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10 pages, 237 KiB  
Article
Current Status of Mental Health in Mexico City
by Erika Sanchez, Humberto Nicolini, Jorge Villatoro, Marycarmen Bustos, María Elena Medina-Mora, Paola Mejía-Ortiz, Beatriz Robles, Diego Mondragón, Gema Ibarra, Daniela Meza and Alma Delia Genis-Mendoza
Int. J. Environ. Res. Public Health 2025, 22(8), 1217; https://doi.org/10.3390/ijerph22081217 - 2 Aug 2025
Viewed by 356
Abstract
There is limited information on the prevalence of mental health symptoms among the population of Mexico City. To provide an update and determine the prevalence of symptoms associated with various disorders in the city, a modified version of the “Screener Questionnaire” was used, [...] Read more.
There is limited information on the prevalence of mental health symptoms among the population of Mexico City. To provide an update and determine the prevalence of symptoms associated with various disorders in the city, a modified version of the “Screener Questionnaire” was used, the same instrument employed in the National Survey on Drug, Alcohol, and Tobacco Use (ENCODAT) 2016–2017. Data were collected at PILARES centers in different boroughs of Mexico City. A total of 868 questionnaires on symptoms of psychiatric disorders and the use of drugs, alcohol, and tobacco were completed. The most frequently reported symptoms were anxiety (52.67%), depression (39.34%), and post-traumatic stress disorder (44.57%). Additionally, results showed alcohol use at 15.1%, followed by tobacco (13.6%) and illicit drug use (6.8%). The prevalence of these symptoms was also compared with data from ENCODAT 2016–2017 to observe changes over the years. Full article
16 pages, 542 KiB  
Article
Adolescent Perceptions and Use of E-Cigarettes as Smoking Cessation Tools and for Pleasure: Data Analysis from National Youth Tobacco Survey (NYTS), 2011, 2015, 2019, and 2023
by Olusoji Ibukun, Chesmi Kumbalatara and Wasantha Jayawardene
Societies 2025, 15(7), 201; https://doi.org/10.3390/soc15070201 - 17 Jul 2025
Viewed by 414
Abstract
Once marketed as smoking cessation tools, e-cigarettes are used by adolescents mainly for entertainment, driven by aggressive marketing, appealing flavors, and safer alternatives to smoking. This study analyzes data from the National Youth Tobacco Survey (NYTS) to explore trends in adolescent perceptions and [...] Read more.
Once marketed as smoking cessation tools, e-cigarettes are used by adolescents mainly for entertainment, driven by aggressive marketing, appealing flavors, and safer alternatives to smoking. This study analyzes data from the National Youth Tobacco Survey (NYTS) to explore trends in adolescent perceptions and usage patterns of e-cigarettes from 2011 to 2023, focusing on their dual roles as cessation aids and recreational products. Cross-sectional data from the NYTS over four years (2011: N = 18,866; 2015: N = 17,711; 2019: N = 19,018; 2023: N = 22,069) formed the foundation of this study. This study investigated demographic trends, usage frequency, initial and future use patterns, and quitting behavior. Descriptive statistics and latent class analysis (LCA) were employed to examine adolescent e-cigarette use patterns, with statistical significance determined at p < 0.05. The reasons for using e-cigarettes have changed significantly over the years because of family or friends. In all years (2015–2023), use for smoking cessation dropped significantly (2.33% in 2023 vs. 6.95% in 2015). In 2023, 38% wanted to quit using e-cigarettes within 30 days, and 25% attempted to quit at least 10 times. Flavored e-cigarette users were more than twice as likely to consider quitting compared to those not interested in flavors (OR = 2.64). Our findings highlight a significant decrease in the use of e-cigarettes for cessation, with a corresponding increase in recreational use over time. These trends emphasize the urgency of implementing interventions to mitigate nicotine addiction and its associated health risks among adolescents. Adolescent e-cigarette use has transitioned from being primarily driven by cessation efforts to recreational purposes, largely influenced by appealing flavors and social factors such as peer influence, showing the need for stricter marketing regulations and targeted educational campaigns. Full article
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13 pages, 327 KiB  
Article
Polysubstance Use and Social Sequelae in Women of Reproductive Age with Recent Marijuana Use
by Sean Hyungwoo Kim, Hua Min, Hong Xue and Panagiota Kitsantas
Pharmacy 2025, 13(4), 92; https://doi.org/10.3390/pharmacy13040092 - 2 Jul 2025
Viewed by 320
Abstract
Polysubstance use (PSU) involving marijuana among women of reproductive age (WRA) is linked to psychosocial harm, yet research on the combined effects of marijuana with stimulants, opioids, tobacco, and binge drinking remains limited. The purpose of this study was to assess the prevalence [...] Read more.
Polysubstance use (PSU) involving marijuana among women of reproductive age (WRA) is linked to psychosocial harm, yet research on the combined effects of marijuana with stimulants, opioids, tobacco, and binge drinking remains limited. The purpose of this study was to assess the prevalence of PSU in WRA with past month MJ use and examine the association between PSU status and social sequelae, including getting in trouble with the law, relationship difficulty with others, and lower achievement in job or educational settings, in this group of women. We used data from the United States 2015–2019 National Survey on Drug Use and Health, which included 11,895 non-institutionalized WRA (18–44 years old) with reported use of MJ in the past month. Descriptive statistics, chi-squared tests, and multivariable logistic regression analyses were conducted to describe the sample and assess associations between PSU and social sequelae. Nearly 4.5% of the women who used MJ in the past month had experienced social sequelae regardless of PSU status. Women who used three or more substances along with MJ had the highest adjusted odds (AOR = 3.18, 95% CI 1.90, 5.31) of social sequelae relative to monosubstance MJ users. Concurrent use of multiple substances significantly increased the likelihood of social sequelae among women MJ users. Full article
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17 pages, 626 KiB  
Article
Exposure to Environmental Chemicals from Environmental Tobacco Smoking in Korean Adolescents
by Jung-Eum Lee, Ah-Reum Jo, Sunho Lee and Wanhyung Lee
Toxics 2025, 13(7), 546; https://doi.org/10.3390/toxics13070546 - 29 Jun 2025
Viewed by 444
Abstract
Background: Environmental tobacco smoke (ETS) exposes adolescents to various environmental toxins, potentially affecting their developmental health. However, limited research exists on the associations between ETS exposure and the bodily burdens of environmental chemicals on adolescents. This study aimed to investigate the relationship between [...] Read more.
Background: Environmental tobacco smoke (ETS) exposes adolescents to various environmental toxins, potentially affecting their developmental health. However, limited research exists on the associations between ETS exposure and the bodily burdens of environmental chemicals on adolescents. This study aimed to investigate the relationship between ETS exposure and the concentration of various environmental chemicals in adolescents, utilizing urinary cotinine as an objective biomarker. Methods: Data from 828 adolescents aged 12–17 years participating in the Korean National Environmental Health Survey (KoNEHS) were analyzed. ETS exposure was assessed via self-reported questionnaires and confirmed by urinary cotinine measurements. Levels of 33 environmental chemicals, including heavy metals, polycyclic aromatic hydrocarbons (PAHs), phthalates, phenols, volatile organic compounds (VOCs), and per- and polyfluoroalkyl substances (PFASs), were measured. Statistical analyses were conducted after adjusting for covariates. Results: Adolescents exposed to ETS showed significantly higher urinary cotinine and mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP) concentrations than non-exposed adolescents. Additionally, significant positive correlations were observed between urinary cotinine levels and metabolites of PAHs (NAP, OHFlu), phenols (BPA, BPS), phthalates (MMP), and VOCs (t,t-MA) after adjustments. However, ETS exposure was not significantly associated with heavy metal concentrations. Conclusions: This study described the association between ETS exposure and environmental chemicals. A trend has been identified between ETS exposure in adolescents and increased bodily concentrations of various environmental chemicals, including PAHs, phenols, phthalates, and VOCs. As adolescence is a critical developmental period of vulnerability to environmental toxins, reducing ETS exposure to protect adolescents’ health and prevent potential lifelong health effects should be emphasized. This study was based on a cross-sectional design, and some confounding factors and measurement limitations may exist. Therefore, caution is needed in interpreting causality, and further research is recommended to determine more precise causality and long-term health effects. Full article
(This article belongs to the Section Human Toxicology and Epidemiology)
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17 pages, 810 KiB  
Article
Analyzing Vietnam’s Economic Transformation from 2007 to 2023: Insights from Structural Decomposition of Input–Output Tables
by Nguyen Thi Bich Ngoc, Ichihashi Masaru and Bui Xuan Hong
Economies 2025, 13(7), 182; https://doi.org/10.3390/economies13070182 - 24 Jun 2025
Viewed by 1251
Abstract
The present study investigates Vietnam’s economic structural transformation from 2007 to 2023, identifying key sectors contributing to output growth and poverty reduction. The study is situated within the broader context of industrialization and sustainable development in emerging economies. It employs structural decomposition analysis [...] Read more.
The present study investigates Vietnam’s economic structural transformation from 2007 to 2023, identifying key sectors contributing to output growth and poverty reduction. The study is situated within the broader context of industrialization and sustainable development in emerging economies. It employs structural decomposition analysis using Vietnam’s national input–output tables for the years 2007, 2011, 2015, 2019, and 2023. The analysis decomposes changes in total output into technical effects and final demand effects, allowing for an evaluation of the relative contributions of sectoral productivity and demand side factors. The findings of the study indicate that the manufacturing and services sectors have been the primary drivers of economic growth, with the electrical and optical equipment, food, beverages and tobacco, and basic metals sectors demonstrating particularly strong performance. The factor of final demand, which is derived from consumption, investment, and exports, has played a dominant role in driving output. Notably, export-led manufacturing has experienced significant benefits due to Vietnam’s engagement in free trade agreements. It is noteworthy that the agriculture sector demonstrated a period of recovery between 2019 and 2023, driven by an increase in final demand. This study underscores the pivotal function of sectoral adaptability, trade openness, and strategic policy in maintaining inclusive economic development. It is evident that the phenomenon under scrutiny is not only indicative of vulnerabilities and opportunities but also shaped by global shocks, for example, the coronavirus pandemic. Full article
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9 pages, 298 KiB  
Review
Molecular Genomics of Oral Submucous Fibrosis: A Narrative Review
by Vasileios Zisis, Stefanos Zisis, Christina Charisi, Konstantinos Poulopoulos, Aristeidis Sarkisian and Athanasios Poulopoulos
Genes 2025, 16(6), 612; https://doi.org/10.3390/genes16060612 - 22 May 2025
Cited by 1 | Viewed by 748
Abstract
Background: Oral Submucous Fibrosis (OSMF) is a chronic, progressive condition characterized by the fibrosis of the oral mucosa, often associated with the habitual consumption of areca nut and tobacco, leading to significant morbidity. Despite its prevalent occurrence in many parts of the world, [...] Read more.
Background: Oral Submucous Fibrosis (OSMF) is a chronic, progressive condition characterized by the fibrosis of the oral mucosa, often associated with the habitual consumption of areca nut and tobacco, leading to significant morbidity. Despite its prevalent occurrence in many parts of the world, the underlying genetic and molecular mechanisms remain poorly understood, highlighting a critical need for research into its molecular genomics. The aim of this literature review is to investigate the molecular genomics of Oral Submucous Fibrosis by analyzing the relevant literature of the past decade. Methods: The search was conducted using MEDLINE (National Library of Medicine)-PubMed, focusing on the period 2015–2025 using the following keywords: Molecular Genomics AND Oral Submucous Fibrosis. This was followed by a manual search, and references were used to identify relevant articles. Results: A total of 12 articles were included in our review according to our inclusion criteria, which illustrated the importance of TGF-β, Wnt inhibitory factor-1, CypA, Hsp-70 1B, Calreticulin, Lumican, Enolase 1, MMP-2, IGF-1R, XIST, Epigallocatechin-3-gallate, Von Hippel-Lindau, and MUC1 and 4. Conclusions: Understanding the molecular pathogenesis of OSMF involves examining the molecular interactions and the roles of specific proteins. Advanced genomic technologies have opened new frontiers in the study of OSMF. As research in OSMF continues to evolve, emerging interdisciplinary approaches may provide therapeutic strategies, aiming to improve management outcomes for the patients. Full article
(This article belongs to the Section Molecular Genetics and Genomics)
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25 pages, 1414 KiB  
Systematic Review
Analysis of Assessment Methods for Detecting Nicotine Residue and Its Impact on Humans: A Systematic Review
by Audrey A. Almassi, Brian G. G. Oliver and Sheree M. Smith
Int. J. Environ. Res. Public Health 2025, 22(4), 621; https://doi.org/10.3390/ijerph22040621 - 16 Apr 2025
Viewed by 1089
Abstract
Introduction: Thirdhand smoke (THS) was first identified by Graham and colleagues in 1953, and nicotine was detected in household dust from smokers in 1991. Thirdhand smoke (THS) consists of toxic nicotine residues that persist on surfaces long after tobacco use, posing a significant [...] Read more.
Introduction: Thirdhand smoke (THS) was first identified by Graham and colleagues in 1953, and nicotine was detected in household dust from smokers in 1991. Thirdhand smoke (THS) consists of toxic nicotine residues that persist on surfaces long after tobacco use, posing a significant public health concern. Individuals can be exposed to thirdhand smoke through skin contact or inhalation, particularly affecting children and infants who are most vulnerable to tobacco contaminants. This review aims to assess the effectiveness of different methods for measuring nicotine THS residues to evaluate their accuracy across various age groups. Methods: Relevant literature was sourced from databases including ProQuest (Ovid), Medline (Ovid), Embase (Ovid), Scopus, and the Cochrane Library. The timeframe for included studies ranged the last 25 years, from 1999 to 2024. Eligible participants consisted of human populations exposed to thirdhand smoke residue. For this review, the animal studies were excluded. There were no restrictions regarding age, sex, ethnicity, or nationality for participant selection. For data management and screening, the Covidence systematic tool was utilized. Data extraction was performed independently by two reviewers. This protocol was registered with PROSPERO (CRD42024574140). Results: A total of 394 studies were retrieved from 5 databases for the initial screening. A total of 67 studies included in full-text screening, and ultimately, 36 studies were selected for full review. The studies were classified into four categories based on assessment methods: (1) analysis of human secretions, including salivary or urinary tests; (2) cellular analysis utilizing cellulose substrates or paper-based materials; (3) environmental assessments, which examined outdoor surfaces, vehicles, residential spaces, and fabrics; and (4) epidemiological assessments, employing surveys or questionnaires. Non-invasive matrices such as saliva and urine were frequently utilized for biomarker analysis. The studies collectively investigated nicotine and its metabolites in human biological samples, environmental surface contamination, and thirdhand smoke (THS) exposure. They employed a diverse range of assessment tools including surveys, machine learning technique, and cellulose-based substrates. Conclusions: This review identified various selective testing methods for detecting thirdhand smoke (THS) from nicotine. These assessment methods have advantages and disadvantages and underscores the need for further research. Improving these techniques for assessment of THS could significantly improve our understanding of the impact THS has on human health. Full article
(This article belongs to the Section Environmental Health)
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13 pages, 276 KiB  
Article
The Effect of Environmental Factors, Health Behaviors, and Psychosocial Aspects on Allergic Diseases in Korean Adolescents
by Hwa-jin Lee and You Hoon Jeon
Medicina 2025, 61(4), 727; https://doi.org/10.3390/medicina61040727 - 14 Apr 2025
Viewed by 773
Abstract
Background and Objectives: Adolescence is a critical period of physical and mental development, yet allergic diseases are often poorly managed. Factors such as sleep deprivation, obesity, smoking, and mental stress can worsen allergic conditions and complicate treatment. This study examines the environmental, [...] Read more.
Background and Objectives: Adolescence is a critical period of physical and mental development, yet allergic diseases are often poorly managed. Factors such as sleep deprivation, obesity, smoking, and mental stress can worsen allergic conditions and complicate treatment. This study examines the environmental, behavioral, and psychosocial factors influencing allergic diseases in Korean adolescents using data from the Korean National Health and Nutrition Examination Survey (KNHNES). Materials and Methods: From the 25,534 participants in the Fifth KNHNES, 1630 adolescents (aged 13–18 years) were selected. We analyzed demographic and lifestyle factors, including gender, age, housing type, family size, economic status, obesity, tobacco and alcohol use, sleep duration, and physical activity. Psychosocial factors such as stress perception, suicidal ideation, depressive symptoms, mental health counseling, and self-rated health were also examined. Results: The prevalence rates of allergic diseases were 23% for allergic rhinitis (AR), 11% for atopic dermatitis (AD), and 9.8% for asthma (AS), with 35.8% of adolescents having at least one allergic condition. Smoking was significantly associated with AS (odds ratio [OR] 1.753, p = 0.006), while shorter sleep durations increased AR risk (p = 0.000). Male adolescents had a lower risk of AD (OR 0.706, p = 0.046), and high economic status was inversely correlated with AD (OR 0.445, p = 0.006). Positive self-rated health was linked to lower AS risk (OR 0.447, p = 0.000). AR was significantly associated with male gender (OR 1.391, p = 0.045), high economic status (OR 1.784, p = 0.026), and high stress perception (OR 1.479, p = 0.013). Conclusions: Low self-rated health and high stress perception have been identified as risk factors for allergic diseases during adolescence. Integrating psychosocial counseling with medical treatment may improve management and outcomes. Full article
(This article belongs to the Section Epidemiology & Public Health)
15 pages, 1514 KiB  
Article
Prevalence and Socioeconomic Disparities of Cigar Use in China: Findings from the China Health Literacy Survey with a Focus on the ‘Knowledgeable but Economically Marginalized’ (KEM) Population
by Yi Liu, Yinghua Li, Xin Xia, Zhao Liu, Zheng Su, Rui Qin, Ying Xie, Zhenxiao Huang, Anqi Cheng, Xinmei Zhou, Jinxuan Li, Xiaowen Wei, Qingqing Song, Liang Zhao, Dan Xiao and Chen Wang
Healthcare 2025, 13(6), 583; https://doi.org/10.3390/healthcare13060583 - 7 Mar 2025
Viewed by 842
Abstract
Background: Cigar smoking poses significant public health challenges due to its rising prevalence and associated health risks. However, research on cigar use in China remains limited. This study investigates the prevalence, demographic characteristics, and key factors associated with cigar use among Chinese [...] Read more.
Background: Cigar smoking poses significant public health challenges due to its rising prevalence and associated health risks. However, research on cigar use in China remains limited. This study investigates the prevalence, demographic characteristics, and key factors associated with cigar use among Chinese adults. Methods: We analyzed data from the 2018–2019 China Health Literacy Survey, including 86,701 participants aged 20–69 years. Multistage stratified sampling was employed, and logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with cigar use. Weighted data were applied to ensure national representation. Results: Of the 86,701 respondents, 1025 participants reported having used cigars, including 248 exclusive cigar users and 777 dual users of cigars and other tobacco products. Cigar use was significantly higher among men (1.93%) than women (0.05%). Most users were aged 50–59, with a mean age of 49.3 years. Factors associated with cigar use among men included higher education (for college and higher, OR: 1.81; 95% CI: 1.42–2.30), lower household income (for income < 20,000, OR: 1.02; 95% CI: 1.08–1.53), poor self-reported health (OR: 1.45; 95% CI: 1.15–1.83), and severe nicotine dependence (FTND ≥ 7 points, OR: 2.09, 95% CI: 1.67–2.61). Cigar use prevalence showed notable regional variation, with the highest rates observed in northern and eastern provinces. Interpretation: The estimated number of cigar users in China is approximately 10.46 million. Male cigar users often represent a unique demographic: “knowledgeable but economically marginalized” individuals, characterized by higher education but lower economic status. Tailored tobacco control measures addressing regional disparities, socioeconomic factors, and marketing-driven misconceptions about cigars are essential to reduce public health impacts. Full article
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12 pages, 249 KiB  
Article
The Acceptability of a Tobacco Dependency Treatment for NHS Staff in the North East of England: A Mixed-Methods Study
by Caitlin Louise Thompson, Kerry Brennan-Tovey, Caitlin Robinson, Rachel McIlvenna, Eileen F. S. Kaner, Sheena E. Ramsay and Maria Raisa Jessica Aquino
Int. J. Environ. Res. Public Health 2025, 22(3), 352; https://doi.org/10.3390/ijerph22030352 - 27 Feb 2025
Viewed by 751
Abstract
Aims: High smoking rates and deprivation levels in the North East of England have led to an opportunity to pilot a tobacco dependency treatment offer for NHS (National Health Service) staff who smoke, to make a supported quit attempt. The direct and indirect [...] Read more.
Aims: High smoking rates and deprivation levels in the North East of England have led to an opportunity to pilot a tobacco dependency treatment offer for NHS (National Health Service) staff who smoke, to make a supported quit attempt. The direct and indirect benefits to staff, patients, and NHS organisations are well documented. This study aimed to evaluate service acceptability. Methods: The service included up to 12 weeks of free nicotine replacement therapy (NRT) and/or a refillable e-cigarette, motivational support, and premium access to the Smoke-Free app. The service evaluation used a mixed-methods design, combining the Theoretical Framework of Acceptability (TFA) questionnaire and semi-structured interviews with staff who had accessed the offer. The quantitative data were analysed using descriptive statistics and qualitative data via thematic analysis. Results: Sixty-eight survey responses reflected high acceptability and revealed four themes relating to the service familiarity and ease of access, suitability of the NRT/E-liquid ordering service, the vape kit, and behavioural support. Conclusions: The service was deemed highly acceptable, and service users’ experiences informed recommendations for improving future tobacco dependency services. This is the first known application of the TFA to an evaluation of a smoking cessation intervention, and it contributes to a broader body of research on reducing tobacco dependency. Full article
13 pages, 506 KiB  
Article
Sex-Specific Risk Factors and Predictors of Major Adverse Cardiac and Cerebrovascular Events in Heart Failure with Preserved Ejection Fraction with SARS-CoV-2 Infection: A Nationwide Analysis
by Sai Prasanna Lekkala, Adil Sarvar Mohammed, Hafeezuddin Ahmed, Meshal Al-Sulami, Jahangir Khan, Rupak Desai, Paritharsh Ghantasala, Hemindermeet Singh, Syed Sohail Ali and Christopher Bianco
J. Clin. Med. 2025, 14(5), 1469; https://doi.org/10.3390/jcm14051469 - 22 Feb 2025
Viewed by 1160
Abstract
Background: Heart failure with preserved ejection fraction (HFpEF) is a condition with limited large-scale data on the short- and long-term effects of SARS-CoV-2 infection. This study aimed to evaluate the prevalence of major adverse cardiac and cerebrovascular events (MACCEs) in HFpEF patients hospitalized [...] Read more.
Background: Heart failure with preserved ejection fraction (HFpEF) is a condition with limited large-scale data on the short- and long-term effects of SARS-CoV-2 infection. This study aimed to evaluate the prevalence of major adverse cardiac and cerebrovascular events (MACCEs) in HFpEF patients hospitalized with SARS-CoV-2 and identify sex-specific risk factors and predictors of MACCEs in this population. Methods: This retrospective study analyzed HFpEF patients hospitalized with SARS-CoV-2 from the 2020 National Inpatient Sample (NIS) using ICD-10 codes. Patients hospitalized with HFpEF and SARS-CoV-2 were categorized by age (18–44, 45–64, ≥65 years). Multivariate logistic regression was used to adjust for potential confounders, with the statistical significance set at a two-tailed p-value < 0.05. Results: Among 109,750 HFpEF patients hospitalized with SARS-CoV-2, 31,960 (29.1%) experienced MACCEs. Males experienced a higher rate of MACCEs than females (31.1% vs. 27.5%, OR: 1.20, 95% CI: 1.12–1.28, p < 0.001). Adjusted analysis revealed that elderly patients (≥65 years, OR: 1.47, 95% CI: 1.33–1.62) compared with the 45–64 age group and males (OR: 1.20, 95% CI: 1.12–1.28, p < 0.001) had a higher risk of MACCEs. Key predictors included prior coronary artery bypass grafting (CABG; OR: 1.15, 95% CI: 1.02–1.30), cancer (OR: 1.24, 95% CI: 1.08–1.42), and chronic kidney disease (OR: 1.15, 95% CI: 1.08–1.23). Subgroup analysis identified additional sex-specific risk factors. In males, hyperlipidemia, obesity, tobacco use disorder, prior stroke/transient ischemic attack (TIA), prior venous thromboembolism (VTE), alcohol abuse, depression, and valvular disease were significant predictors of MACCEs. In females, hyperlipidemia, tobacco use disorder, prior stroke/TIA, prior VTE, and depression were significant predictors. Conclusions: HFpEF patients hospitalized with SARS-CoV-2 have a high risk of MACCEs, with male sex, older age, prior CABG, cancer, and chronic kidney disease as key risk factors. This study provides the first large-scale analysis of sex-specific predictors of MACCEs in HFpEF patients hospitalized with SARS-CoV-2. These findings underscore the need for focused research and clinical gender-based strategies to mitigate cardiovascular risks in this unique and high-risk population. Full article
(This article belongs to the Section Cardiology)
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13 pages, 230 KiB  
Article
Clinical Trial Participation Motivation: Role of Smoking Status
by Chidubem Egboluche, Rifath Ara Alam Barsha, Shervin Assari and Payam Sheikhattari
Healthcare 2025, 13(4), 389; https://doi.org/10.3390/healthcare13040389 - 11 Feb 2025
Viewed by 785
Abstract
Introduction: The success of clinical trials hinges on the effective recruitment and retention of participants, which remains a persistent challenge. Smoking has well-documented adverse effects on health and is a significant predictor of various chronic diseases. However, smoking status impact on the [...] Read more.
Introduction: The success of clinical trials hinges on the effective recruitment and retention of participants, which remains a persistent challenge. Smoking has well-documented adverse effects on health and is a significant predictor of various chronic diseases. However, smoking status impact on the motivation to participate in clinical trials is less clear. Methods: This cross-sectional study, utilizing data from the Health Information National Trends Survey (HINTS) 5 Cycle 4 with a sample of 3793 participants, investigates how smoking status (current, former, and never smoker) influences motivation to participate in clinical trials using a structural equation model. Key predictors of trial participation include age, gender, education level, race/ethnicity, income, ethnicity, depression, and chronic respiratory conditions. Results: In the overall sample, 51.2% of the participants were females, 76.0% were White adults, 83.1% were non-Hispanic, 39.0% had some college education, and 42.5% had a household income of $75,000 or more. The mean age of the participants was 48.4 years, and the mean depression score was 2.2. Structural equation model results showed a significant positive association between female gender and motivation in clinical trial participation for current smokers. For former smokers, older age and Hispanic ethnicity showed negative associations, while education showed a positive association. For those who have never smoked, older age and other races showed negative associations. Conclusions: This study highlights the significant role of education, age, gender, and race/ethnicity among people with different smoking statuses in motivating clinical trial participation. Tailored strategies that address these barriers are essential for improving recruitment and retention in tobacco cessation trials. Full article
21 pages, 4020 KiB  
Article
Trends in the Incidence and Mortality of Tobacco-Related Cancers Among Adults in the United States
by Nandika Mansingka, Victor Adekanmbi, Christine D. Hsu, Thao N. Hoang, Jacques G. Baillargeon, Abbey B. Berenson and Fangjian Guo
Cancers 2025, 17(3), 534; https://doi.org/10.3390/cancers17030534 - 5 Feb 2025
Viewed by 1530
Abstract
Background: Tobacco use remains a global challenge to public health, accounting for almost eight million deaths per year worldwide, with a significant portion attributable to tobacco-related cancers. Examining the epidemiology of tobacco-related cancers and assessing the trends in the incidence and mortality will [...] Read more.
Background: Tobacco use remains a global challenge to public health, accounting for almost eight million deaths per year worldwide, with a significant portion attributable to tobacco-related cancers. Examining the epidemiology of tobacco-related cancers and assessing the trends in the incidence and mortality will allow for more effective prevention, treatment, and targeted strategies. Methods: We assessed the trends in the incidence and mortality of tobacco-related cancers among adults in the United States using data from United States Cancer Statistics (USCS) 2001–2021 and mortality data 1975–2022 from the National Center for Health Statistics (NCHS). The incidence and mortality rates of tobacco-related cancers were calculated as cases per 1,000,000 persons and age-adjusted to the 2000 United States standard population. Results: There was a recent overall decreasing trend in both the incidence (2001–2021) and mortality rate (2001–2022). Among adults 20–49 years old, there was an increasing trend from 2001 to 2021 in the incidence among non-Hispanic American Indians/Alaska Natives (APC 2.6, 95% CI 2.1–3.0) and those in the West (APC 0.2, 95% CI 0.0–0.4); in Hispanics, the incidence rate increased most recently from 2013 to 2021 (APC 1.7, 95% CI 1.0–3.0). The mortality rate first increased from 1975 to 1990 among females 50–64 years old and males 65+ years old and from 1975 to 2000 among females 65+ years old, and then decreased thereafter. Conclusions: The rising incidence in some younger groups highlights the need for targeted public health interventions to address disparities and improve cancer prevention in these vulnerable populations. Full article
(This article belongs to the Section Cancer Epidemiology and Prevention)
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12 pages, 597 KiB  
Article
Tobacco Use and Second-Hand Smoke Exposure Among Athletes; Assessment by Urine Cotinine Level and Exhaled Carbon Monoxide: A Cross-Sectional Study
by Erdogan Asar, Yunus Emre Bulut, Nermin Dindar Badem, Aydan Orscelik, Cagri Emin Sahin, Gokhan Buyukluoglu, Ismail Kucuk, Tugba Kocahan and Toker Erguder
Healthcare 2025, 13(2), 198; https://doi.org/10.3390/healthcare13020198 - 20 Jan 2025
Cited by 2 | Viewed by 1869
Abstract
Background and Objectives: Tobacco use and exposure to tobacco products remain a major public health challenge, even among athletes. This study aimed to evaluate tobacco use and second-hand smoke exposure in athletes through urinary cotinine levels and exhaled air carbon monoxide (CO) measurements. [...] Read more.
Background and Objectives: Tobacco use and exposure to tobacco products remain a major public health challenge, even among athletes. This study aimed to evaluate tobacco use and second-hand smoke exposure in athletes through urinary cotinine levels and exhaled air carbon monoxide (CO) measurements. Materials and Methods: This cross-sectional study included licensed athletes who visited the sports medicine outpatient clinic of a tertiary hospital. Participants completed an electronic questionnaire on smoking habits and second-hand smoke exposure. Urine samples were analysed for cotinine levels, while CO levels were measured in exhaled breath. Results: A total of 421 athletes participated (57.8% male, median age: 18 years). Tobacco use was reported by 29.9% (n = 126) of participants. Median urinary cotinine levels were 22.9 ng/mL among daily tobacco users and 17.4 ng/mL among athletes exposed daily to second-hand smoke, with a statistically significant difference between exposure levels (p < 0.05). The optimal cut-off value for detecting second-hand smoke exposure was identified as 12.5 ng/mL. Median exhaled air CO levels were 5 ppm in daily tobacco users. Conclusions: This study demonstrates that tobacco use prevalence among athletes mirrors Türkiye’s national rates. Despite legal measures to curb tobacco use, direct use and second-hand smoke exposure remain pressing issues among athletes. Full article
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14 pages, 472 KiB  
Article
Lifestyle Factors and Associations with Individual and Comorbid Cardiometabolic and Pulmonary Disease Among U.S. Adults
by Osayande Agbonlahor, Delvon T. Mattingly, Maggie K. Richardson, Joy L. Hart, Alison C. McLeish and Kandi L. Walker
Int. J. Environ. Res. Public Health 2024, 21(12), 1674; https://doi.org/10.3390/ijerph21121674 - 16 Dec 2024
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Abstract
Background: Although lifestyle factors have been linked to chronic diseases among adults, their association with diagnosed individual and comorbid cardiometabolic (CMD) and pulmonary disease (PD) is not fully known. This study aimed to examine the associations between lifestyle factors and individual and comorbid [...] Read more.
Background: Although lifestyle factors have been linked to chronic diseases among adults, their association with diagnosed individual and comorbid cardiometabolic (CMD) and pulmonary disease (PD) is not fully known. This study aimed to examine the associations between lifestyle factors and individual and comorbid CMD and PD among U.S. adults. Methods: We used cross-sectional data from the 2017–2020 National Health and Nutrition Examination Survey (n = 7394). Health care provider’s diagnosis of CMD and PD and lifestyle factors (i.e., past 5-day tobacco use, past 12-month alcohol use, diet, sleep troubles, and physical activity) were assessed. Adjusted odds ratios were estimated using logistic and multinomial logistic regression. Results: Trouble sleeping was associated with increased odds of CMD (OR: 2.47) and PD (OR: 2.29) individually, while physical activity was associated with lower odds (OR: 0.75, OR: 0.77). Past 5-day tobacco (OR: 2.36) and past year alcohol (OR: 1.61) use were associated with increased PD odds. Lifestyle factors were associated with increased odds of comorbid CMD and PD. Conclusions: Lifestyle factors were associated with increased odds of individual and comorbid CMD and PD among adults. CMD and PD prevention should involve promoting lifestyle modification and implementation of policies that eliminate structural barriers to healthy lifestyle adoption. Full article
(This article belongs to the Special Issue The 20th Anniversary of IJERPH)
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