Net Effect of Short-Term Smoking Cessation on Mental Health Changes:Inverse Probability of Treatment Weighting and Difference-in-Differences Method

Background:In response to the need for research clearly demonstrating the net effect of smoking cessation on mental health status,considering the causal relationship between smoking cessation and changes in mental health status,this study was undertaken.Thus,this study aimed to examine the net effect of short-term smoking cessation on five specific mental health metrics and the overall mental health status score.Methods:We used data from the first wave of the Korean Health Panel(KHP)Survey(2011–2013,2016–2018)and focused on men aged 19 years and older,to explore the effects of smoking cessation.We compared mental health status before and after cessation among current non-smokers who had quit smoking and continuous smokers.We ensured homogeneity between the two groups via inverse probability of treatment weighting(IPTW)and employed a difference-in-differences(DID)analysis to assess changes in mental health status.This study controlled for factors that could influence mental health and explored the net effect of short-term smoking cessation through difference-in-differences model using multiple regression analysis.Results:The results showed that short-term smoking cessation significantly alleviated mental and physical stress(p<0.1),reduced experiences of frustration(p<0.01),and improved the overall mental health status score(p<0.1).Conclusion:Thus,these results highlight a meaningful link between positive health behavior changes,such as smoking cessation,and enhanced mental health.Moreover,the application of temporal variables further improved the understanding of the causal relationship between health behaviors and mental health.

Effect of smoking on the risk of gastrointestinal cancer after cholecystectomy: A national population-based cohort study

BACKGROUND The role of smoking in the incidence of colorectal cancer(CRC)or gastric cancer(GC)in populations undergoing cholecystectomy has not been investigated.AIM To evaluate the effect of smoking on CRC or GC development in cholecystectomy patients.METHODS A total of 174874 patients who underwent cholecystectomy between January 1,2010 and December 31,2017 were identified using the Korean National Health Insurance Service claims database.These patients were matched 1:1 with mem-bers of a healthy population according to age and sex.CRC or GC risk after cholecystectomy and the association between smoking and CRC or GC risk in cholecystectomy patients were evaluated using adjusted hazard ratios(HRs)and 95%CIs.RESULTS The risks of CRC(adjusted HR:1.15;95%CI:1.06-1.25;P=0.0013)and GC(adjusted HR:1.11;95%CI:1.01-1.22;P=0.0027)were significantly higher in cholecystectomy patients.In the population who underwent cholecystectomy,both CRC and GC risk were higher in those who had smoked compared to those who had never smoked.For both cancers,the risk tended to increase in the order of non-smokers,ex-smokers,and current smokers.In addition,a positive correlation was observed between the amount of smoking and the risks of both CRC and GC.CONCLUSION Careful follow-up and screening should be performed,focusing on the increased risk of gastrointestinal cancer in the cholecystectomy group,particularly considering the individual smoking habits.

Smoking cessation prior to elective total joint arthroplasty results in sustained abstinence postoperatively

BACKGROUND Tobacco use is a well-documented modifiable risk factor for perioperative complications.AIM To determine the tobacco abstinence rates of patients who made cessation efforts prior to a total joint arthroplasty(TJA)procedure.METHODS A retrospective evaluation was performed on 88 self-reported tobacco users who underwent TJA between 2014-2022 and had tobacco cessation dates within 3 mo of surgery.Eligible patients were contacted via phone survey to understand their tobacco use pattern,and patient reported outcomes.A total of 37 TJA patients participated.RESULTS Our cohort was on average 61-years-old,60%(n=22)women,with an average body mass index of 30 kg/m^(2).The average follow-up time was 2.9±1.9 years.A total of 73.0%(n=27)of patients endorsed complete abstinence from tobacco use prior to surgery.Various cessation methods were used perioperatively including prescription therapy(13.5%),over the counter nicotine replacement(18.9%),cessation programs(5.4%).At final follow up,43.2%(n=16)of prior tobacco smokers reported complete abstinence.Patients who were able to maintain cessation postoperatively had improved Patient-Reported Outcomes Measurement Information System(PROMIS)-10 mental health scores(49 vs 58;P=0.01),and hip dysfunction and osteoarthritis outcome score for joint replacement(HOOS.JR)scores(63 vs 82;P=0.02).No patients in this cohort had a prosthetic joint infection or required revision surgery.CONCLUSION We report a tobacco cessation rate of 43.2%in patients undergoing elective TJA nearly 3 years postoperatively.Patients undergoing TJA who were able to remain abstinent had improved PROMIS-10 mental health scores and HOOS.JR scores.The perioperative period provides clinicians a unique opportunity to assist active tobacco smokers with cessation efforts and improve postoperative outcomes.

The impact of tobacco use and nicotine addiction on health: A literature review of nursing interventions for smoking cessation

Tobacco use remains one of the leading preventable causes of morbidity and mortality globally,with nicotine addiction significantly impacting health outcomes.This literature review explores the multifaceted nature of tobacco use and its health implications,emphasizing the role of nursing interventions in smoking cessation.The review highlights various strategies employed by nurses,including assessment,counseling,pharmacotherapy support,and behavioral interventions,which are essential for effective tobacco cessation.By analyzing current evidence-based practices,the study underscores the importance of comprehensive assessments and personalized care plans tailored to individual patient needs.It also addresses the significance of motivational interviewing and the 5 A’s framework in facilitating successful quit attempts.In addition,the review discusses the integration of cognitive-behavioral therapy and stress management techniques as vital components of behavioral interventions.Recommendations for improving tobacco cessation efforts include enhanced training for healthcare professionals,the establishment of community-based support groups,and advocacy for robust tobacco control policies.The findings underscore the critical need for ongoing research into the long-term effectiveness of cessation interventions across diverse populations.This study aims to inform nursing practice and public health policy,ultimately contributing to the reduction of tobacco-related health issues and promoting healthier communities.

Does Smoking Weaken the Immune System: A Narrative Review

Smoking has a complex impact on the immune system, affecting both innate and adaptive immunity. It can exacerbate pathogenic immune responses and attenuate defensive immunity, leading to a higher susceptibility to infections and certain diseases. The chemicals in cigarette smoke, such as nicotine and carbon monoxide, can alter immune cell functions and inflammatory responses. Smoking can also have long-term effects on the immune system, with some changes persisting even after quitting [1]. According to a Penn Medicine Physician, the Medical Oncologist Dr. David Porter, “People who are smokers tend to get sicker from infections”, “It may be that smoking impacts the immune system’s ability to respond appropriately”. Thus, such individuals within smoking exposure history might be considered as immunocompromised due to the altered and weakened immune system. Cigarette smoking is a prevalent habit with far-reaching health implications. Among its many adverse effects, smoking significantly alters the immune system’s functionality [1].

Exploring the Impact of Alcohol Consumption and Smoking on Primary Open Angle Glaucoma: A Mendelian Randomization Study

Objective: Utilizing Mendelian Randomization, this study employs Single Nucleotide Polymorphisms (SNPs) as instrumental variables to explore the causal relationships between bibulosity, smoking, and Primary Open Angle Glaucoma (POAG). Methods: GWAS data for bibulosity, smoking, and POAG were obtained from the Social Science Genetic Association Consortium website and the IEU OpenGWAS Project website, respectively. Using a P-value threshold of −8, a linkage disequilibrium coefficient (r2) of 0.001, and a linkage disequilibrium region width of 10,000 kb, the data were aggregated, resulting in 6 SNPs for bibulosity and 253 SNPs for smoking. Three regression models, MR-Egger, Weighted Median Estimator (WME), and Random-Effects Inverse-Variance Weighted (IVW) were applied to analyze the causal impact of bibulosity and smoking on POAG. Results: The GWAS data for alcohol consumption and smoking were derived from European populations, while the GWAS data for Primary Open-Angle Glaucoma (POAG) were sourced from East Asian populations, with no gender restrictions. Analysis using three different regression models revealed that neither excessive alcohol consumption nor smoking significantly increased the risk of developing POAG. Specifically, the odds ratios with 95% confidence intervals for the alcohol consumption group were 0.854 (0.597 - 1.221) in MR-Egger regression, 0.922 (0.691 - 1.231) in WME regression, and 0.944 (0.711 - 1.252) in IVW regression. For the smoking group, the odds ratios were 1.146 (0.546 - 2.406) in MR-Egger regression, 0.850 (0.653 - 1.111) in WME regression, and 0.939 (0.780 - 1.131) in IVW regression. Given the significant heterogeneity in the SNPs associated with smoking, the focus was primarily on the results from the IVW regression model. Conclusion: Alcohol consumption and smoking are not significant risk factors for the development of POAG.

The Prevalence of Smoking in Caribbean Towns and Correlation with Disease States: A Survey

Background: Smoking continues to be one of the most popular recreational practices despite its known harmful effects. Aim: The purpose of this survey was to assess the prevalence of smoking in the Caribbean and the correlation of smoking with the disease states of high blood pressure, diabetes and high cholesterol whose risk is known to be higher among smokers. Findings: Our study found a smoking prevalence of 22% in the population, similar to that reported by the World Health Organization (20%) and a positive correlation between smoking and diabetes. Conclusion: The survey shows that smoking numbers within the population are still high and that smoking increases the risk of certain disease states within smokers. Aggressive global efforts to reduce smoking should continue so as to minimize the negative impact of smoking on health.

Persuasive Technology for the Future of Smoking Cessation*

This paper explores the integration of persuasive technology into smoking cessation efforts through the development and evaluation of a mobile app, “No-Smoke.” Leveraging compelling features like social support, tracking, planning, and motivation, the app aims to augment user engagement and support the process of quitting smoking. The efficacy of these features has been substantiated through both automated testing and user feedback, highlighting their potential to enhance awareness, motivation, and behavior modification. Despite notable successes, limitations, including a limited user base and uncertainties regarding long-term efficacy, have been acknowledged, stemming from the inherent complexities of smoking cessation. Nevertheless, based on user experiences and feedback, “No-Smoke” represents a promising advancement in the use of technology for public health interventions, particularly in the realm of smoking cessation. To address existing challenges, future research is recommended to encompass a comprehensive, long-term study involving a larger and more diverse user base. Additionally, further investigation should focus on personalization enhancements and the integration of machine learning algorithms to better understand and respond to user behavior.

Mining twitter to understand the smoking cessation barriers

Smoking cessation is challenging and lack of positive support is a known major barrier to quitting cigarettes.Previous studies have suggested that social influences might increase smokers' awareness of social norms for appropriate behavior,which might lead to smoking cessation.Although social media use is increasing among young adults in the United States,research on the relationship between social media use and smoking cessation is lacking.Twitter has provided a rich source of information for researchers,but no overview exists as to how the field uses Twitter in smoking cessation research.To the best of our knowledge,this study conducted a data mining analysis of Twitter to assess barriers to smoking cessation.In conclusion,Twitter is a cost-effective tool with the potential to disseminate information on the benefits of smoking cessation and updated research to the Twitter community on a global scale.

The Effects of Smoking Ban in Closed Public Spaces on the Status of Smoking

Smoking Ban in Closed Public Spaces went into effect in Turkey on May 19, 2008. We aimed at investigating the status of smoking among hospital staff following the ban. The study was conducted with the staff of the university hospital other than physicians. A questionnaire form investigating the status of smoking among hospital staff, the effects of the ban on smoking in closed public spaces, their thoughts that might affect their decisions to quit smoking or to decrease the number of cigarettes smoked was implemented. Prior to each interview, the participants read and signed the informed consent form. Mean and percentage distributions were used in the evaluation of the data. Of 60 individuals, 68% were female, mean age was 40.72 ~ 7.25. Of them 50% were active smokers. After the ban 55% of the smokers declared a decrease in the number of cigarettes they smoked, 37% said no change. The ban had no effect on smokers＇ decisions about quitting smoking. Social leadership and role model characteristics of healthcare professionals should be taken into consideration and the habit of smoking should be handled as a disease, and medical approaches including behavioral therapy should be given the necessary significance they deserve.

Impacts of Preoperative Smoking and Smoking Cessation Time on Preoperative Peripheral Blood Inflammatory Indexes and Postoperative Hospitalization Outcome in Male Patients with Lung Cancer and Surgery Treatment

Objectives To investigate the effects of preoperative smoking and smoking cessation time on preoperative peripheral blood inflammatory indexes and postoperative hospitalization outcomes in male patients with lung cancer and surgery therapy.Methods We retrospectively enrolled 637 male patients who underwent curative-intent lung cancer resection between January 2014 and December 2016.Patients were classified as the current smokers,the never smokers,and the ex-smokers based on their smoking history,and the ex-smokers were allocated into five subgroups according to their smoking cessation times(CeT):CeT W6 weeks,6weeks<CeT W lyear,lyear<CeT<5years,5years<CeT<lOyears,CeT>10years.The preoperative peripheral blood white blood cells(WBCs),albumin,neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),intraoperative blood loss,30-day mortality,in-hospital days,hospitalization costs,intensive care un辻(ICU),admission days and placement time of closed thoracic drainage tube were compared among difTerent groups.Results There were significant differences in WBC(F=S.275,P<0.001)and albumin(F=2,470,P<0.05)among patients of current smokers,ex-smokers with different smoking cessation time,and never-smokers.The blood WBC count in current smokers(7.7 X 109/L)was significantly higher than that in ex・smokers(7.0 X 109/L)and never-smokers(5.9 X 109/L)(t=-2.145,P<0.05;t=-6.073,P<0.01,respectively).The level of peripheral blood albumin in current smokers(41.1 g/L)was lower than that in ex・smokers(42.1 g/L)and neve—smokers(43.2 g/L)(t=2.323,P<0.05;t=3.995,P<0.01,respectively).The level of peripheral blood NLR in current smokers(3.7)was higher than that in ex-smokers(3.1)and never smokers(2.8)(t—-1.836,P<0.05;t=-2.889,P<0.01,respectively).There was no significant difference in WBC,albumin and NLR among five subgroups of different smoking cessation time.No significant difference was observed in intraoperative blood loss,30-day mortality,hospitalization costs,hospital stay,ICU stay and placement time of closed thoracic drainage tube among groups either.Conclusion Smoking increases the preoperative inflammatory indexes in peripheral blood of lung cancer patients.Smoking cessation has beneficial effect on reducing levels of these inflammatory indexes,which may be not impacted by the time length of smoking cessation.Therefore,lung cancer patients should be encouraged to quit smoking at any time.

Impact of Smoking Status on Lipoprotein Subfractions： Data from an Untreated Chinese Cohort

Objective Cigarette smoking is one of the established risk factors of atherosclerotic cardiovascular disease, however, its impact on lipids is not completely understood, especially in the Chinese population. Therefore, this study evaluated the impact of smoking status （non, former, and current smoking） on the distribution of lipoprotein subfractions in untreated patients with angina-like chest pain. Methods A total of 877 patients were consecutively enrolled and divided into nonsmoking （n = 528）, former smoking （n = 103）, and current smoking （n = 256） groups. Both low- and high-density lipoprotein cholesterol （LDL-C and HDL-C） subfractions were measured using the Quantimetrix Lipoprint System. The distributions of lipoprotein subfractions were evaluated among the groups. Results Compared with nonsmoking subjects, the current smoking group had significantly lower large/medium HDL-C （both P 〈 0.001） concentration and large HDL subfraction percentage but higher small HDL-C and medium LDL-C concentrations as well as medium LDL subfraction percentage. Importantly, former smoking subjects showed elevated levels of large HDL-C concentration, large HDL particle percentage, and mean LDL particle size and attenuation in small HDL/LDL percentages and small LDL-C concentration, but these levels did not reach the optimal status compared with those of the non-smoking group （data not shown）. Conclusion Smoking has an adverse impact on the lipoprotein subfractions, presented as lower large HDL particles besides higher small HDL and medium LDL particles, whereas smoking cessation could reverse these change to a certain degree.

Effects of Different Yellowing Conditions on Neutral Aroma Components and Smoking Quality of Flue-cured Upper Leaves

A heated air circulation standard curing barn was used for baking tobacco leaves, and the effects of different yellowing conditions during the baking process on contents of neutral aroma components and smoking quality of upper leaves were studied by setting different yellowing time and color-fixing time. The results showed that during the baking process, only by prolonging the yellowing time by 24 h on the basis of control, the content of every kind of neutral aroma components in- creased obviously and the content of solanone increased by nearly 2.20 times. It was unfavorable for the degradation and accumulation of aroma components when only prolonging color-fixing time by 24 h. Prolonging both yellowing time and color- fixing time by 24 h mainly promoted the accumulation of chlorophyll degradation product neophytadiene, which increased by 33.24%, while the degradation and ac- cumulation of some aroma components were inhibited, indicating that only prolonging the yellowing time by 24 h could promote the accumulation of various kinds of neu- tral aroma components and improve the quality of tobacco leaves. The regression models were established of neutral aroma components in the first and second prin- cipal components to total aroma content, which were y=x＋0.053 47 （R^2=0.919 7） and y=x＋0.147 5 （R^2=0.698 4）, respectively, and they were verified to be feasible.

Supporting smoking cessation in healthcare: obstacles in scientific understanding and tobacco addiction management

Despite ongoing efforts to reduce tobacco smoking, the smoking prevalence in many countries has remained stable for years. This may be a consequence of either lack of knowledge about effective ways to reduce smoking, or failing treatment of tobacco addiction in healthcare. This study explored gaps in the current understanding of smoking cessation and the challenges facing tobacco addiction management in order to formulate recommendations for future research and healthcare practice. A narrative review was written to determine areas in which more research is needed as well as areas in which sufficient knowledge is already available. Recommendations for future research were prioritised using a Delphi-procedure. Recommendations for healthcare practice were confirmed by expert’s assessment. Smoking is not widely acknowledged as an addiction and a relatively small number of smokers ask help from a healthcare professional when trying to stop smoking. Most healthcare professionals recognise the importance of advising patients to stop smoking, but experience certain barriers to actually do this. Overall, healthcare professionals need to be convinced that tobacco smoking is an addiction and should be treated likewise. If all healthcare professionals systematically advise their patients to give up smoking, eventually more smokers will successfully stop smoking.

Impact of stopping smoking on metabolic parameters in diabetes mellitus:A scoping review

The purpose of this scoping review is to create a single narrative that describes the impact of smoking cessation on metabolic parameters in people with diabetes.It is generally well accepted that smoking enhances the harmful effects of elevated blood glucose levels,accelerating the vascular damage seen in patients with diabetes.Smoking cessation has clear benefits in terms of reducing cardiovascular morbidity and mortality.However,there is less evidence for the impact of smoking cessation on other diabetes-related complications.Studies in people with diabetes have shown improvement as well as temporary deterioration in glycemic control after ceasing smoking.Only a few studies have described the effect of quitting smoking on insulin resistance and lipid parameters,however,their results have been inconclusive.In this situation,healthcare professionals should not assume that cessation of smoking will improve metabolic parameters in patients with diabetes.It seems they should, first of all, emphasize the prevention of weight gain that may be associatedwith quitting smoking. The lack of data regarding the metabolic effects of smoking and smokingcessation in diabetes is very disappointing and this area needs to be addressed.

Resumption of Smoking by Women after Childbirth: Influence of Spousal Smoking

To investigate factors related to resumption of smoking by women after childbirth, the smoking habits of 241 postnatal women, who initially had stopped smoking after pregnancy, in a rural city in Aomori Prefecture, Japan, were studied at 5 - 6 days, 1 month, and 12 months after childbirth. At 1 month after childbirth, only nine women had resumed smoking, but a total of 40 women had resumed smoking after 12 months. Factors related to smoking resumption after childbirth included the switching from breast feeding to bottle feeding and the influence of smoking by their spouses. Spousal smoking is an important factor in the resumption of smoking by women after childbirth.

A Comparative Study for Successful Treatment per Gender in a Specialized Smoking Cessation Unit in the Albacete University Hospital during Two Years

Objective： Analysis of abstinence rates of smokers per gender at 3, 6, 9 and 12 months in a Smoking Cessation Unit from January 2008 to December 2009. Methods： Descriptive retrospective study. Analysis of socio-demographic variables, smoking patterns, associated comorbidities, continuous abstinence rates, success, relapses, failure and dropping out. Results： 278 smokers started treatment （33%）; 55.4% males and 44.6% females （mean age of 48.3 and 44.06 years, respectively）. The main associated comorbidities were： psychiatric （38.7%）, cardiovascular （dyslipemia 25%） and respiratory （COPD （chronic obstructive pulmonary disease） 9.7%） in females; cardiovascular （dyslipemia 34.4%）, psychiatric （34.4%） and respiratory （COPD 19.5%） in males. VRN （Varenicline） was prescribed in 40.2% males and 32.2% females; NRT （nicotine replacement therapy） was used in 46.6% and 38.7%, respectively; bupropion was employed in 6.5% and 21.8%, respectively. Psychological counseling was offered only to 7.8% males and 8.1% females. The continuous abstinence rates in males at 3, 6, 9 and 12 months were 51.3%, 37.7%, 32.5% and 30.5%, respectively, and were 45.2%, 29.8%, 25.0% and 24.2% for females. Failure was 9.7% for females and 18.8% for males. Success was more frequent for those on VRN （n = 41 males; n = 12 females）. No relapses were indicated for 42 females and 71 males. The percentage of relapses was higher at 3 months （29.0% females, 19.5% males）. Conclusions： The study observed differences in treating abstinence between genders （in the abstinence rates and failure index）. This implies having to consider incorporating the gender variable into the diagnosis, treatment and prevention of smoking.

Implementation of Smoking Ban in Mental Hospitals： Views of Patients, Relatives and Staff

The Law on Tobacco Control of the Republic of Lithuania （issued in 1996） prohibits smoking in health care facilities. The security implementation is particularly problematic in psychiatric hospitals, where patients with adaptation problems are used to smoking feeling anxiety. Meanwhile, experts and scholars do not agree on the benefits or harm of smoking for individuals suffering from mental disorder. Republican Vilnius Psychiatric Hospital undertook an investigation of the attitudes of those mostly concerned--the patients, their relatives and the staff of the hospital, also of their views on the ways and feasibility to reduce smoking in the hospital. It was concluded that the main cause of patients＇ smoking is addiction, and hospital staff recognize that mental disorders contribute to the increase in dependency. Other reasons--smoking reduces tension, facilitates adaptation to environments, enhances contacts. Most patients and their relatives believe that smoking should not be banned, while the staff believes it should be prohibited in part by a variety of increasing of constraints. The most effective means to reduce smoking in the hospital would be rich leisure activities, education and professional help.

Miss Chimp Says No to Smoking

A chimpanzee(大猩猩)in the zoo in Xi'an,Shaanxi Province has given up smoking after 16 years with the help of her keepers(饲养员).The zookeepers,wor- ried about her health,helped 27-year-old“Ai Ai”off tobacco(烟草)by treating her with entertainment(娱乐)and tasty diets.

Dental Implant Patients Grouped by the Brinkman Index: Their Attitude toward Smoking, Nicotine Dependence, and Knowledge of Peri-Implantitis

Purpose: This study investigated the attitude of patients, grouped by the Brinkman index, towards smoking by using the Kano Test for Social Nicotine Dependence (KTSND) and their knowledge of peri-implantitis. Methods: The participants were 3093 new patients who visited the Tokyo Medical and Dental University Hospital from January 2012 to December 2013 for an oral implant. The methodology included a questionnaire about sex, age, smoking status, daily average number of cigarettes, years of smoking, knowledge of peri-implantitis, and the KTSND. The patients were grouped according to their smoking status by calculating their Brinkman index (over 200 or not): current smokers with the possibility of nicotine dependence (BI(+)CS), current smokers with no possibility of nicotine dependence (BI(-)CS), ex-smokers (ES), and non-smokers (NS). The Brinkman index is obtained by multiplying one’s daily average number of cigarettes by the number of years they have been smoking. Results: Data were collected from 2182 respondents (response rate = 71%). The KTSND scores of BI(+)CS (16.89 ± 4.26) were significantly higher than the scores of ES (11.99 ± 4.52) and NS (11.53 ± 5.01). In current smokers, there were no significant differences between BI(+)CS and BI(-)CS. The patients replied “I don’t know” about peri-implantitis most often in all groups;however, there were no significant differences between the groups. Discussion: BI(+)CS were more dependent on nicotine in social situations than the other groups were. In Japan, a Brinkman index over 200 is required for a nicotine-dependence management fee to be instituted for health insurance treatment. This is a major concern for young smokers, who may be excluded from treatment because their years of smoking are substantially less. Results revealed that there were no significant differences between BI(+)CS and BI(-)CS. Therefore, it was suggested that the Brinkman index did not sufficiently group the participants.