Psychological distress related to smoking cessation in patients with acute myocardial infarction

Among all causes of preventable deaths, smoking is responsible for the greatest number of deaths worldwide and predisposes to fatal, noncommunicable diseases, especially cardiovascular diseases. Lifestyle changes are effective in the treatment of patients with smoking-related diseases and assist in the prevention of premature mortality. Our objective was to investigate the available scientific evidence regarding the psychological distress related to smoking cessation in patients who have had acute myocardial infarction. To that end, we conducted an integrative review of the literature in order to summarize relevant studies on this topic. The selected databases were Scopus, PubMed Central, Institute for Scientific Information Web of Science (Core Collection), ScienceDirect, EMBASE, SciELO, LILACS e PsycINFO. On the basis of the inclusion and exclusion criteria adopted for this study, 14 articles were selected for analysis. Those studies showed that the prevalence of psychological distress is higher among smokers than among nonsmokers, and distress-related symptoms are much more common in smokers with acute myocardial infarction than in those without. Smoking cessation depends on the active participation of the smoker, whose major motivation is the underlying disease. Most studies have shown that there is a need to create treatment subgroups as a means of improving the treatment provided. This review article expands the knowledge regarding smoking cessation and shows the need to invest in future research that investigates subgroups of smokers diagnosed with the major smoking-related comorbidities, such as acute myocardial infarction, in order to develop specific interventions and psychological support strategies.     

Nicotine dependence and smoking habits in patients with head and neck cancer

Objective:

To assess smoking habits and nicotine dependence (ND) in patients with head and neck cancer

Methods:

This study involved 71 smokers or former smokers with squamous cell carcinoma in the oral cavity, pharynx, or larynx who were treated at a university hospital in the city of São Paulo between January and May of 2010. We used the Fagerström Test for Nicotine Dependence to evaluate smoking habits and ND in the sample. Data regarding cancer treatment were collected from medical records. Depending on the variables studied, we used the chi-square test, Fisher''s exact test, Student''s t-test, or Spearman''s correlation test.

Results:

Of the 71 patients, 47 (66.2%) presented with high or very high ND, 40 (56.3%) smoked more than 20 cigarettes/day, and 32 (45.1%) smoked their first cigarette within 5 min of awakening. Advanced disease stage correlated significantly with the number of cigarettes smoked per day (p = 0.011) and with smoking history (p = 0.047). We found that ND did not correlate significantly with gender, disease stage, smoking cessation, or number of smoking cessation attempts, nor did the number of cigarettes smoked per day correlate with smoking cessation or gender. Treatment for smoking cessation was not routinely offered.

Conclusions:

In most of the patients studied, the level of ND was high or very high. The prevalence of heavy smoking for long periods was high in our sample. A diagnosis of cancer is a motivating factor for smoking cessation. However, intensive smoking cessation treatment is not routinely offered to smoking patients diagnosed with cancer.     

Experimentation with and knowledge regarding water-pipe tobacco smoking among medical students at a major university in Brazil,

OBJECTIVE:

Water-pipe tobacco smoking is becoming increasingly more common among young people. The objective of this study was to estimate the prevalence of the use of water pipes and other forms of tobacco use, including cigarette smoking, among medical students, as well as to examine the attitudes, beliefs, and knowledge of those students regarding this issue.

METHODS:

We administered a questionnaire to students enrolled in the University of São Paulo School of Medicine, in São Paulo, Brazil. The respondents were evaluated in their third and sixth years of medical school, between 2008 and 2013. Comparisons were drawn between the two years.

RESULTS:

We evaluated 586 completed questionnaires. Overall, the prevalence of current cigarette smokers was low, with a decline among males (9.78% vs. 5.26%) and an increase among females (1.43% vs. 2.65%) in the 3rd and 6th year, respectively. All respondents believed that health professionals should advise patients to quit smoking. However, few of the medical students who smoked received physician advice to quit. Experimentation with other forms of tobacco use was more common among males (p<0.0001). Despite their knowledge of its harmful effects, students experimented with water-pipe tobacco smoking in high proportions (47.32% and 46.75% of the third- and sixth-year students, respectively).

CONCLUSIONS:

The prevalence of experimentation with water-pipe tobacco smoking and other forms of tobacco use is high among aspiring physicians. Our findings highlight the need for better preventive education programs at medical schools, not only to protect the health of aspiring physicians but also to help them meet the challenge posed by this new epidemic.     

226例成人哮喘患者吸烟状况调查

目的 了解哮喘患者的吸烟状况以及主动吸烟和被动吸烟对于哮喘控制的影响.方法 利用调查问卷的形式,对复旦大学附属中山医院哮喘门诊的哮喘患者的吸烟状况进行分析.结果 所调查的哮喘患者中目前吸烟者占13.3%,戒烟者占16.8%,被动吸烟者26.5%.男性患者的吸烟率达20.97%,而女性患者的被动吸烟率达36.27%.41～60岁年龄层的男性患者吸烟率达30.16%,高于其他年龄层（P＜0.05）.吸烟组哮喘控制测试评分较非吸烟组低,1年内急性发作次数较非吸烟组多,平均吸人性糖皮质激素的使用量较非吸烟组高,两组比较差异有统计学意义（P＜0.05）.两组患者的过敏史和家族史比较,均无统计学差异（P＞0.05）.结论 本次调查中哮喘患者中主动吸烟者多为男性中年患者,而女性患者多数为被动吸烟者.吸烟组的哮喘发病年龄明显晚于开始吸烟年龄,且哮喘更难控制.     

Acute lung injury induced by the intravenous administration of cigarette smoke extract

OBJECTIVE:

To investigate the acute effects of intravenous administration of cigarette smoke extract (CSE) on histological, inflammatory, and respiratory function parameters in rats, as well as to compare this potential acute lung injury (ALI) model with that with the use of oleic acid (OA).

METHODS:

We studied 72 Wistar rats, divided into four groups: control (those injected intravenously with saline); CSE (those injected intravenously with CSE and saline); OA (those injected intravenously with saline and OA); and CSE/OA (those injected intravenously with CSE and OA).

RESULTS:

Mean lung compliance was significantly lower in the OA and CSE/OA groups (2.12 ± 1.13 mL/cmH₂O and 1.82 ± 0.77 mL/cmH₂O, respectively)than in the control group (3.67 ± 1.38 mL/cmH₂O). In bronchoalveolar lavage fluid, the proportion of neutrophils was significantly higher in the OA and CSE/OA groups than in the control group, as was the activity of metalloproteinases 2 and 9. Pulmonary involvement, as assessed by morphometry, was significantly more severe in the OA and CSE/OA groups (72.9 ± 13.8% and 77.6 ± 18.0%, respectively) than in the control and CSE groups (8.7 ± 4.1% and 32.7 ± 13.1%, respectively), and that involvement was significantly more severe in the CSE group than in the control group.

CONCLUSIONS:

The intravenous administration of CSE, at the doses and timing employed in this study, was associated with minimal ALI. The use of CSE did not potentiate OA-induced ALI. Additional studies are needed in order to clarify the potential role of this model as a method for studying the mechanisms of smoking-induced lung injury.     

吸烟的冠心病患者戒烟现状及影响因素分析

目的 了解吸烟的冠心病患者对于吸烟问题的认识及戒烟状况,揭示戒烟及戒烟未成功的原因和影响因素,为更有效地帮助冠心病患者控烟提供参考.方法 对350例吸烟的冠心病患者进行问卷调查,包括性别、年龄、吸烟史等,采用分组分析、logistic回归分析等方法分析戒烟的影响因素.结果 350例吸烟的冠心病患者平均年龄(59.6±10.2)岁,男321例(占91.7%).57.1%(200/350)的患者已戒烟,42.9%(150/350)的患者目前仍在吸烟.将患者按年龄分两组,非老年组患者(≤65岁,n=239)戒烟率50.6%,显著低于老年组患者(>65岁,n=111)的71.2%(P<0.001).非老年组有戒烟意愿及尝试过戒烟的比例分别为70.3%和48.3%,均低于老年组的81.2%和59.4%(P<0.001).76例戒烟复吸者中,复吸最主要原因为缺乏自我控制能力,占76.3%.logistic回归分析,影响戒烟未成功的因素:年龄≤65岁(OR=2.336,P=0.004)、文化程度低(OR=1.310,P=0.028)、行经皮冠状动脉介入治疗术(OR=0.261,P<0.001)、行冠状动脉旁路移植术(OR=0.107,P=0.004)、家庭总收入>4000 元/月(OR=1.828,P=0.003).结论 吸烟的冠心病患者戒烟水平和意识仍有待提高;除现有的控烟政策外,应更加关注中青年、文化程度较低、未行经皮冠状动脉介入治疗及冠状动脉旁路移植术、家人有人吸烟、体质指数及家庭总收入越高的吸烟冠心病患者的控烟活动;在针对吸烟冠心病患者控烟活动的同时对其周围环境宣传控烟活动也是迫切需要的.

Abstract：

Objective To investigate the status quo of smoking cessation and analyze factors influencing smoking cessation in cigarette smoking patients with coronary artery disease(CAD).Method A total of 350 smoking patients with CAD was surveyed by questionnaire,logistic regression analysis was performed to analyze factors influencing smoking cessation.Results Incidence of smoking cessation was 57.1%(200/350)in this cohort.Patients were divided into two groups,the elderlv(>65 years old,n=111)and the young group(≤65 years old,n=239).The smoking cessation rate in the elderlv group is significantly higher than in the young group(71.2%vs.50.6%,P<0.001).Aged patients and patients with high cultural level are easier to give up smoking.Logistic analysis showed that age≤65 years old (OR=2.336,P=0.004),low cultural level(OR=1.310,P=0.028),PCI(OR=0.261.P<0.001).coronary artery bypass graft(OR=0.107,P=0.004),total family income>4000 RMB/month (OR=1.828,P=0.003)are risk factors for failed smoking cessation.There are 76 patients smoking again in current smokers,most due to lack of self-control(76.3%).Compared to the elderly group,there is a higher proportion of smoking again due to the need of daily communication and work in the young group.Conclusions We still need to raise the awareness of smoking cessation for smoking patients with CAD.Following factors should be focused for tobacco control in CAD patients:younger age,lower cuItural level,not treated with PCI or CABG,patients with smoking family members.higher body mass index and higher total family income.     

Clinical benefits of smoking cessation in reducing all-cause and disease-specific mortality among older people in Taiwan: A 10-year nationwide retrospective cohort study

ObjectiveTo investigate the relationship between smoking cessation and disease mortality risks among elderly Taiwanese.MethodsWe identified 1677 people aged 65 or above from the 2001 National Health Interview Survey in Taiwan (2001 NHIST) and linked with the 2000–2010 National Health Insurance Research Data (2000–2010 NHIRD) and 2001–2010 Death Registry. Subjects were classified into four groups: never smokers, current smokers, former smokers quitting less than 5 years and former smokers quitting at least 5 years. Information on medical history was drawn from 2000–2001 NHIRD. Cox proportional hazards models were used to analyze the smoking status and mortality risk.ResultsOver 10 years, incidences of all-cause death per person-year was 0.048 among the never smokers, 0.058 for current smokers and 0.057 for former smokers. Current smokers had higher risk of all-cause death (HR = 1.38, 95%CI = 1.13–1.68), all-cause cancers (HR = 1.85, 95%CI = 1.28–2.69), lung cancer (HR = 3.02, 95%CI = 1.56–5.85) and cardiovascular disease (HR = 1.71, 95%CI = 1.17–2.48) as compared to never smokers. Former smokers who quit smoking for < 5 years has higher mortality risk in lung cancer (HR = 3.89, 95%CI = 1.33–11.40), respiratory diseases (HR = 2.79, 95%CI = 1.32–5.87) and chronic obstructive pulmonary disease (COPD) (HR = 3.13, 95%CI = 1.07–9.17) as compared to never smokers. Former smokers who quit smoking for over 5 years were similar to never smokers on all-cause death, lung cancer, all-cause cancers, COPD, respiratory diseases and cardiovascular diseases.ConclusionSmoking plays a prominent role in increasing the mortality risk among the Taiwanese elderly. Disease mortality risks of elderly former smokers who quit smoking over 5 years were reduced to the same level as the never smokers.     

Prevalence of and factors influencing smoking among medical and non-medical students in Tbilisi,Georgia

OBJECTIVE:

Smoking is a serious problem that has a devastating impact on health. The objective of this study was to describe the prevalence of and factors influencing smoking among medical and non-medical students in Tbilisi, Georgia, as well as to determine whether medical education has an impact on smoking.

METHODS:

A cross-sectional study was carried out at Tbilisi State Medical University and Tbilisi State University, both of which are located in Tbilisi, Georgia. A total of 400 4th-year students (200 students at each university) were asked to complete standardized questionnaires.

RESULTS:

Of the sample as a whole, 48.75% were identified as smokers and 51.25% were identified as nonsmokers. The mean age was 20.24 years among smokers and 20.26 years among nonsmokers. Of the medical students, 49.5% were smokers, as were 48.0% of the non-medical students. The male-to-female ratio in the study population was 0.9:1.1. Smoking was found to have a strong relationship with gender, males accounting for 65% of all smokers. Of the smokers, 56.9% stated that they would like to quit smoking (for health or financial reasons). Of the medical students, 59.5% expressed a willingness to quit smoking, as did 54.2% of the non-medical students.

CONCLUSIONS:

There is a need to improve smoking education for undergraduate students. Special attention should be given to the inclusion of anti-smoking education in undergraduate curricula, as well as to the implementation of smoking prevention campaigns at institutions of higher education. However, such measures will be effective only if tobacco control policies are strictly enforced on the national level as well.     

Psychological morbidity as a moderator of intention to quit smoking: a study of smokers and former smokers

OBJECTIVE:

To analyze psychological morbidity as a moderator of the relationship between smoking representations and quality of life in smokers and former smokers, as well as to determine which psychological variables discriminate between smokers with and without the intention to quit smoking.

METHODS:

This was a quantitative, correlational cross-sectional study involving a convenience sample of 224 smokers and 169 former smokers.

RESULTS:

In smokers and former smokers, psychological morbidity had a moderating effect on the relationship between mental/physical quality of life and smoking representations (cognitive representations, emotional representations, and comprehensibility). Smokers with the intention to quit smoking more often presented with low comprehensibility, threatening emotional representations, behavioral beliefs, and perceived behavioral control, as well as with normative/control beliefs, than did those without the intention to quit.

CONCLUSIONS:

The results of this study underscore the importance of the moderating effect exerted by psychological morbidity, as well as that of sociocognitive variables, among smokers who have the intention to quit smoking.     

Design of prospective study of acute coronary syndrome hospitalization after smoking ban in public places in Hyogo prefecture: Comparison with Gifu,a prefecture without a public smoking ban

BackgroundHyogo is the second prefecture, after Kanagawa, to enact a smoking ban in public places in Japan. The effect of this smoking ban on acute coronary syndrome (ACS) has not been evaluated.PurposeChanges in the annual number of ACS hospital cases in Hyogo Prefecture, before and after the enactment of the prefectural legislative ban on smoking in public places, are to be compared with those in Gifu Prefecture, where there is no smoking-ban legislation.MethodsConsecutive Hyogo residents with ACS, admitted to 33 major hospitals in the Hanshin-Awaji-Kobe district, which covers 56% of the population, during the 12 months before implementation of the legislation (April 2012 through March 2013) and during the same 24 months thereafter (April 2013 through March 2015) will be enrolled. Consecutive patients with ACS, who are Gifu residents, treated at the 20 major hospitals in Gifu Prefecture will be enrolled as geographical controls. The primary endpoint is the change in number of ACS admissions from April 2012 through March 2015, considering the periods before and after the smoking-ban legislation in Hyogo prefecture.ConclusionOur study has certain strengths: (1) This is the first large Japanese study of ACS registry with smoking-ban legislation. (2) Major hospitals in the Hanshin-Awaji-Kobe district are included. (3) The data will cover 3 years including 1 year before legislation enactment. (4) The data will be compared with those of Gifu Prefecture, where smoking-ban legislation will not be enacted. (5) The very large database makes possible analysis of subgroups based on age and gender.     

The rs1801278 G>A polymorphism of IRS-1 is associated with metabolic syndrome in healthy nondiabetic men. Modulation by cigarette smoking status

Aims

To explore associations between IRS-1 rs1801278 G > A polymorphism and metabolic syndrome (MS).

Methods

rs1801278 G > A was genotyped in 610 healthy Argentinian men.

Results

GA carriers had lower risk of MS (OR = 0.52, P = 0.045), particularly among smokers (OR = 0.10, P = 0.006).

Conclusions

rs1801278 GA carriers had lower risk of MS, especially among smokers.     

内分泌科门诊糖尿病患者吸烟现况调查

目的 了解糖尿病患者的吸烟和戒烟状况以及对于吸烟与疾病关系的认知情况,分析目前仍在吸烟患者戒烟失败的原因,为指导戒烟治疗提供依据.方法 由呼吸科专科医师根据事先设计的调查问卷,对2010年7月至2010年9月我院内分泌科门诊就诊的糖尿病患者进行问卷调查.结果 共调查患者270例,男性67.8％,平均年龄(64.3±10.8)岁.吸烟者41.1％,被动吸烟者29.3％,其中目前吸烟者19.6％,曾经吸烟者21.5％.19.3％伴发其他疾病.目前吸烟者中,71.7％知晓所患疾病与吸烟相关,43.4％曾尝试戒烟.所有吸烟患者接受过医师戒烟劝告的为78.4％,戒烟成功患者中77.6％经医师劝导戒烟.目前吸烟患者接受过医师戒烟劝告的为79.2％,其中59.5％认为医师的劝告和建议对其戒烟有帮助.结论 糖尿病患者目前吸烟率仍较高.研究结果提示需要加强对糖尿病患者戒烟的宣教,医师劝导戒烟的方式和内容还需改善.     

Smoking and endocrine ophthalmopathy: impact of smoking severity and current vs lifetime cigarette consumption

OBJECTIVE  Smoking has been associated with an increased incidence of endocrine ophthalmopathy (EO). In this study we examined the relation between smoking severity and the incidence of EO symptoms in patients with Graves' hyperthyroidism.
DESIGN  Patients were prospectively followed for at least one year after the onset of hyperthyroidism. Smoking and EO status were evaluated at 3−6- months intervals.
PATIENTS  Two hundred and fifty-three ambulatory patients with recent onset of Graves' hyperthyroidism were studied.
MEASUREMENTS  The incidence of total EO symptoms, proptosis, and diplopia at any time point before and after the occurrence of Graves' hyperthyroidism was assessed by interview and physical examination.
RESULTS  Smoking was associated with a 1.3-fold increase in the overall incidence of symptomatic EO, and a 2.6 and 3.1-fold increase in the incidence of proptosis and diplopia, respectively. The relative risk increased in parallel with the current number of cigarettes smoked per day. In contrast, lifetime tobacco use was not an independent risk factor for the development of EO symptoms. Former smokers had a significantly lower risk for the occurrence of proptosis and diplopia than active smokers with a comparable lifetime cigarette consumption.
CONCLUSIONS  Our data suggest that current, but not lifetime, tobacco consumption constitutes a risk for the incidence of proptosis and diplopia in patients with Graves' hyperthyroidism, and that this risk increases with smoking severity.     

Positive smoking cessation-related interactions with HIV care providers increase the likelihood of interest in cessation among HIV-positive cigarette smokers

Smoking cessation has proven to be a challenge for HIV-positive smokers. Patient and provider characteristics may provide barriers to smoking cessation. We aimed to identify characteristics associated with interest in cessation as well as characterize use of, current interest in, and provider recommendations for smoking cessation modalities. Data came from 275 HIV-positive smokers recruited online. Half (49.1%) of the sample was interested in quitting; daily smoking was associated with decreased likelihood of interest in cessation, whereas making a lifetime quit attempt, receiving encouragement to quit from an HIV care provider, and greater frequency of discussions regarding cessation with HIV care providers were associated with increased likelihood of interest in cessation. Nicotine replacement therapy was the most commonly used (42.9%), generated the most interest (59.1%), and was the most commonly clinician-recommended (70.7%) cessation modality. Findings emphasize the importance of the healthcare provider-patient relationship for smoking cessation promotion in HIV-positive smokers.     

Acute effects of cigarette smoking on arterial stiffness and blood pressure in male smokers with hypertension

BACKGROUND: Although the acute increase of arterial stiffness and blood pressure (BP) after cigarette smoking in healthy smokers is considered a possible mechanism of increased cardiovascular risk, the acute effect of smoking on arterial stiffness in hypertensive smokers is unknown. We investigated the acute effects of cigarette smoking on arterial stiffness and BP in hypertensive male smokers. METHODS: Heart rate (HR), brachial and ankle BP, and pulse-wave velocity (PWV) were measured in 22 hypertensive male smokers (HTs) and in 30 normotensive male smokers (NTs) before and 5, 10, and 15 min after smoking one cigarette (nicotine content, 0.9 mg). RESULTS: Smoking induced acute increases of HR, brachial BP, and heart-femoral PWV (hfPWV) in NTs and HTs (P < .05). Ankle systolic BP and femoral-ankle PWV were acutely increased in HTs (P < .05), but not in NTs. In HTs, brachial systolic BP and hfPWV at 15 min were higher than at baseline (P < .05). An acute increase of hfPWV in the HTs was significant (P = .025) after adjustment for total cholesterol, time-dependent HR, and brachial mean arterial pressure, but acute changes of other PWVs lost statistical significance. CONCLUSIONS: Cigarette smoking acutely increases aortic stiffness and BP in male smokers with hypertension, and the effects persist longer than in male smokers without hypertension.     

Characteristics associated with sustained abstinence from smoking among patients with COPD

Purpose

Smoking cessation is the mainstay of recommended treatment for chronic obstructive pulmonary disease (COPD), yet many continue smoking. This study seeks to understand the characteristics of patients with COPD who have quit and those who have not quit to identify important factors to evaluate in smoking-cessation interventions.

Subjects/methods

A cross-sectional survey of a random sample of 1.5 million, predominantly male Veterans Administration enrollees. Of the respondents (63% [n = 887 775]), those with at least 1 COPD visit, a smoking history, and aged more than 34 years were included in this analysis (n = 89 337). Differences in demographics, functional status, comorbidities, and provider-patient interactions were evaluated for current and former smokers.

Results

Ninety-seven percent of the cohort with COPD was male. Former smokers (n = 58 482) were older (mean age of 69.6 vs 62.8, P<.001) and had more cardiac comorbidities, but better mental health (Mean Mental Component Summary score from the Veterans Short Form-36 ± standard deviation of 43.4 ± 13.2 vs 39.9 ± 13.7, P<.001) than current smokers (n = 25 595), respectively. In addition, former smokers more actively participated in their health care and had a better relationship with their provider than current smokers.

Conclusion

Former smokers with COPD were older, had more cardiac comorbidities, better mental health, and better perceived provider-patient interactions than active smokers. This study highlights the importance of screening participants with COPD who are enrolling in forthcoming smoking cessation trials for mental illnesses. In addition, developing interventions that address psychiatric comorbidities and potentially improve provider-patient communication may be other key areas to evaluate in future smoking cessation trials in patients with COPD.     

Prevalences of asthma and rhinitis among adolescents in the city of Fortaleza,Brazil: temporal changes

OBJECTIVE:

To describe the prevalences of asthma and rhinitis in adolescents (13-14 years of age) in the city of Fortaleza, Brazil, in 2010, comparing the results with those obtained in a prevalence survey conducted in 2006-2007.

METHODS:

This was a cross-sectional study involving probabilistic samples of 3,015 and 3,020 adolescents in surveys conducted in 2006-2007 and 2010, respectively. The International Study of Asthma and Allergies in Childhood protocol was used on both occasions.

RESULTS:

Comparing the two periods, there were no significant differences regarding cumulative wheezing, active asthma, four or more wheezing attacks within the last year, sleep disturbed by wheezing more than one night per week, and speech-limiting wheezing. The prevalences of exercise-induced wheezing, dry cough at night, and physician-diagnosed asthma were significantly higher in 2010 than in the 2006-2007 period (p < 0.01 for all). The prevalence of physician-diagnosed rhinitis was significantly lower in 2010 (p = 0.01), whereas there were no significant differences between the two periods regarding cumulative rhinitis, current rhinitis, and rhinoconjunctivitis. In both periods, dry cough at night, current rhinitis, and rhinoconjunctivitis were significantly more prevalent in females than in males (p < 0.01 for all). Also in both periods, active asthma, current rhinitis, and rhinoconjunctivitis were more prevalent in private school students than in public school students (p < 0.01 for all).

CONCLUSIONS:

Our data show that the prevalences of asthma and rhinitis symptoms remain high among 13- and 14-year-olds in Fortaleza, predominantly among females and private school students.     

Effects of coffee consumption and smoking habit on bone mineral density

This study aims to investigate how a person’s smoking and coffee consumption habits in the premenopausal stage can affect the postmenopausal BMD values. Two hundred females in the postmenopause stage were evaluated. The average daily coffee consumption and smoking habits in the premenopause stage and the demographic characteristics, age and duration of menopause of all the cases were identified and noted. The bone mineral density (BMD) evaluations of these cases were made with Dual Energy X-ray Absorbsiometer (DEXA) technique. The relationship of the questioned risk factors with BMD and differences among the groups were investigated. No correlation was found between the amount of coffee consumption and BMD. The BMD values of the smokers’ group were lower than non-smokers’ group. As a result, advancing age, duration of menopause and smoking habits have been identified to be risk factors in relation to OP.     

Helping smokers with diabetes quit: A scoping review of the interventions utilised,and the challenges and barriers to smoking cessation

Tobacco smoking is recognised as a priority in diabetes management, yet many individuals with diabetes continue to smoke beyond diagnosis. This paper identifies the most promising smoking cessation strategies by reviewing the literature reporting interventions carried out amongst this study population, and the challenges and barriers to smoking cessation. Stand-alone smoking cessation interventions which included pharmacotherapy were found to be more successful in achieving abstinence than interventions which included smoking cessation as part of a broader intervention for improving diabetes management. Misconceptions about smoking and diabetes management were frequently reported, undervaluing smoking cessation. This emphasizes further the need to inform smokers with diabetes about the link between tobacco use and diabetes complications.     

Efficacy of smoking cessation intervention delivered through mobile tele-counseling among smokers with tuberculosis in a Revised National Tuberculosis Control Program

BackgroundIndia has high burden of tuberculosis and smokers. Prevalence of tuberculosis is three times higher in smokers than non-smokers. Active smoking causes severe disease, delay in seeking treatment, lost to treatment follow up, delayed sputum conversion and drug resistance. WHO advocates mobile phone technology to improve health outcomes (mHealth). We used mobile tele-counseling as a smoking cessation intervention in smokers with tuberculosis (TB) receiving treatment under tuberculosis control program.AimTo determine smoking quit rate at six months of TB treatment among smokers receiving mobile tele-counseling versus brief advice and to estimate smoking quit rates and relapse rates during the tele-counseling period.MethodsOpen label randomized controlled trial. Newly detected pulmonary tuberculosis or pleural effusion patients received brief advice on smoking cessation as per The UNION's guiding framework. Subjects were then randomly allocated to intervention or control group. Intervention group was contacted telephonically at 2,3,4,5 and 6 months to assess smoking quit rates and provide continued smoking cessation advice.ResultsIntervention group had 80 and 82 in the control group, mean (SD) age was 40.6(12.6), 43.5(12.7) p = 0.53. Quit rate at six months was 54 (67.5%) in intervention group versus 34 (42%) in control group; RR 1.60 (95% CI 1.19, 2.16) p = 0.001. Trend in smoking quit rates in intervention group was 81.3%, 61.3%, 55%, 73.8% at 2,3,4 and 5 months respectively. Smoking relapse rate was 43.1%, 53.1%, 20.5%,15.3% at 3,4,5 and 6 months respectively. 27.5%, 43.8% were abstinent for last three, two months.ConclusionsMobile tele-counseling is an effective strategy for smoking cessation among TB patients.