036) was associated with former smoking. Studying medical and natural sciences (OR=2.07, 95%CI 1.05-4.18, p=0.040), consuming alcohol (OR=2.98, 95%CI 1.19-10.03, p=0.020), living with smokers (OR=2.88, 95%CI 1.49-5.56, p=0.002), longer exposure to second hand smoke (OR=1.06, 95%CI 1.01-1.11, p=0.019) and having a more intense depressive symptoms (OR=1.08, 95%CI 1.03-1.13, p=0.002) was associated with light smoking. Being male (OR=0.22, 95%CI 0.07-0.41, p=0.001), older (OR=1.47, 95%CI 1.21-1.78, p=0.001), living with smokers (OR=3.78, 95%CI 1.69-8.07, p=0.001), longer daily exposure to second-hand smoke (OR=1.10, 95%CI 1.04-1.16, p=0.001), and having more severe depressive symptoms (OR=1.12, 95%CI 1.07-1.18, p=0.001) were associated with heavy smoking. Conclusion: Smoking prevention and cessation programs should include the entire community, because exposure to en- vironmental second hand smoke may facilitate initiation and more intense smoking. Screening of student smokers for depression should be prioritized in the process of rebuilding the framework for primary and secondary prevention in the post-conflict period. Keywords: Students; smoking; tobacco; prevention.

scholarly journals Validation of Self-Reported Smoker and Second Hand Smoke Exposure by Urinary Cotinine within The Malaysian Cohort Project

2019 ◽  
Vol 5 (1) ◽  
pp. 15
Author(s):  
Noraidatulakma Abdullah
Keyword(s):  
High Performance ◽  
Smoking Status ◽  
Smoke Exposure ◽  
Misclassification Rate ◽  
Second Hand Smoke ◽  
Urinary Cotinine ◽  
Urine Cotinine ◽  
Second Hand Smoke Exposure ◽  
Former Smokers

Background: Validation of self-reported questionnaire is very crucial in ensuring the quality and reliability of data collection. Objective: The aim of this study were i) to validate the questionnaire on tobacco smoke intake and second hand smoke exposure among The Malaysian Cohort (TMC) subjects through the determination of urinary cotinine levels, ii) to determine the optimal cut-off point of urine cotinine that discriminates smokers from non-smokers and iii) to estimate misclassification rate between self-reported smoking and urinary cotinine level.Methods: Urine samples from a total of 775 The Malaysian Cohort subjects (104 smokers, 102 former smokers and 569 non-smokers) were obtained and urinary cotinine levels were determined by high-performance liquid chromatography (HPLC). Differences between groups were compared using Kruskal Wallis and Mann-Whitney tests. The Receiver Operating Characteristic (ROC) curved was performed to define the optimal urinary cotinine cut-off point.Results: Urinary cotinine concentration significantly (p<0.001) correlated with smoking status (r=0.46), the average number of cigarettes smoked per day (r=0.53), duration of smoking (r=0.33) and number of cigarettes packed per year (r=0.47). Smokers and second hand smokers have significantly higher median cotinine levels (978.40 and 21.31 respectively) compared to non-smokers (15.52) and non-exposed (13.60) subjects. Cotinine level at cut-off value of 1.51 ng/mg creatinine is able to distinguish smokers and non-smokers with a sensitivity of 84.62% and specificity of 81.97%.Conclusion: The Malaysian Cohort self-reported smoking questionnaire is a reliable tool in assessing the use of tobacco and second hand smoke exposure among the subjects.

Smoking history and PD-1/PDL-1 pathway blockade: Predicting response to treatment in metastatic cancer.

2019 ◽  
Vol 37 (8_suppl) ◽  
pp. 95-95 ◽  
Author(s):  
Caitlin Marie Sullivan ◽  
Jonathan Lu ◽  
John Ross Kucharczyk ◽  
Diana Vesselinovitch ◽  
Neharika Khurana ◽  
...  
Keyword(s):  
Treatment Response ◽  
Smoking Status ◽  
Metastatic Cancer ◽  
Post Treatment ◽  
Inhibitor Therapy ◽  
Response To Treatment ◽  
Smoking History ◽  
Heavy Smoking ◽  
Never Smokers ◽  
Heavy Smokers

95 Background: Identifying patients who will benefit from immune-checkpoint inhibitor therapy is a challenge as proven predicative indicators remain to be elucidated. High tumor mutational burden (TMB) represents a possible biomarker for response to PD1 blockade such as in nivolumab or pembrolizumab. Genomic analyses have shown that patients with heavy smoking history are more likely to have high TMB. However smoking status alone has not been examined independently in relation to treatment response. We sought to determine whether a relationship existed between smoking history and response to treatment in metastatic non-small cell lung cancer (NSCLC), metastatic renal cell carcinoma (mRCC) and metastatic melanoma (mMelanoma). Methods: A retrospective analysis was conducted of Ochsner Health System patients with mRCC, mMelanoma, and NSCLC receiving a minimum of two cycles of nivolumab or pembrolizumab between 12/2014 and 01/2018. Pre- and post-treatment target lesions were analyzed using RECIST criteria to calculate best response to treatment. Patient demographic information was gathered including age, sex, smoking history, and performance status pre and post treatment. Kaplan-Meier method was used to estimate progression free survival (PFS) and overall survival (OS) outcomes. Results: Heavy smokers (>10 pack-years) had a higher response to immunotherapy than light (< 10 years) and never smokers (p = 0.0500). Heavy smokers with NSCLC treated with immuno-therapy also had significantly improved OS compared to light smokers with NSCLC (p=0.003). mRCC immuno-therapy patients with heavy smoking history showed increased PFS compared to light/never smokers (p=0.026). Conclusions: In summary, in response to PD-1 blockade heavy smokers showed improved survival compared to light and never smokers suggesting smoking history may represent a potential predictor of treatment response to PD-1 inhibitor therapy.[Table: see text]

scholarly journals Indonesian adolescents’ perspectives on smoking habits: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fithria Fithria ◽  
Muhammad Adlim ◽  
Syarifah Rauzatul Jannah ◽  
Teuku Tahlil
Keyword(s):  
Qualitative Study ◽  
Junior High School ◽  
Smoking Status ◽  
Smoking Habit ◽  
Peer Pressure ◽  
Prevention Programs ◽  
Smoking Prevention ◽  
Smoking Habits ◽  
Related Factors ◽  
Effective Prevention

Abstract Background The prevalence of smoking among adolescents is high in Indonesia. Therefore, this qualitative research aimed to explore the perspectives of Muslim adolescents on smoking habits as a reference for developing effective prevention programs. Methods Three focus group discussions involving 24 junior high school male students (mean age = 13.75 years) were the main source of data for this phenomenological qualitative study. The discussion guide was developed by the researchers based on the reviewed literature and validated by experts. The research findings were analyzed using an inductive content analysis with systematic steps based on the stages of qualitative data analysis. Results Adolescent perspectives on smoking were grouped into two themes: perception of smoking and smoking-related factors. The perception of smoking encompassed three sub-themes: smoking as a social habit, contradictive feelings, and the Islamic perspective. The smoking-related factors included peer pressure, the parents’ smoking status, masculinity and curiosity. The results indicated that adolescents consider smoking as a social habit but with contradictory feelings. The smoking habit was also stimulated by peer pressure, imitating parents who smoke, feeling masculine and curiosity. Conclusion We suggest that health professionals who are interested in developing smoking prevention programs in Indonesia should consider the adolescent perspective on smoking so that the prevention program will be more effective and appropriate for adolescents.

scholarly journals Pre-diagnosis neutrophil-to-lymphocyte ratio and mortality in individuals who develop lung cancer

2021 ◽  
Author(s):  
Laurie Grieshober ◽  
Stefan Graw ◽  
Matt J. Barnett ◽  
Gary E. Goodman ◽  
Chu Chen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Proportional Hazards ◽  
Smoking Status ◽  
Cox Proportional Hazards ◽  
Neutrophil To Lymphocyte Ratio ◽  
Blood Draw ◽  
Lymphocyte Ratio ◽  
Cox Proportional Hazards Models ◽  
Inflammatory Profile ◽  
Heavy Smokers

Abstract Purpose The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation that has been reported to be associated with survival after chronic disease diagnoses, including lung cancer. We hypothesized that the inflammatory profile reflected by pre-diagnosis NLR, rather than the well-studied pre-treatment NLR at diagnosis, may be associated with increased mortality after lung cancer is diagnosed in high-risk heavy smokers. Methods We examined associations between pre-diagnosis methylation-derived NLR (mdNLR) and lung cancer-specific and all-cause mortality in 279 non-small lung cancer (NSCLC) and 81 small cell lung cancer (SCLC) cases from the β-Carotene and Retinol Efficacy Trial (CARET). Cox proportional hazards models were adjusted for age, sex, smoking status, pack years, and time between blood draw and diagnosis, and stratified by stage of disease. Models were run separately by histotype. Results Among SCLC cases, those with pre-diagnosis mdNLR in the highest quartile had 2.5-fold increased mortality compared to those in the lowest quartile. For each unit increase in pre-diagnosis mdNLR, we observed 22–23% increased mortality (SCLC-specific hazard ratio [HR] = 1.23, 95% confidence interval [CI]: 1.02, 1.48; all-cause HR = 1.22, 95% CI 1.01, 1.46). SCLC associations were strongest for current smokers at blood draw (Interaction Ps = 0.03). Increasing mdNLR was not associated with mortality among NSCLC overall, nor within adenocarcinoma (N = 148) or squamous cell carcinoma (N = 115) case groups. Conclusion Our findings suggest that increased mdNLR, representing a systemic inflammatory profile on average 4.5 years before a SCLC diagnosis, may be associated with mortality in heavy smokers who go on to develop SCLC but not NSCLC.

scholarly journals E-cigarettes from the perspective of teenagers – results of focus studies

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Pluta ◽  
Ł Balwicki
Keyword(s):  
Young People ◽  
Preventive Measures ◽  
Electronic Cigarettes ◽  
Smoking Status ◽  
Risky Behaviors ◽  
Tobacco Prevention ◽  
Tobacco Products ◽  
Traditional Tobacco ◽  
The Impact ◽  
Natural Way

Abstract Research shows that over 80% of smokers start their habit under the age of 18. A few years ago young people undertook risky behaviors related to nicotine initiation mainly by smoking cigarettes. Today, next to traditional tobacco products, electronic cigarettes are becoming more and more popular. Due to the prevalence of new forms of nicotine addiction, modification of anti-tobacco prevention programs is required. The purpose of the research was exploration - learning the opinions and attitudes of young people towards e-cigarettes. The qualitative study was conducted using the FGI method (focus group interview). The meetings were modereted by specially trained psychologists. 48 students participated in the meetings of six focus groups, divided by gender and smoking status (smokers/non-smokers). The participants are young people aged 15-19, attending high schools in Warsaw, Kielce and Lublin. In conversations, young people emphasized the impact of e-cigarettes in smoking initiation - it usually occurs at the age of 12-14. E-cigarettes are perceived as cigarettes “for younger”, non-addictive, less serious, providing more entertainment. 'Cloud chasing' is particularly popular. They perform social functions - they are helpful in establishing relationships. Teenagers do not see the harmfulness of e-cigarettes. Participants mentioned their advantages over traditional tobacco products - they can be smoked everywhere and do not leave an unpleasant smell. Some of the respondents admit to the simultaneous use of electronic and traditional cigarettes. Moreover, many parents allow children to smoke electronic cigarettes. Vaping have become a natural way to relaxation and socialization for adolescents. E-cigarettes do not have such a negative connotation as traditional tobacco products. Young people do not see them as harmful, which is a challenge for effective preventive measures. Key messages Adolescents do not see e-cigarettes as harmful, which is a challenge for effective preventive measures. Vaping have become more and more popular - it's natural way to relaxation and socialization for young people.

scholarly journals Smoking status and second-hand smoke biomarkers in COPD, asthma and healthy controls

2020 ◽  
Vol 6 (2) ◽  
pp. 00192-2019 ◽  
Author(s):  
Matteo Bradicich ◽  
Macé M. Schuurmans
Keyword(s):  
Sensitivity And Specificity ◽  
Smoking Status ◽  
Final Analysis ◽  
Integrated Approach ◽  
Second Hand Smoke ◽  
Healthy Controls ◽  
Tobacco Exposure ◽  
Urinary Cotinine ◽  
Pubmed Database ◽  
Shs Exposure

IntroductionTobacco smoke worsens COPD and asthma. For healthy individuals, quantifying active and second-hand smoke (SHS) exposure clarifies the epidemiology of tobacco consumption and the efficacy of nonsmoking measures. Identifying tobacco exposure biomarkers and cut-offs might allow the creation of sensitive and specific tests.AimWe describe the state-of-the-art serum, urinary cotinine and exhaled carbon monoxide (CO) cut-offs for assessing smoking status and SHS exposure in adult patients with COPD or asthma, and healthy controls.MethodologyAfter a keyword research in the PubMed database, we included papers reporting on the cut-offs of the investigated biomarkers in one of the populations of interest. Papers published before 2000, not in English, or reporting only data on nonadult subjects or on pregnant women were excluded from the analysis. 14 papers were included in the final analysis. We summarised diagnostic cut-offs for smoking status or SHS exposure in COPD, asthmatic and healthy control cohorts, reporting sensitivity and specificity when available.ConclusionSerum and urinary cotinine and exhaled CO are easy-to-standardise, affordable and objective tests for assessing smoking status and SHS exposure. Evidence on cut-offs with good sensitivity and specificity values is available mainly for healthy controls. For COPD and asthmatic patients, most of the currently available evidence focuses on exhaled CO, while studies on the use of cotinine with definite sensitivity and specificity values are still missing. Solid evidence on SHS exposure is available only for healthy controls. An integrated approach with a combination of these markers still needs evaluation.

scholarly journals Self-reported and cotinine-verified smoking and increased risk of incident hearing loss

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Woncheol Lee ◽  
Yoosoo Chang ◽  
Hocheol Shin ◽  
Seungho Ryu
Keyword(s):  
Smoking Status ◽  
Objective Measure ◽  
Self Report ◽  
Urinary Cotinine ◽  
Increased Risk ◽  
Former Smokers ◽  
Never Smokers ◽  
Time Varying Covariates ◽  
New Onset

AbstractWe examined the associations of smoking status and urinary cotinine levels, an objective measure of smoking, with the development of new-onset HL. This cohort study was performed in 293,991 Korean adults free of HL who underwent a comprehensive screening examination and were followed for up to 8.8 years. HL was defined as a pure-tone average of thresholds at 0.5, 1.0, and 2.0 kHz ≥ 25 dB in both ears. During a median follow-up of 4.9 years, 2286 participants developed new-onset bilateral HL. Self-reported smoking status was associated with an increased risk of new-onset bilateral HL. Multivariable-adjusted HRs (95% CIs) for incident HL comparing former smokers and current smokers to never-smokers were 1.14 (1.004–1.30) and 1.40 (1.21–1.61), respectively. Number of cigarettes, pack-years, and urinary cotinine levels were consistently associated with incident HL. These associations were similarly observed when introducing changes in smoking status, urinary cotinine, and other confounders during follow-up as time-varying covariates. In this large cohort of young and middle-aged men and women, smoking status based on both self-report and urinary cotinine level were independently associated with an increased incidence of bilateral HL. Our findings indicate smoking is an independent risk factor for HL.

scholarly journals Electronic cigarette use is associated with depressive symptoms among smokers and former smokers: Cross-sectional and longitudinal findings from the Constances cohort

2019 ◽  
Vol 90 ◽  
pp. 85-91 ◽  
Author(s):  
Emmanuel Wiernik ◽  
Guillaume Airagnes ◽  
Emeline Lequy ◽  
Ramchandar Gomajee ◽  
Maria Melchior ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Electronic Cigarette ◽  
Cigarette Use ◽  
Cross Sectional ◽  
Former Smokers

scholarly journals 364 KRAS mutations in patients with nonsquamous non–small-cell lung cancer: prevalence and relationship with PD-L1 expression, tumor mutation burden and smoking status

2021 ◽  
Vol 9 (Suppl 3) ◽  
pp. A391-A391
Author(s):  
Marina Chiara Garassino ◽  
Delvys Rodriguez-Abreu ◽  
Shirish M Gadgeel ◽  
Dariusz M Kowalski ◽  
Kazuo Kasahara ◽  
...  
Keyword(s):  
Smoking Status ◽  
Patient Characteristics ◽  
First Line ◽  
Link Type ◽  
First Line Therapy ◽  
Mutational Status ◽  
Mutation Burden ◽  
Platinum Based Chemotherapy ◽  
Former Smokers ◽  
Nonsquamous Nsclc

BackgroundPembrolizumab is a standard-of-care first-line treatment for advanced/metastatic NSCLC, either as monotherapy (for patients with PD-L1 tumor proportion score [TPS] ≥1%) or combined with platinum chemotherapy. An improved OS benefit has been demonstrated for both pembrolizumab monotherapy and pembrolizumab plus chemotherapy in patients with higher tumor PD-L1 expression, and for pembrolizumab monotherapy in patients with higher tissue tumor mutation burden (tTMB). Mutations in KRAS occur relatively frequently in patients with nonsquamous NSCLC but infrequently in those with squamous NSCLC; most mutations are in codon 12. Notably, the pembrolizumab OS treatment effect was not diminished in patients with KRAS G12C mutations in phase 3 studies evaluating pembrolizumab monotherapy and pembrolizumab in combination with chemotherapy.1 2 Herein we describe prevalence of KRAS mutations among patients with advanced nonsquamous NSCLC from two phase 3 clinical studies evaluating first-line pembrolizumab (KEYNOTE-042 and KEYNOTE-189) and the relationship of such mutations with select patient characteristics.MethodsKEYNOTE-042 (NCT02220894) evaluated pembrolizumab versus platinum-based chemotherapy for advanced PD-L1–positive NSCLC (any histology) without EGFR/ALK alterations. KEYNOTE-189 (NCT02578680) evaluated pembrolizumab plus platinum-based chemotherapy versus platinum-based chemotherapy alone for metastatic nonsquamous NSCLC without EGFR/ALK alterations irrespective of tumor PD-L1 expression. Whole-exome sequencing of tumor tissue and matched normal DNA (blood) was performed for patients with nonsquamous histology. PD-L1 TPS was evaluated using the PD-L1 IHC 22C3 pharmDx assay (Agilent Technologies, Carpinteria, CA, USA). Prevalence of KRAS mutations and their relationships with TMB, PD-L1 TPS, and smoking status were analyzed descriptively.Results590 patients with nonsquamous NSCLC were included in these analyses (KEYNOTE-042, n=301; KEYNOTE-189, n=289). Overall, 42.9% of patients had tTMB ≥175 mut/exome, 81.4% were current/former smokers and, 40.3%, 42.7%, and 16.9% had PD-L1 TPS ≥50%, 1–49% and <1% respectively. KRAS G12C, G12D, and G12V mutations occurred in 11.0%, 4.1%, and 5.4% of patients, respectively. Prevalence of KRAS mutations by patient characteristics is summarized in the table (table 1). KRAS G12C mutations occurred almost exclusively in current/former smokers. KRAS G12C was enriched in tumors with tTMB ≥175 mut/exome and tumors with PD-L1 TPS ≥50%. Prevalence was highest in tumors with both tTMB ≥175 mut/exome and PD-L1 TPS ≥50%.Abstract 364 Table 1KRAS Mutation PrevalenceConclusionsKRAS G12C mutations occurred with moderate frequency in patients with nonsquamous NSCLC, with most occurring in current/former smokers. KRAS G12C mutations occurred at higher frequency in patient subgroups defined by higher tTMB and PD-L1 TPS.AcknowledgementsMedical writing assistance was provided by Christabel Wilson, MSc, of ICON plc (North Wales, PA, USA), funded by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA.Trial RegistrationKEYNOTE-042, ClinicalTrials.gov, NCT02220894; KEYNOTE-189, ClinicalTrials.gov, NCT02578680ReferencesGadgeel S, Rodriguez-Abreu D, Felip E, et al. KRAS mutational status and efficacy in KEYNOTE-189: pembrolizumab (pembro) plus chemotherapy (chemo) vs placebo plus chemo as first-line therapy for metastatic non-squamous NSCLC. Ann Oncol 2019;30(suppl 11):xi64-xi5.Herbst RS, Lopes G, Kowalski DM, et al. Association of KRAS mutational status with response to pembrolizumab monotherapy given as first-line therapy for PD-L1-positive advanced non-squamous NSCLC in KEYNOTE-042. Ann Oncol 2019;30(suppl 11):xi63-xi4.Ethics ApprovalFor both trials, the protocol and all amendments were approved by the appropriate ethics committee at each center, the study was conducted in accordance with the standards of Good Clinical Practice. Patients provided written informed consent before enrollment.

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