Search Results (81)

Purpose: Smoking is a major preventable cause of illness and death. Quitting smoking can reduce related health complications. Numerous factors, including age, socioeconomic status, smoking habits, and availability of support, influence smoking cessation success. Despite anti-smoking measures and smoking cessation clinics in Saudi Arabia, smoking-related deaths are increasing. This study aimed to identify factors influencing successful smoking cessation among Saudi adults and examine the relationship between cessation methods and success rates. Patients and methods: A cross-sectional study was conducted through an online survey targeting Saudi adults who had attempted to quit smoking of all types, whether traditional cigarettes, e-cigarettes, shisha, or others. Success was defined as quitting for at least six months. The data collected included sociodemographic details, smoking history, and experiences with cessation. Logistic regression analysis was used to identify factors associated with successful cessation. Results: Of 364 participants, 18.4% were successful quitters, with a mean age of 34.94. Occupation was a key predictor; freelance workers had significantly higher odds of unsuccessful quitting (OR = 12.96, 95% CI: 2.08–80.79, p = 0.006). Those who continued smoking despite illness were less likely to quit successfully (OR = 2.33, 95% CI: 1.16–4.68, p = 0.018). Early initiation of smoking also negatively impacted cessation success (OR = 1.10, 95% CI: 1.03–1.17, p = 0.006). Successful quitters reported fewer adverse symptoms during their attempts (p = 0.018) and employed behavioral strategies, such as disposing of tobacco products (p < 0.001), avoiding smoking triggers (p = 0.002), and engaging in exercise (p < 0.001). Confidence in quitting significantly contributed to success (p < 0.001). Conclusions: This study highlights the role of individual, social, and environmental factors in smoking cessation. Tailored interventions that address socioeconomic, psychological, and lifestyle factors are crucial for enhancing cessation success among Saudi adults. Full article

Periodontal disease is a common and serious oral disease among older adults. As the global older population increases, preventing periodontal disease is vital for healthy ageing. Poor oral hygiene, uncontrolled diabetes, and smoking are key risk factors of periodontal disease. Improving oral hygiene, diabetes management, and quitting smoking are essential health behavioural change interventions to manage periodontal disease. The objective of this study is to review the prevention of periodontal disease among older adults through health behavioural change interventions. Effective strategies to improve oral hygiene include personalised education on proper brushing and interdental cleaning. Educating caregivers is equally important as they supervise care-dependent older adults to maintain oral health. For those with diabetes, physical activity improves glycated haemoglobin levels and clinical periodontal parameters by reducing reactive oxygen species and systemic inflammation. Smoking cessation could be achieved through a multi-faceted approach. Effective smoking cessation combines brief interventions with intensive behavioural/pharmacological support for long-term success, especially in highly dependent individuals. Tailored strategies for older adults, integrated care, and expanded research improve outcomes and health equity in ageing populations. In conclusion, health behavioural change interventions are non-invasive preventive measures that include oral hygiene reinforcement, diabetic management, and smoking cessation. Prioritising these interventions empowers older adults to maintain oral health, reducing disease burden and enhancing overall well-being for healthy ageing. Full article

Despite a general decline in smoking rates among the U.S. population, smoking among low-income populations remains disproportionately high, likely due to the social determinants of health. To inform tailored approaches and responsive public health policies, the aim of this study was to qualitatively explore the sociocultural contexts, attitudes, and behaviors regarding smoking and quitting in a sample of low-income adults who smoke. In-depth, semi-structured qualitative interviews were conducted with 20 adults. Participants were recruited through local safety-net primary care clinics and community sites. A thematic analytic approach was utilized to analyze transcribed interviews. In exploring smoking and quitting within the context of low-income individuals, the following six themes were identified: caught between health and tobacco use; the nuances of context; roadblocks to quitting; motivation without movement; a temporary escape; and one size does not fit all. Insights into sociocultural and environmental contexts that shape smoking and quitting among low-income individuals revealed a complex interplay of factors that perpetuate smoking behavior and make it difficult to achieve sustained cessation. The study findings point to the importance of patient-centered and collaborative approaches that tailor smoking cessation efforts to the unique needs and lived experiences of low-income people who smoke. Full article

Background/Objectives: Frontal fibrosing alopecia (FFA) is a scarring alopecia with an unclear aetiology, primarily affecting postmenopausal women. This study aims to identify potential risk factors contributing to FFA development and progression, as well as provide a clinical profile to aid in the differential diagnosis. Methods: The study included 19 women diagnosed with FFA. The participants completed a 20-question survey based on a literature review of potential risk factors. Statistical analyses were performed to investigate the associations between patient characteristics and FFA. Results: All patients were female and their mean age was 60.58 years (SD = 12.81). In 63.1% of the cases, FFA onset occurred postmenopause, with a mean latency of 8.17 years. In the majority of cases, the diagnostic delay exceeded five years. The average menarche age was 13.68 years (SD = 2.06), whereas late menarche (≥15 years) was found in two subjects. A history of reproductive organ or breast malignancy was reported by 42.1% of the patients, which frequently required surgery. Most subjects did not receive hormone replacement therapy, or hormonal contraception. The most prevalent comorbidity was hypothyroidism (89.47%). Although smoking was rare among the subjects, hair colouring was quite common, yet no participant underwent scalp aesthetic procedures. In 47.4% of cases, scalp itching or pain was present. Sunscreens were frequently used, mostly on a daily or seasonal basis. Conclusions: FFA predominantly affects women in their early 60s, often following the menopause. In our study, a tendency toward an early menopause and an above-average menarche age of the subjects was observed. In the analysed group, only reproductive and breast cancers were reported, which requires further investigation. Frequent β-blocker use, second only to levothyroxine, may suggest that they play a role in FFA pathogenesis. Itching and pain of the scalp may contribute to the correct diagnosis, although these symptoms are not universal. Moreover, sunscreens were indicated as a potential trigger, yet avoiding them should not be routinely recommended due to the risk of carcinogenesis. The variability in the diagnostic delay emphasises the need for increasing clinician awareness and conducting further research. Full article

Background: The aging process is accompanied by changes in the immunological status of a person. Immunosenescence is considered a significant cause of the development of cardiovascular diseases (CVD) in elderly people. However, to date, the relationship between immune/inflammatory processes and diseases associated with age is considered quite complex and is not fully understood. Immunophenotyping and the intracellular production of cytokines involved in the processes of inflammatory aging will allow us to identify biomarkers that are associated with cardiovascular diseases in the elderly. Objectives: To identify immunological markers associated with the process of inflammatory aging in older individuals with cardiovascular diseases. Methods: CD-phenotyping and intracellular cytokine analysis of peripheral blood using the flow cytometry method were conducted in 52 people over 60 years of age (group 1 had CVD and group 2 did not). Blood samples were stained with monoclonal antibodies (mAb) using Becton Dickinson (BD) reagents for the staining and binding of surface receptors CD4+, CD8+, CD14+, CD19+, CD16+, CD56+, CD59+, CD95+, and HLA DR+ and intracellular receptors TNF, IL-10, GM-CSF, VEGFR-2, IGF, and perforin. In addition, the following parameters were studied: questionnaire data (gender, age, alcohol consumption, smoking, physical activity, and marital status), clinical data (blood pressure (BP), heart rate (HR), body mass index (BMI)), comorbid conditions, and cardiovascular diseases (coronary heart disease (CHD), chronic heart failure (CHF), arterial hypertension (AH), previous myocardial infarction (PICS), diabetes mellitus (DM), atrial fibrillation (AF), and stroke). Results: The older patients with cardiovascular pathology had high levels of monocytes CD14+ (p = 0.014), low levels of CD8+ lymphocytes (p = 0.046), and low intracellular production of GM-CSF (p = 0.013) compared to the older people without CVD. Conclusions: The revealed differences in the expression of CD14+ monocytes indicate their role in the development of cardiovascular pathology associated with age-related changes. A decrease in cytotoxic CD8+ lymphocytes and intracellular GM-CSF production leads to an increased risk of developing cardiovascular diseases in older individuals. These observed changes with age will not only expand existing knowledge about the aging of the regulatory link of the immune system but also help to obtain data to predict CVD in older people. Thus, the obtained results support the use of these immunological markers to identify the risk of circulatory disease and a personalized approach in geriatric practice. Full article

Background: Healthcare providers (HCPs) can play a pivotal role in providing vaping cessation support to adolescents. They can screen adolescents for vaping, offer interventions to quit, and educate adolescents about the dangers of vaping, including nicotine addiction. This review aims to assess the knowledge, attitudes, and practices of HCPs regarding vaping cessation promotion to adolescents. Methods: We conducted a scoping review following the Arksey and O’Malley framework and searched five databases, including MEDLINE, PubMed, PsycINFO, CINAHL, and Scopus, to identify relevant articles. We created a comprehensive search strategy using keywords relevant to healthcare providers, adolescents, practices, and vaping. Results: A total of 1387 articles were identified from the initial search, and 14 were included. There was considerable variation regarding the knowledge, attitudes, and practices of HCPs in supporting adolescents. Although 50–92% of HCPs reported some knowledge about vaping, significant gaps persisted, especially regarding health effects and cessation strategies. Many HCPs lacked confidence in discussing vaping with adolescent patients. While most of the HCPs, 86%, screened for cigarette smoking, only 14% routinely screened adolescents for vaping. They expressed concerns about vaping as a gateway to tobacco use and believed that it was less harmful than cigarettes. HCPs encountered barriers with a lack of time, knowledge, and screening tools in supporting adolescents to quit vaping, particularly related to counselling, treatment recommendations, and referral procedures. Conclusions: There is an urgent need for enhanced understanding, evidence-based guidelines, and clinical tools for HCPs to address the current vaping epidemic among adolescents. Full article

Background: Financial Incentive Treatments (FIT) can be effective in the treatment of smoking. However, weaknesses in current biochemical approaches for assessing smoking cessation may hinder its implementation, particularly for management of long-term smoking cessation. The use of cg05575921 methylation assessments could address some of the shortcomings of current self-report and non-self-report methods, but additional information is needed about the speed of methylation reversion as a function of key clinical and demographic variables. Methods: To better understand those relationships, we analyzed data from 3040 subjects from the National Lung Screening Trial (NLST), including 1552 self-reported quitters. Results: Plotting of the data as a function of time since quitting shows that methylation increases approximately 14%, on average, after at least one full year of cessation with a subsequent slow non-linear increase in methylation over the next 14 years. Least Squares Regression modeling shows strong effects of quit time and a modest, yet significant, effect of body mass index (BMI) on the rate of reversion. Prior cigarette consumption characteristics and sex made modest contributions as well, with the latter largely offset by pre-cessation methylation levels. Race and age were not significant factors in the models. Conclusions: When combined with data from prior studies, these analyses of the long-term reversion of cg05575921 methylation will be informative to those considering FIT approaches to incentivizing reversion of cg05575921 as an index of short- and long-term smoking cessation. Full article

People who undergo lung cancer screening (LCS) and continue to smoke are at risk for negative clinical outcomes and lowered survival and need effective smoking cessation interventions. This pilot study tested an 8-week intervention for smoking cessation after LCS. The participants (N = 40) were randomized to the intervention group (combination nicotine replacement therapy [NRT] plus gain-framed text messaging for 8 weeks) or the control group (standard cessation counseling) after LCS. Assessments were completed at 8-week and 3-month follow-ups, including self-reported 7-day point prevalence abstinence. The mean age was 64.4 years old (SD = 6.2); 32.5% were Black or African American; and 55% were female. At Week 8, 14.3% (3/21) of the participants in the intervention group were abstinent versus 0% (0/19) in the control group (p > 0.05). At 3-month follow-up, 4.8% (1/21) of the participants in the intervention group were abstinent versus 0% (0/19) in the control group. Among the intervention group participants, up to 52.4% used the provided patches and up to 61.9% used the provided lozenges during the study period. This study demonstrated modest quit rates for LCS patients receiving gain-framed text messages and NRT. The results highlight the need for more effective smoking cessation interventions for this priority population. Full article

Human papillomavirus (HPV) infection poses significant public health issues for both men and women. Recent studies have brought attention to the substantial impact of HPV-linked cancers in men despite historically focusing more on its effects on women. It was revealed that in 2019, HPV was the root cause of approximately 70,000 cancer cases in men. Modes of transmission for HPV include sexual contact, encompassing various practices such as vaginal, anal, and oral intercourse, as well as the use of sexual devices. Moreover, HPV-associated cancers are becoming increasingly common in men, with anal, penile, and oral cancers being the most prevalent. Although the human body can clear HPV infection in about 90% of cases, it’s crucial to take preventive measures to lower the risk of transmission and developing cancer. Using condoms, quitting smoking, and male circumcision are identified as essential factors in preventing HPV among heterosexual couples. However, the most promising preventive measure is HPV vaccination. There are ongoing discussions regarding its protective efficacy and cost-effectiveness; vaccinating boys before their sexual debut presents a compelling rationale. The existing literature primarily focuses on HPV-linked cancer in women and lacks a comprehensive review of the development and prevention methods specifically related to HPV-related cancers in men. This review strives to bridge this gap by offering a detailed overview of HPV-linked cancers in males, particularly anal, penile, and head & neck cancer. It will cover important aspects of prevention and treatment strategies to provide valuable information for public health initiatives and clinical practice. Full article

Background/Objective: Smoking is an individual risk factor for bladder cancer. Many patients are still smoking at the time of their diagnosis, yet few trials have examined smoking cessation interventions (SCIs) in relation to transurethral resection of the bladder tumor (TURBT). This study therefore aimed to compare the efficacy of a hospital-based 6-week intensive SCI with standard treatment among this patient group. Methods: A parallel-arm randomized controlled trial was conducted from December 2021 to March 2024 at two university hospital urology departments in Denmark. A total of 38 daily smokers undergoing TURBT were allocated to the hospital-based intensive SCI, including weekly meetings, patient education, motivational support, and complimentary nicotine replacement therapy or the standard treatment with very brief advice and referral to the same intensive SCI at a municipality clinic. The primary outcome was smoking cessation at the end of the intervention, assessed through participant interviews. The secondary outcomes included continuous abstinence at three and six months, quality of life, and frailty. Analyses were performed as intention-to-treat. Results: After six weeks, 37% in the hospital-based group and 6% in the standard group achieved smoking cessation (p = 0.042). At three and six months the quit rates were, 37% and 26% in the hospital-based group, compared to 0% and 0% in the standard group, respectively. No significant differences in quality of life or frailty were found. Conclusions: This trial found that hospital-based intensive SCI increased cessation rates compared to standard treatment. It would be valuable to evaluate the impact on postoperative complications, cancer prognosis, and long-term cessation in a sizeable new study. Full article

Pharmacists are often the first point of contact for healthcare advice in rural communities, where access to healthcare is limited. Tobacco cessation rates improve with counseling from a pharmacist, and in many states, pharmacists can now prescribe medications for quitting. This study aimed to explore smoking behavior and cessation motivations among patients at a Federally Qualified Health Center (FQHC) clinic in rural Wyoming, estimate the prevalence of tobacco-related interventions by clinic staff, and assess patients’ interest in engaging in pharmacist-led cessation programs. A cross-sectional survey was administered over three months to clinic patients who self-identified as current tobacco users. Survey items assessed sociodemographics, tobacco use and vaping behaviors, previous cessation advice from pharmacists, and interest in pharmacist-led support for quitting. Of 63 respondents, 57 (90.5%) reported current tobacco use. Most were ready to quit within the next month (43.9%) or the next six months (33.3%), and 26.3% had previously received advice about quitting from a pharmacist. Most (59.6%) expressed interest in establishing care with a pharmacist for cessation support, and 45.3% requested to be contacted by a pharmacist for assistance with quitting. Interest did not differ by gender or age. The results indicate that rural patients are interested in engaging with pharmacists for quitting. Further research is needed to determine how pharmacy-led programs can complement existing healthcare resources to improve access to cessation support in underserved areas. Full article

The prevalence of prenatal tobacco exposure remains high in many countries, particularly in southern Europe. The aims of this study were to estimate the prevalence of smoking among pregnant women in a southern Spanish city (Seville) and to identify the associated sociodemographic and obstetric characteristics. In a descriptive, cross-sectional study, a random sample of pregnant women who were scheduled to undergo a morphology scan at their public referral hospital in their 20th week of gestation were interviewed in person. At the start of pregnancy, 38.2% of the pregnant women were smokers. In the twentieth week, 19.1% continued to smoke, and the same percentage had quit. The prevalence of smoking in pregnant women was higher among those with a low level of education (60% among pregnant women with no studies and 30.4% in those with primary education) and among those who had had abortions (38.5%). Pregnant smokers with obesity were the least likely to have given up smoking during pregnancy. Women with a lower educational level should be a prime target for cross-sectoral interventions aimed at preventing prenatal tobacco exposure. Implementation of support measures for providing effective clinical advice in preconception and prenatal care regarding healthy lifestyles is particularly needed. Full article

Bladder cancer (BCa) is the fourth most common cancer in men and one of the most common urinary tract cancers, especially in developed countries. The aim of this paper is to comprehensively analyze the biology of bladder cancer, including its epidemiology, etiology, histological types, risk factors, clinical symptoms, and diagnostic methods. The paper presents the dominant histological types of bladder cancer, such as transitional cell carcinoma (TCC), which accounts for 90–95% of cases, squamous cell carcinoma (SCC), and adenocarcinoma, which is much rarer. Risk factors, such as smoking, occupational exposure to chemicals, schistosomiasis, and genetic factors, which significantly affect the pathogenesis of bladder cancer, are also discussed. The paper focuses on modern diagnostic methods, including blue light cystoscopy (BLC) and computed tomography urography (CTU), which show increased sensitivity and specificity in detecting early neoplastic changes. The importance of TNM classification and the role of neoadjuvant chemotherapy in improving patient prognosis are also discussed. Based on a review of the scientific literature, the paper emphasizes the need for early diagnosis and an individualized therapeutic approach, which may contribute to improving the survival and quality of life of patients with bladder cancer. The potential for prevention, including quitting smoking and limiting exposure to harmful chemicals, has also been demonstrated to significantly reduce the risk of disease. Patient education and monitoring high-risk groups are key to reducing the incidence of bladder cancer. Full article

The aim of this study was to identify the determinants of smoking cessation outcomes and reasons for relapse following smoking cessation treatment. Using a mixed-method design, 179 patients were recruited from the Smoking Cessation outpatient clinic of Ankara Numune Training and Research Hospital between May 2016 and May 2017. Quantitative data were collected via questionnaires or from patient files and qualitative data were obtained via 5 focus group interviews with 28 patients who relapsed to smoking following treatment. The success rate of the smoking cessation clinic at the end of one year was 26%. The number of applications to the clinic was significantly higher in the group who quit smoking. Treatment success was found to be higher in the group that applied behavioral recommendations. In focus group interviews with patients who relapsed, the most common causes were stressful events, especially workplace problems and serious health problems experienced by relatives. The presence of smokers in the immediate vicinity increased the risk of relapse. It was concluded that not stopping treatment before the recommended period, continuity in follow-up appointments, support of the environment, support of pharmacotherapy with cognitive behavioral therapy and improving patients’ coping skills were important. Full article

Background: Lung cancer screening with low-dose helical computed tomography (LDCT) reduces mortality in high-risk subjects. Cigarette smoking is linked to up to 90% of lung cancer deaths. Even more so, it is a key risk factor for many other cancers and cardiovascular and pulmonary diseases. The Smokers health Multiple ACtions (SMAC-1) trial aimed to demonstrate the feasibility and effectiveness of an integrated program based on the early detection of smoking-related thoraco-cardiovascular diseases in high-risk subjects, combined with primary prevention. A new multi-component screening design was utilized to strengthen the framework on conventional lung cancer screening programs. We report here the study design and the results from our baseline round, focusing on oncological findings. Methods: High-risk subjects were defined as being >55 years of age and active smokers or formers who had quit within 15 years (>30 pack/y). A PLCO_m2012 threshold >2% was chosen. Subject outreach was streamlined through media campaign and general practitioners’ engagement. Eligible subjects, upon written informed consent, underwent a psychology consultation, blood sample collection, self-evaluation questionnaire, spirometry, and LDCT scan. Blood samples were analyzed for pentraxin-3 protein levels, interleukins, microRNA, and circulating tumor cells. Cardiovascular risk assessment and coronary artery calcium (CAC) scoring were performed. Direct and indirect costs were analyzed focusing on the incremental cost-effectiveness ratio per quality-adjusted life years gained in different scenarios. Personalized screening time-intervals were determined using the “Maisonneuve risk re-calculation model”, and a threshold <0.6% was chosen for the biennial round. Results: In total, 3228 subjects were willing to be enrolled. Out of 1654 eligible subjects, 1112 participated. The mean age was 64 years (M/F 62/38%), with a mean PLCO_m2012 of 5.6%. Former and active smokers represented 23% and 77% of the subjects, respectively. At least one nodule was identified in 348 subjects. LDCTs showed no clinically significant findings in 762 subjects (69%); thus, they were referred for annual/biennial LDCTs based on the Maisonneuve risk (mean value = 0.44%). Lung nodule active surveillance was indicated for 122 subjects (11%). Forty-four subjects with baseline suspicious nodules underwent a PET-FDG and twenty-seven a CT-guided lung biopsy. Finally, a total of 32 cancers were diagnosed, of which 30 were lung cancers (2.7%) and 2 were extrapulmonary cancers (malignant pleural mesothelioma and thymoma). Finally, 25 subjects underwent lung surgery (2.25%). Importantly, there were zero false positives and two false negatives with CT-guided biopsy, of which the patients were operated on with no stage shift. The final pathology included lung adenocarcinomas (69%), squamous cell carcinomas (10%), and others (21%). Pathological staging showed 14 stage I (47%) and 16 stage II-IV (53%) cancers. Conclusions: LDCTs continue to confirm their efficacy in safely detecting early-stage lung cancer in high-risk subjects, with a negligible risk of false-positive results. Re-calculating the risk of developing lung cancer after baseline LDCTs with the Maisonneuve model allows us to optimize time intervals to subsequent screening. The Smokers health Multiple ACtions (SMAC-1) trial offers solid support for policy assessments by policymakers. We trust that this will help in developing guidelines for the large-scale implementation of lung cancer screening, paving the way for better outcomes for lung cancer patients. Full article