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Keywords = smoking exposure

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12 pages, 2873 KB  
Communication
Histopathological Study of Changes in White-Pulp Structure Due to Lymphoid Depletion in the Spleen in Male Rats Caused by Exposure to Transitional Cigarette Smoke
by Tyagita Hartady, Stevania Sifora, Ronny Lesmana and Brian Christian Sarniem
Toxics 2026, 14(2), 113; https://doi.org/10.3390/toxics14020113 - 26 Jan 2026
Abstract
Conventional cigarette smoke and electronic cigarette vapor contain toxic compounds that may impair immune function, particularly in the spleen. This study evaluated histopathological changes in the spleen in male white rats (Rattus norvegicus, n = 32) divided into four groups: control, conventional-cigarette smoke [...] Read more.
Conventional cigarette smoke and electronic cigarette vapor contain toxic compounds that may impair immune function, particularly in the spleen. This study evaluated histopathological changes in the spleen in male white rats (Rattus norvegicus, n = 32) divided into four groups: control, conventional-cigarette smoke (CCS), electronic cigarette vapor (ECS), and transitional cigarette smoke (TCS). The TCS group was sequentially exposed to CCS for 15 days followed by ECS for 15 days, with twice-daily exposure. Spleen tissues were analyzed semi-quantitatively using ImageJ and statistically using the Kruskal–Wallis test after Shapiro–Wilk normality testing. Comparisons among the four groups showed significant differences in necrosis (p = 0.025) and vascular degeneration (p = 0.027). In contrast, hemosiderin, congestion, stretching, and vacuolization parameters did not show statistically significant differences among groups (p > 0.05). These findings suggest that switching from conventional cigarettes to e-cigarettes does not protect against splenic damage and may exacerbate immune dysfunction due to cumulative toxic exposure. Full article
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35 pages, 4501 KB  
Article
Developmental Nicotine Exposure Induces Intergenerational Transmission of an Ensemble of Neurodevelopmental Disorder-Related Translatomic Perturbations in DRD1-Expressing Striatal Cells of Adolescent Male Mice
by Jordan M. Buck, Marko Melnick and Jerry A. Stitzel
Genes 2026, 17(2), 128; https://doi.org/10.3390/genes17020128 - 25 Jan 2026
Abstract
Background/Objectives: Coupled with the already-problematic background rates of traditional cigarette consumption during pregnancy, the surging epidemic of electronic cigarette usage among pregnant women redoubles the importance of understanding the impacts of nicotine exposure during critical periods of development. To date, a burgeoning body [...] Read more.
Background/Objectives: Coupled with the already-problematic background rates of traditional cigarette consumption during pregnancy, the surging epidemic of electronic cigarette usage among pregnant women redoubles the importance of understanding the impacts of nicotine exposure during critical periods of development. To date, a burgeoning body of human epidemiological and animal model research indicates that not only the children but also the grandchildren of maternal smokers are at higher risk for neurodevelopmental disorders such as ADHD, autism, and schizophrenia and are predisposed to neurodevelopmental abnormalities which transcend these diagnoses. However, the roles of discrete cellular sub-populations in these and other intergenerational consequences of smoking during pregnancy remain indeterminate. Methods: Toward the resolution of this void in the literature, the present study characterized alterations in the gene expression profiles of dopamine receptor D1-expressing striatal cells from the first- and second-generation male progeny of female mice that were continuously exposed to nicotine beginning prior to conception, continuing throughout pregnancy, and concluding upon weaning of offspring. Results: Dopamine receptor D1-expressing striatal cells from our mouse models of the children and grandchildren of maternal smokers exhibit differential expression patterns for a multitude of genes that are (1) individually associated with neurodevelopmental disorders, (2) collectively overrepresented in gene set annotations related to brain, behavioral, neurobiological, and epigenomic phenotypes shared among neurodevelopmental disorders, and (3) orthologous to human genes that exhibit differential DNA methylation signatures in the newborns of maternal smokers. Conclusions: Together with our and others’ previous findings, the results of this study support the emerging theory that, by inducing extensive alterations in gene expression that in turn elicit cascading neurobiological changes which ultimately confer widespread neurobehavioral abnormalities, nicotine-induced epigenomic dysregulation may be a primary driver of neurodevelopmental deficits and disorders in the children and grandchildren of maternal smokers. Full article
(This article belongs to the Special Issue Genetics and Genomics of Pediatric Neurological Disorders)
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19 pages, 1781 KB  
Review
Diet–Oral Microbiota Interactions and Salivary Biomarkers of Nutritional Health: A Narrative Review
by Liliana Anchidin-Norocel, Andrei Lobiuc and Mihai Covasa
Nutrients 2026, 18(3), 396; https://doi.org/10.3390/nu18030396 - 25 Jan 2026
Abstract
Diet plays a central role in shaping the composition and metabolic activity of the oral microbiota, thereby influencing both oral and systemic health. Disturbances in this delicate host–microbe balance, triggered by dietary factors, smoking, poor oral hygiene, or antibiotic use, can lead to [...] Read more.
Diet plays a central role in shaping the composition and metabolic activity of the oral microbiota, thereby influencing both oral and systemic health. Disturbances in this delicate host–microbe balance, triggered by dietary factors, smoking, poor oral hygiene, or antibiotic use, can lead to microbial dysbiosis and increase the risk of oral diseases such as periodontitis, as well as chronic systemic disorders including diabetes, cardiovascular disease, Alzheimer’s disease, and certain cancers. Among dietary contaminants, exposure to toxic heavy metals such as cadmium (Cd), lead (Pb), mercury (Hg), nickel (Ni), and arsenic (As) represents an underrecognized modifier of the oral microbial ecosystem. Even at low concentrations, these elements can disrupt microbial diversity, promote inflammation, and impair metabolic homeostasis. Saliva has recently emerged as a promising, non-invasive biofluid for monitoring nutritional status and early metabolic alterations induced by diet and environmental exposures. Salivary biomarkers, including metabolites, trace elements, and microbial signatures, offer potential for assessing the combined effects of diet, microbiota, and toxicant exposure. This review synthesizes current evidence on how diet influences the oral microbiota and modulates susceptibility to heavy metal toxicity. It also examines the potential of salivary biomarkers as integrative indicators of nutritional status and metabolic health, highlights methodological challenges limiting their validation, and outlines future research directions for developing saliva-based tools in personalized nutrition and precision health. Full article
(This article belongs to the Special Issue Probiotics and Prebiotics for Oral Health Improvement)
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21 pages, 351 KB  
Review
Beyond the Usual Suspects: Unmasking Low-T2 Asthma in Children
by Iva Mrkić Kobal, Marta Navratil, Helena Munivrana Škvorc, Andrija Miculinić and Davor Plavec
J. Clin. Med. 2026, 15(2), 907; https://doi.org/10.3390/jcm15020907 (registering DOI) - 22 Jan 2026
Viewed by 43
Abstract
Background: T2 low asthma in children is an emerging yet underexplored endotype that challenges traditional views of type 2 inflammation. Recent data suggest that it is more prevalent than previously thought and is defined by low type 2 biomarkers, non-allergic clinical profiles, and [...] Read more.
Background: T2 low asthma in children is an emerging yet underexplored endotype that challenges traditional views of type 2 inflammation. Recent data suggest that it is more prevalent than previously thought and is defined by low type 2 biomarkers, non-allergic clinical profiles, and strong associations with modifiable comorbidities such as obesity, passive smoke exposure, and recurrent respiratory infections. This phenotype often shows a poor response to standard inhaled corticosteroid therapy and T2-targeted biologics, underscoring the urgent need for improved diagnostic and therapeutic approaches. Methods: This narrative review conducted a literature search from PubMed and WoS databases (2020–2025), focusing on T2-low asthma defined by low blood eosinophils (<150–300/µL), FeNO (<20–25 ppb), and absent atopy in children under 18. Results: This review highlights the heterogeneity of T2-low asthma, including subtypes from neutrophilic/Th 17-high to paucigranulocytic airway remodeling and metabolic driven forms, as well as diagnostic challenges from biomarker supresssion by high-dose therapies. Pragmatic phenotyping algorithms using routine tests enable identification, directing comorbidity management over ineffective biologics. Conclusions: Systematic T2-low phenotyping in pediatric practice, alongside prospective studies and non-T2 therapy trials, promises precision medicine to enhance outcomes for these children, moving beyond eosinophil-centric care. Full article
(This article belongs to the Special Issue New Clinical Advances in Pediatric Asthma)
14 pages, 490 KB  
Article
Prostate Cancer in the MENA Region: Attributable Burden of Behavioral and Environmental Exposures
by Magie Tamraz, Razan Al Tartir, Sara El Meski and Sally Temraz
Toxics 2026, 14(1), 96; https://doi.org/10.3390/toxics14010096 - 21 Jan 2026
Viewed by 212
Abstract
Background: Prostate cancer in the Middle East and North Africa (MENA) region is shaped by a complex interplay of behavioral and environmental risk factors, yet comprehensive estimates of preventable cases remain scarce. To address this gap, we estimated population-attributable fractions (PAFs) for a [...] Read more.
Background: Prostate cancer in the Middle East and North Africa (MENA) region is shaped by a complex interplay of behavioral and environmental risk factors, yet comprehensive estimates of preventable cases remain scarce. To address this gap, we estimated population-attributable fractions (PAFs) for a range of modifiable exposures among men aged 50 years and older and assessed potential reductions in incidence under feasible intervention scenarios. Methods: Regional prevalence data were combined with relative risks from meta-analyses to compute closed-form PAFs for tobacco smoking, obesity, physical inactivity, high dairy and calcium intake, heavy alcohol use, drinking water nitrates, trihalomethanes, arsenic, lead, selenium status, ambient PM2.5 and NO2, and occupational diesel exhaust, covering an estimated 47 million men. Estimates were validated using a synthetic cohort simulation of 100,000 individuals, with uncertainty quantified through Monte Carlo sampling. Results: Results showed that drinking water nitrate exposure accounted for the largest single fraction (17.4%), followed by tobacco smoking (9.5%), physical inactivity (6.7%), and trihalomethane exposure (5.0%), while other exposures contributed smaller but meaningful shares. Joint elimination of all exposures projected a 45.5% reduction in incidence, and simultaneous feasible reductions in four targeted exposures yielded a combined potential impact fraction of 12.1%. Conclusions: These findings suggest that integrated water quality management, tobacco control, lifestyle interventions, and targeted environmental surveillance should be prioritized to reduce prostate cancer burden in the MENA region. However, estimates of drinking-water nitrate exposure rely on limited evidence from a single case–control study with a relatively small sample size, and should therefore be considered exploratory and primarily hypothesis-generating. Full article
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13 pages, 262 KB  
Article
Suicidal Behaviour, Self-Harm and Related Factors: A Retrospective Study from the Adolescent Psychiatric Unit
by Sigita Lesinskienė, Miglė Zabarauskaitė, Tadas Valiulis, Giedrius Dailidė and Arūnas Germanavičius
Children 2026, 13(1), 147; https://doi.org/10.3390/children13010147 - 20 Jan 2026
Viewed by 170
Abstract
Background and objectives: Suicide attempts and self-harm are critical issues in adolescence, often leading to serious and irreversible consequences. These behaviours frequently co-occur and share common biopsychosocial risk factors. Identifying these factors enables a more comprehensive assessment of suicide and self-harm risk, [...] Read more.
Background and objectives: Suicide attempts and self-harm are critical issues in adolescence, often leading to serious and irreversible consequences. These behaviours frequently co-occur and share common biopsychosocial risk factors. Identifying these factors enables a more comprehensive assessment of suicide and self-harm risk, helping specialists recognize high-risk individuals and implement effective preventive measures. This study aimed to examine the association between suicide attempts, self-harm and psychosocial factors among hospitalized adolescents. Materials and methods: A retrospective data analysis was performed using the database of the University Department of Children and Adolescents of the Republican Vilnius Psychiatric Hospital. The study covered patients’ records from December 2022 to February 2025. Information on gender, age, suicide attempts, self-harm, adverse events (bullying, psychological abuse, physical violence within the family, and sexual abuse) and unhealthy habits (smoking, harmful alcohol consumption, and psychoactive substance use), was selected and analyzed in this study. A Chi-square test was used to assess the difference between groups. Results were considered statistically significant when p < 0.05. Results: The study included 599 hospitalized adolescents (26.9% boys; mean age 15.1 ± 1.4 years), of whom 70.8% reported at least one episode of self-harm and 37.8% at least one suicide attempt. Rates of self-harm and suicide attempts were significantly higher in girls than in boys (self-harm: 81.3% vs. 42.2%, ϕ=0.381, p<0.001; suicide attempts: 45.5% vs. 16.5%, ϕ=0.304, p<0.001), and adolescents with self-harm had a significantly higher prevalence of suicide attempts than those without self-harm (46.7% vs. 15.8%, ϕ=0.308, p<0.001). Adverse childhood experiences and unhealthy behaviours were significantly more frequent in adolescents with self-harm and suicide attempts, although effect sizes were small to moderate (ϕ range 0.086–0.230, all p<0.05). In multivariable models, female gender (β=0.355, p<0.001) and smoking (β=0.330, p<0.001) were the strongest predictors of self-harm, whereas alcohol use (β=0.337, p<0.001) and self-harm (β=0.232, p<0.001). Conclusions: Exposure to adverse childhood experiences and engagement in unhealthy habits were associated with higher rates of both self-harm and suicide attempts. A comprehensive assessment and early detection of self-harm behaviours and adverse psychosocial circumstances are crucial elements of effective suicide prevention strategies and prompt intervention among high-risk adolescents. Full article
19 pages, 3780 KB  
Article
Carbon Nanotube-Based Filters for the Adsorption of Toxic Compounds in Cigarette Smoke
by Luigi Madeo, Pietro Figliuzzi, Assunta Perri, Anastasia Macario, Carlo Siciliano and Pierantonio De Luca
C 2026, 12(1), 8; https://doi.org/10.3390/c12010008 - 20 Jan 2026
Viewed by 120
Abstract
This study investigates the use of carbon nanotubes (CNTs) in the development of a filter capable of capturing toxic and carcinogenic compounds found in cigarette smoke dispersed in the environment. The aim is to contribute to the reduction in passive exposure to these [...] Read more.
This study investigates the use of carbon nanotubes (CNTs) in the development of a filter capable of capturing toxic and carcinogenic compounds found in cigarette smoke dispersed in the environment. The aim is to contribute to the reduction in passive exposure to these substances, with potential benefits for public health and air quality. Carbon nanotubes were selected for their exceptional adsorption properties, attributed to their high specific surface area and porous structure. The material’s adsorptive performance was evaluated based on the quantity used, to determine the optimal mass that ensures the best filtering capacity. To test the system, an experimental setup was assembled to simulate real-world smoke emission conditions. Filters containing CNTs were subjected to gravimetric analysis to measure the amount of retained substances, and to gas chromatography to identify the adsorbed chemical compounds. The results confirm the potential of carbon nanotubes as an advanced filtering material, paving the way for robust solutions to mitigate the environmental impact of secondhand smoke. The results indicate that CNT-based filters, particularly those containing 0.06 g of material, are highly effective in retaining several toxic components of cigarette smoke, including nicotine. This configuration achieves a strong reduction in harmful organic species while using a moderate amount of adsorbent, suggesting a promising selectivity of CNTs toward the most hazardous molecules. Full article
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18 pages, 1191 KB  
Article
Diabetic Kidney Disease Associated with Chronic Exposure to Low Doses of Environmental Cadmium
by Soisungwan Satarug, Tanaporn Khamphaya, Donrawee Waeyeng, David A. Vesey and Supabhorn Yimthiang
Stresses 2026, 6(1), 4; https://doi.org/10.3390/stresses6010004 - 16 Jan 2026
Viewed by 139
Abstract
Accumulating evidence suggests that exposure to pollution from environmental cadmium (Cd) contributes to diabetic kidney disease as indicated by albuminuria and a progressive decrease in the estimated glomerular filtration rate (eGFR). This study examined the effects of Cd exposure on eGFR and the [...] Read more.
Accumulating evidence suggests that exposure to pollution from environmental cadmium (Cd) contributes to diabetic kidney disease as indicated by albuminuria and a progressive decrease in the estimated glomerular filtration rate (eGFR). This study examined the effects of Cd exposure on eGFR and the excretion rates of albumin (Ealb) and β2-microglobulin (Eβ2M) in 65 diabetics and 72 controls. Excretion of Cd (ECd) was a measure of exposure, while excretion of N-acetylglucosaminidase (ENAG) reflected the extent of kidney tubular cell injury. In participants with an elevated excretion of Eβ2M, the prevalence odds ratios (POR) for a reduced eGFR rose 6.4-fold, whereas the POR for albuminuria rose 4.3-fold, 4.1-fold, and 2.8-fold in those with a reduced eGFR, diabetes, and hypertension, respectively. Using covariance analysis, which adjusted for the interactions, 43% of the variation in Ealb among diabetics could be explained by female gender (η2 = 0.176), ENAG2 = 0.162), hypertension (η2 = 0.146), smoking (η2 = 0.107), and body mass index (η2 = 0.097), while the direct contribution of ECd to Ealb variability was minimal (η2 = 0.005). Results from a mediating-effect analysis imply that Cd could contribute to albuminuria and a falling eGFR through inducing tubular cell injury, leading to reduced reabsorption of albumin and β2M. Full article
(This article belongs to the Section Animal and Human Stresses)
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18 pages, 4298 KB  
Article
Development of Low-Power Forest Fire Water Bucket Liquid Level and Fire Situation Monitoring Device
by Xiongwei Lou, Shihong Chen, Linhao Sun, Xinyu Zheng, Siqi Huang, Chen Dong, Dashen Wu, Hao Liang and Guangyu Jiang
Forests 2026, 17(1), 126; https://doi.org/10.3390/f17010126 - 16 Jan 2026
Viewed by 93
Abstract
A portable and integrated monitoring device was developed to digitally assess both water levels and surrounding fire-related conditions in forest firefighting water buckets using multi-sensor fusion. The system integrates a hydrostatic liquid-level sensor with temperature–humidity and smoke sensors. Validation was performed through field-oriented [...] Read more.
A portable and integrated monitoring device was developed to digitally assess both water levels and surrounding fire-related conditions in forest firefighting water buckets using multi-sensor fusion. The system integrates a hydrostatic liquid-level sensor with temperature–humidity and smoke sensors. Validation was performed through field-oriented experiments conducted under semi-controlled conditions. Water-level measurements were collected over a three-month period under simulated forest conditions and benchmarked against conventional steel-ruler readings. Early-stage fire monitoring experiments were carried out using dry wood and leaf litter under varying wind speeds, wind directions, and representative extreme weather conditions. The device achieved a mean water-level bias of −0.60%, a root-mean-square error of 0.64%, and an overall accuracy of 99.36%. Fire monitoring reached a maximum detection distance of 7.30 m under calm conditions and extended to 16.50 m under strong downwind conditions, with performance decreasing toward crosswind directions. Stable operation was observed during periods of strong winds associated with typhoon events, as well as prolonged high-temperature exposure. The primary novelty of this work lies in the conceptualization of a Collaborative Forest Resource–Hazard Monitoring Architecture. Unlike traditional isolated sensors, our proposed framework utilizes a dual-domain decision-making model that simultaneously assesses water-bucket storage stability and micro-scale fire threats. By implementing a robust ‘sensing–logic–alert’ framework tailored for rugged environments, this study offers a new methodological reference for the intelligent management of forest firefighting resources. Full article
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18 pages, 2782 KB  
Article
Can Cigarette Butt-Derived Cellulose Acetate Nanoplastics Induce Toxicity in Allolobophora caliginosa? Immunological, Biochemical, and Histopathological Insights
by Zeinab Bakr, Shimaa Mohamed Said, Naser A. Elshimy, Mohamed Abd El-Aal and Gehad N. Aboulnasr
Microplastics 2026, 5(1), 12; https://doi.org/10.3390/microplastics5010012 - 15 Jan 2026
Viewed by 144
Abstract
Plastic pollution is a major global challenge, especially nanoplastics (NPs) emerging as harmful pollutants due to their small size, reactivity, and persistence in ecosystems. Among them, cigarette butts composed of cellulose acetate (CA) are one of the most widespread and hazardous sources of [...] Read more.
Plastic pollution is a major global challenge, especially nanoplastics (NPs) emerging as harmful pollutants due to their small size, reactivity, and persistence in ecosystems. Among them, cigarette butts composed of cellulose acetate (CA) are one of the most widespread and hazardous sources of terrestrial NPs. In this study, the immunotoxic, biochemical, and histopathological effects of cellulose acetate nanoplastics (CA-NPs) derived from smoked cigarette butts (SCB-NPs), unsmoked cigarette butts (USCB-NPs), and commercial cellulose acetate (CCA-NPs) were evaluated on the earthworm Allolobophora caliginosa. Adult worms were exposed for 30 days to 100 mg/kg CA-NPs in artificial soil under controlled laboratory conditions. Results revealed that SCB-NPs induced the most pronounced alterations, including increased lysozyme and metallothionein levels, reduced phagocytic and peroxidase activities, and depletion of protein and carbohydrate reserves. Histological examination showed vacuoles in epithelial layer vacuolization, space between muscle fiber disruption, and degeneration in gut and body wall, especially under SCB-NP exposure. USCB-NPs and CCA-NPs caused milder but still significant effects. Taken together, these findings highlight that the high toxicity of SCB-NPs is due to the presence of combustion-derived toxicants (nicotine, polycyclic aromatic hydrocarbons, and heavy metals), which exacerbate oxidative stress, immune suppression, and tissue damage in soil invertebrates. This study underscores the ecological risk of cigarette butt-derived NPs and calls for urgent policy measures to mitigate their terrestrial impacts. Full article
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16 pages, 770 KB  
Review
Sex-Specific Vulnerabilities in Lung Adenocarcinoma Among Non-Smoking Women: A Conceptual Review of Multisystem Pathways and Preventive Implications
by Ren-Jen Hwang, Hsiu-Chin Hsu and Yueh-O Chuang
Cancers 2026, 18(2), 266; https://doi.org/10.3390/cancers18020266 - 15 Jan 2026
Viewed by 141
Abstract
Background: Lung adenocarcinoma in non-smoking women represents a distinct clinical entity that cannot be fully explained by traditional exposure-centered carcinogenic models. Although ambient air pollution is a recognized risk factor, sex-specific vulnerability suggests the involvement of additional biological modulators shaping inflammatory, immune, and [...] Read more.
Background: Lung adenocarcinoma in non-smoking women represents a distinct clinical entity that cannot be fully explained by traditional exposure-centered carcinogenic models. Although ambient air pollution is a recognized risk factor, sex-specific vulnerability suggests the involvement of additional biological modulators shaping inflammatory, immune, and proliferative responses. Main body: In this conceptual review, we integrate epidemiological, experimental, and mechanistic evidence to propose a multisystem framework of lung carcinogenesis in non-smoking women. We delineate a central carcinogenic spine encompassing lung epithelial injury, chronic inflammation, growth factor signaling activation—particularly epidermal growth factor receptor (EGFR) pathways—and tumor microenvironment remodeling. Within this framework, three interacting domains function as biological modulators that amplify carcinogenic processes: chemosensory–neural–immune modulation, hormonal–endocrine signaling including estrogen–EGFR crosstalk, and psychosocial stress–hypothalamic–pituitary–adrenal (HPA) axis dysregulation. These domains converge through feedback mechanisms that reinforce systemic dysregulation and tumor-promoting microenvironments. Implications: This integrative model provides a biologically grounded perspective on female-specific vulnerability to lung adenocarcinoma and informs precision prevention, risk stratification, and ESG-informed public health strategies beyond conventional exposure reduction. Full article
(This article belongs to the Section Cancer Causes, Screening and Diagnosis)
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22 pages, 800 KB  
Article
The Influence of Smoking on Respiratory Function in Medical Students at the University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș
by Edith-Simona Ianosi, Renata-Ingrid Ianosi, Hajnal Finta, Raul-Alexandru Lefter, Anca Meda Văsieșiu, Dragoș Huțanu and Maria-Beatrice Ianosi
Biomedicines 2026, 14(1), 164; https://doi.org/10.3390/biomedicines14010164 - 13 Jan 2026
Viewed by 281
Abstract
Background: Cigarette smoking remains one of the most important preventable causes of respiratory morbidity, exerting detrimental effects even in young adults. Medical students represent a particularly relevant population, as the lifestyle habits they adopt during their training years may influence both their personal [...] Read more.
Background: Cigarette smoking remains one of the most important preventable causes of respiratory morbidity, exerting detrimental effects even in young adults. Medical students represent a particularly relevant population, as the lifestyle habits they adopt during their training years may influence both their personal health and professional credibility. Methods: We conducted a cross-sectional analysis of 264 medical students from the University of Medicine, Pharmacology, Science and Technology of Târgu-Mures, aged 18–30 years, stratified according to smoking status, type of tobacco product used, and lifestyle characteristics (athletic vs. sedentary). Standardized spirometry was performed to assess FVC, FEV1, FEV1/FVC ratio, PEF, and small airway flow parameters (MEF25, MEF50, MEF75). Statistical comparisons between groups were performed using t-tests, Mann–Whitney U tests, chi-square tests, and correlation analyses, with p < 0.05 considered statistically significant. Results: Smokers demonstrated significantly lower values for FEV1, PEF, and MEF parameters compared with non-smokers, confirming early functional impairment of both large and small airways. Within the smoking group, users of e-cigarettes or heated tobacco products exhibited more favorable FEV1 and small airway flow values than conventional cigarette smokers. However, differences in FVC were less pronounced. Significantly, athletes consistently outperformed their sedentary peers across all respiratory parameters, regardless of smoking status, with markedly higher FEV1, FVC, and MEF values and a lower prevalence of obstructive patterns. Cumulative smoking exposure (pack-years) was inversely associated with small airway function, whereas higher levels of physical activity were independently linked to a pronounced protective effect. Conclusions: Even in early adulthood, smoking is related to measurable declines in lung function, particularly affecting small airway dynamics. Although alternative products may appear less harmful than conventional cigarettes, they cannot be considered risk-free. Conversely, regular physical activity demonstrated a protective association in the case–control analysis, attenuating functional decline and supporting the preservation of long-term respiratory health. These findings underscore the importance of integrated prevention strategies in medical universities, combining smoking cessation initiatives with the systematic promotion of physical activity to safeguard the health of future physicians and reinforce their role as credible health advocates. Full article
(This article belongs to the Special Issue New Insights in Respiratory Diseases)
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22 pages, 6253 KB  
Review
Lung Cancer in Never-Smokers: Risk Factors, Driver Mutations, and Therapeutic Advances
by Po-Ming Chen, Yu-Han Huang and Chia-Ying Li
Diagnostics 2026, 16(2), 245; https://doi.org/10.3390/diagnostics16020245 - 12 Jan 2026
Viewed by 373
Abstract
Background and Objectives: Lung cancer in never-smokers (LCINS) has become a major global health concern, ranking as the fifth leading cause of cancer-related mortality. Unlike smoking-related lung cancer, LCINS arises from complex interactions between environmental carcinogens and distinct genomic alterations. This review [...] Read more.
Background and Objectives: Lung cancer in never-smokers (LCINS) has become a major global health concern, ranking as the fifth leading cause of cancer-related mortality. Unlike smoking-related lung cancer, LCINS arises from complex interactions between environmental carcinogens and distinct genomic alterations. This review summarizes current evidence on environmental risks, molecular features, and therapeutic progress shaping lung cancer management. Methods: A narrative review was conducted to examine risk factors for lung cancer in non-smokers. Studies reporting driver mutations in never-smokers and smokers were identified across major lung cancer histological subtypes, including small-cell lung cancer (SCLC), lung adenocarcinoma (LUAD), squamous cell carcinoma (SCC), and large-cell carcinoma (LCC). In addition, PubMed was searched for phase III trials and studies on targeted therapies related to driver mutations published between 2016 and 2025. Results: Environmental factors such as cooking oil fumes, radon, asbestos, arsenic, and fine particulate matter (PM2.5) are strongly associated with LCINS through oxidative stress, DNA damage, and chronic inflammation. EGFR, PIK3CA, OS9, MET, and STK11 mutations are characteristic of never-smokers, in contrast to TP53 mutations, which are more common in smokers. Recent advances in targeted therapy and immunotherapy have improved survival and quality of life, emphasizing the importance of molecular profiling for treatment selection. Conclusions: LCINS represents a distinct clinical and molecular entity shaped by complex interactions between environmental exposures and genetic susceptibility. Genetic alterations promote tumor immune evasion, facilitating cancer development and progression. Continued advances in air quality control, molecular diagnostics, and precision therapies are essential for prevention, early detection, and reduction of the global disease burden. Full article
(This article belongs to the Special Issue Lung Cancer: Screening, Diagnosis and Management: 2nd Edition)
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12 pages, 319 KB  
Brief Report
Does Vertical Density Affect Lung Cancer Mortality Differently for Men and Women?
by Yuval Arbel
Urban Sci. 2026, 10(1), 39; https://doi.org/10.3390/urbansci10010039 - 9 Jan 2026
Viewed by 194
Abstract
This study examines the relationship between lung and bronchus cancer mortality, vertical urban density, and smoking prevalence across 48 U.S. states from 1999 to 2022. Using 2034 state-year observations, skyscraper counts are employed as a proxy for vertical urban density, together with sex-specific, [...] Read more.
This study examines the relationship between lung and bronchus cancer mortality, vertical urban density, and smoking prevalence across 48 U.S. states from 1999 to 2022. Using 2034 state-year observations, skyscraper counts are employed as a proxy for vertical urban density, together with sex-specific, age-adjusted mortality and smoking data. A fully interacted empirical model identifies a non-linear, inverted U-shaped relationship between vertical density and lung cancer mortality for both men and women: mortality initially increases with greater vertical density but declines at higher levels, consistent with offsetting effects of environmental exposure and improved access to healthcare in highly dense urban environments. Importantly, the shape and magnitude of this relationship differ by gender. While smoking prevalence is strongly associated with lung cancer mortality for both sexes, mortality rates are consistently higher among males, and the marginal effect of smoking on mortality is more pronounced for men than for women. These findings highlight the importance of accounting for both non-linearity and gender heterogeneity when assessing the public health implications of urban form. Full article
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20 pages, 8216 KB  
Article
Urban Oases: The Critical Role of Green and Blue Spaces in Mental Well-Being
by Oluwaseun Ipede, Meimei Lin, Christine Hladik and Wei Tu
Sustainability 2026, 18(2), 642; https://doi.org/10.3390/su18020642 - 8 Jan 2026
Viewed by 181
Abstract
Urbanization has significantly affected the availability and quality of urban green and blue spaces (UGBSs), which may affect mental health. In the United States, rates of anxiety and depression continue to rise, particularly in urban regions. This study examined the relationship between UGBS [...] Read more.
Urbanization has significantly affected the availability and quality of urban green and blue spaces (UGBSs), which may affect mental health. In the United States, rates of anxiety and depression continue to rise, particularly in urban regions. This study examined the relationship between UGBS exposure and mental health, measured by Frequent Mental Distress (FMD), across major cities in the contiguous United States (CONUS) from 2015 to 2017. UGBS exposure was estimated using remote sensing and GIS, and its association with FMD was assessed using Ordinary Least Squares (OLS) regression and Geographically Weighted Regression (GWR). The analyses also included smoking, binge drinking, median income, and educational attainment as covariates. OLS results indicated statistically significant but spatially uniform associations, whereas GWR revealed considerable spatial variation in UGBS and covariate effects across cities. Median income and educational attainment consistently showed inverse relationships with FMD, while smoking showed direct relationships across all years. Binge drinking exhibited both direct and inverse relationships. Additionally, both green space and blue space showed different relationships with FMD depending on location and year. The beneficial effect of UGBS on FMD was not observed in every instance. These findings help clarify the relationship between environmental, behavioral, and socioeconomic factors and mental health in urban settings, providing information that may support informed urban planning and public health decisions. Full article
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