Tobacco Induced Diseases最新文献

{"title":"Global burden of smoking-associated age-related macular degeneration: Spatiotemporal trends from 1990 to 2021 and projections to 2040.","authors":"Pengcheng Hu, Ming He, Junyang Cai, Zequn Lin, Shiying Zheng, Zihao Zhuang, Jialing Liu, Luoming Huang","doi":"10.18332/tid/205665","DOIUrl":"10.18332/tid/205665","url":null,"abstract":"<p><strong>Introduction: </strong>Smoking is a major modifiable risk factor for age-related macular degeneration (AMD); however, the long-term trends and sociodemographic disparities in its global burden remain insufficiently characterized. This study aimed to assess the evolving burden of smoking-associated AMD from 1990 to 2021 and project its trajectory to 2040.</p><p><strong>Methods: </strong>Data from the Global Burden of Disease (GBD) 2021 database were used to extract smoking-associated AMD burden, measured by years lived with disability (YLDs) and age-standardized YLDs rate (ASYLDsR). Trends were stratified by sociodemographic index (SDI) and GBD super-regions, analyzed via estimated annual percentage change (EAPC), and projected using an autoregressive integrated moving average (ARIMA) model.</p><p><strong>Results: </strong>In 2021, the global burden of smoking-associated AMD reached 58858 YLDs (a 47.1% increase from 1990), with an ASYLDsR of 2.47 per 100000 population. The burden in males significantly exceeded the female burden (45442 vs 13417 YLDs in 2021), with a widening disparity. YLDs peaked in the age group of 65-69 years (12528 cases), while ASYLDsR increased with age. East Asia had the highest cases (23248 cases, 39.5% of the global total), whereas Central Asia exhibited rising ASYLDsR. ARIMA projections estimated global YLDs to rise to 72574 (95% CI: 61319-83828) by 2040, with ASYLDsR declining to 1.54 per 100000 (95% CI: 0.90-2.17).</p><p><strong>Conclusions: </strong>The burden of smoking-associated AMD demonstrates marked demographic and geographical heterogeneity. Aging populations drive rising absolute case numbers, while disparities in tobacco control policies contribute to regional divergence in ASYLDsR.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"23 ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interdisciplinary perspective-based behavioral prediction of e-cigarette use: A population-based study among Chinese college students.","authors":"Yu Chen, Zining Wang, Shaoying Jiang, Yujiang Cai, Jing Xu, Ying Wang","doi":"10.18332/tid/204743","DOIUrl":"10.18332/tid/204743","url":null,"abstract":"<p><strong>Introduction: </strong>E-cigarette use is rising among young adults globally, and college students are particularly vulnerable due to high social media engagement and targeted promotions. Understanding which factors predispose this population to initiate vaping is critical for designing effective prevention strategies.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of 303 never-smoking, never-vaping Chinese college students (aged 18-24 years) recruited via online platforms and referrals. The 25-item questionnaire assessed six domains: demographics, parental smoking, peer e-cigarette use, 'quasi-deviant' behaviors (regular alcohol consumption and bar attendance), social media use and trust, and exposure to e-cigarette marketing across five media channels. A three-item susceptibility scale was combined into a single index via principal component analysis. An Extremely Randomized Trees classifier (n_estimators=60, max_depth=6) with grid-search and five-fold cross-validation on a 75:25 train-test split, identified the strongest predictors of high susceptibility. Model performance was evaluated by accuracy and area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>The model achieved 81% classification accuracy. Feature importance (FI) indicated that bar attendance (FI=0.21), alcohol consumption frequency (FI=0.12), exposure to e-cigarette marketing messages (FI=0.08), social media use (FI=0.08), peer e-cigarette use (FI=0.05), and parental smoking (FI=0.05) were the most influential predictors. Among the participants, 18.8% were classified as high-susceptibility, indicating elevated risk for future vaping initiation.</p><p><strong>Conclusions: </strong>'Quasi-deviant' behaviors (regular alcohol use and bar attendance), social media marketing exposure, and social influences (peer and parental smoking) are key predictors of e-cigarette susceptibility in Chinese college students. Multi-level prevention strategies - enforcing digital marketing restrictions, peer-focused education, and integrated substance-use interventions - may effectively reduce susceptibility and avert vaping initiation in this high-risk group.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"23 ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polytobacco usage and mental health among Malaysian secondary school-going adolescents: Findings from the national school-based study.","authors":"Kuang Hock Lim, Yoon Ling Cheong, Jia Hui Lim, Chee Cheong Kee, Sumarni Mohd Ghazali, Yong Kang Cheah, Pei Pei Heng, Ali Aman Marine, Mohd Hazilas Mat Hashim, Wei Wen Goh, Hui Li Lim","doi":"10.18332/tid/204789","DOIUrl":"10.18332/tid/204789","url":null,"abstract":"<p><strong>Introduction: </strong>The emergence of novel tobacco products has led to an increase in the consumption of diverse tobacco items among adolescents. The smoking habits of adolescents adversely affect their physical and emotional health. This study aimed to ascertain the prevalence of polytobacco use among Malaysian teenagers and to identify the mental health issues associated with dual or polytobacco use.</p><p><strong>Methods: </strong>This is a secondary dataset analysis of cross-sectional data from 27479 secondary school adolescents who participated in the 2017 Malaysian Adolescent School Health survey. The primary outcome of our study pertained to self-reported mental health characteristics (stress and depressive symptoms). The research used multivariable logistic regression analysis to assess the associations between the use of tobacco products and mental wellness.</p><p><strong>Results: </strong>Of the respondents, 79.9% were non-tobacco users, 9.2% were single tobacco users, 4.7% were dual tobacco users, and 7.3% were polytobacco users. Individuals engaged in polytobacco use exhibited elevated levels of stress (16.7%; p<0.001) and depression (33.7%; p<0.001) relative to those utilizing fewer tobacco products. Polytobacco product users exhibited a 1.64-fold (95% CI: 1.30-2.06) increased likelihood of reporting stress symptoms and a 1.75-fold (95% CI: 1.46-2.09) increased likelihood of reporting depression symptoms in comparison to non-tobacco users.</p><p><strong>Conclusions: </strong>Adolescents who engage in dual or polytobacco use frequently experience internalized mental health issues, including symptoms of stress and despair. It is essential to perform early assessments of high-risk individuals, provide them with information regarding the importance of cessation, and implement proactive interventions for these groups' psychological challenges.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"23 ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Media representation of tobacco control in China: A comparative analysis of agenda-setting across different policy contexts during 2017-2022.","authors":"Yu Chen, Yujiang Cai, Xinrui Yang, Xinyao Yu, Rui Zhang, Heng Zhang, Jing Xu, Kin-Sun Chan","doi":"10.18332/tid/204741","DOIUrl":"10.18332/tid/204741","url":null,"abstract":"<p><strong>Introduction: </strong>While media play a crucial role in tobacco control policy advancement, little is known about how different policy contexts shape media coverage of tobacco control, particularly in China's unique political and administrative systems. This study innovatively compares tobacco control news coverage across three regions with distinct tobacco control policy environments: mainland China, Guangdong Province, and Macao SAR, examining how policy contexts influence media agenda-setting before and during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Using the WisersOne database, we analyzed 749 tobacco control news articles from three influential newspapers (<i>People's Daily, Nanfang Daily, and Macao Daily News</i>) from 2017-2022. We employed a mixed-methods approach combining co-word analysis and topic modeling using Python. The analysis was divided into pre-pandemic (2017-2019) and pandemic (2020-2022) periods, to examine temporal changes in media coverage patterns and policy priorities.</p><p><strong>Results: </strong>Significant disparities in coverage intensity and thematic focus were found across regions. <i>Macao Daily News</i> published substantially more tobacco control articles (596) than <i>People's Daily</i> (46) and <i>Nanfang Daily</i> (107). While mainland media primarily focused on youth tobacco prevention and World No Tobacco Day, Macao's coverage demonstrated more comprehensive themes including enforcement, legislative participation, and addiction prevention. During the pandemic, all regions showed reduced coverage but maintained distinct thematic priorities, with emerging emphasis on e-cigarette regulation and youth protection.</p><p><strong>Conclusions: </strong>This study reveals how policy environments substantially influence media agenda-setting in tobacco control. Macao's comprehensive tobacco control legislation corresponds to more frequent and diverse media coverage, while mainland China's limited national smoke-free legislation is reflected in sparse, fragmented coverage. These findings suggest the need to strengthen media advocacy strategies in mainland China to advance national tobacco control policies, particularly by leveraging successful examples from regions with strong tobacco control measures.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"23 ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective features of e-cigarette prevention videos: A qualitative study with primary school students.","authors":"Yu Chen, Jinhui Chen, Ziliang Wang, Xinjie Zhao, Rong Gao, Yujiang Cai, Shiyu Liu, Jing Xu, Si Chen","doi":"10.18332/tid/205839","DOIUrl":"10.18332/tid/205839","url":null,"abstract":"<p><strong>Introduction: </strong>While video-based prevention campaigns show promise in addressing the rising e-cigarette use among youth, little is known about what makes such videos effective from children's perspectives, particularly in China's cultural context. This study aimed to investigate which video content elements could be effective in preventing e-cigarette use among children, providing evidence-based guidance for developing e-cigarette prevention materials and information design targeting children.</p><p><strong>Methods: </strong>Using purposive sampling, we conducted four gender-stratified focus groups with 35 primary school students (aged 12-13 years) in Beijing and Yunnan. Participants watched four stimulus videos with different messaging approaches and discussed their perceptions of effective and ineffective features. Focus group discussions were audio-recorded, transcribed, and analyzed using thematic analysis with NVivo software.</p><p><strong>Results: </strong>Children identified several key features that enhanced prevention effectiveness -most prominently, explicit specific health consequences and testimonials were mentioned by a majority of participants - along with chemical component, maternal love, and emotional appeals (particularly fear). Visual elements like dynamic animations and medical expert appearances strengthened message credibility. Ineffective features included overly complex explanations, perceived inauthenticity, and news-style reporting. Notably, while some participants reported discomfort with fear-based appeals, they demonstrated high recall of these message elements.</p><p><strong>Conclusions: </strong>This study provides novel insights into developing appropriate e-cigarette prevention videos for children. Findings suggest that effective videos should combine authentic testimonials with clear health risk information, appropriate fear appeals, and engaging visual elements while avoiding overly complex or news-style presentations. These insights can guide the development of more effective youth-focused e-cigarette prevention communication strategies.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"23 ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional, and national temporal trends in mortality and disease burden of nasopharyngeal carcinoma attributable to smoking from 1990 to 2021 and predictions to 2040.","authors":"Defeng Liu, Lulu Zhuang, Yueze Li, Jinming Yu, Minghuan Li","doi":"10.18332/tid/204742","DOIUrl":"10.18332/tid/204742","url":null,"abstract":"<p><strong>Introduction: </strong>Smoking is a major environmental risk factor for nasopharyngeal carcinoma (NPC), but the global burden and epidemiological trends of NPC attributable to smoking remain unclear.</p><p><strong>Methods: </strong>Data were obtained from the 2021 Global Burden of Disease study. A comprehensive analysis was conducted on mortality, years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life years (DALYs) attributable to NPC attributable to smoking. Clustering analysis was applied to evaluate the variation patterns across 21 regions. The NORDPRED age-period-cohort model was used for prediction.</p><p><strong>Results: </strong>In 2021, there were 13410 deaths globally from NPC attributable to smoking, 10031 YLDs, 1379583 YLLs, and 389614 DALYs. The disease burden was most severe in Asia. Males bore a significantly higher burden than females, mainly concentrated in middle-aged and older populations. From 1990 to 2021, although the number of cases increased, ASRs showed a marked decline, particularly among females and in regions with both high and low sociodemographic index (SDI) levels. Regional analyses revealed significant reductions of the disease burden in Australasia and Western Europe. The 21 regions were divided into 4 groups based on changes in mortality, representing distinct variation patterns. Projections from 2022 to 2040 indicate that, while the total number of deaths and disease burden is expected to rise, ASRs are anticipated to decline except YLDs.</p><p><strong>Conclusions: </strong>Smoking contributes significantly to the disease burden of NPC, posing a serious threat to public health. Targeted intervention strategies should be implemented according to the regional clustering results of disease burden.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"23 ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An examination of the relationship between perceptions that cigarette smoking increases the severity of COVID-19 and reduction in smoking during the COVID-19 pandemic: Findings from the 2021 ITC Korea Survey.","authors":"Hae-Ryoung Chun, Geoffrey T Fong, Shannon Gravely, Steve S Xu, Anne C K Quah, Heewon Kang, Wonjeong Yoon, Hong G Seo, Yeol Kim, Sungkyu Lee, Gil-Yong Kim, Chang Bum Kang, Sujin Lim, Mi Yan, Sung-Il Cho","doi":"10.18332/tid/205468","DOIUrl":"10.18332/tid/205468","url":null,"abstract":"<p><strong>Introduction: </strong>This study examined whether Korean adults who smoked cigarettes during the COVID-19 pandemic decreased their smoking because of COVID-19, with a focus on whether perceptions of susceptibility and severity of COVID-19 disease were associated with reduced smoking.</p><p><strong>Methods: </strong>Data came from 1506 Korean adults (aged ≥19 years) who exclusively smoked cigarettes (weekly) and participated in the 2021 International Tobacco Control (ITC) Korea Survey. Weighted analyses assessed pandemic-related changes in smoking and whether reductions in smoking were related to: 1) perceived susceptibility to contracting COVID-19; 2) perceiving that smoking increases the severity of COVID-19 disease; and 3) general worry about getting a smoking-related disease.</p><p><strong>Results: </strong>Korean adults were significantly more likely to have reduced their smoking because of COVID-19 (18.9%) than increased their smoking (6.3%) (p<0.001); 74.8% made no changes to their smoking. Reducing smoking was associated with being very worried about contracting COVID-19 (adjusted odds ratio, AOR=4.25; 95% CI: 1.65-10.99) and believing that smoking increases COVID-19 severity (AOR=2.34; 95% CI: 1.19-4.61). General worry about getting smoking-related diseases was not associated with smoking reduction (p=0.53). We also found an interaction between perceived severity and worry about getting COVID-19; those who were very worried about getting COVID-19 and perceive smoking as increasing its severity, were more likely to reduce smoking (p=0.049).</p><p><strong>Conclusions: </strong>In response to the COVID-19 pandemic, Korean adults who smoked were much more likely to reduce than increase their smoking, unlike in most countries where there was no net change. The higher smoking reduction rate in Korea may reflect successful and strong communication by the Korean government regarding the importance of reducing smoking during the pandemic, compared to the general future threat of health risks from smoking.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"23 ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardizing smokeless tobacco packs in India to enhance health warning visibility and harm perceptions.","authors":"Hannah E Barker, Raniyan Zaman, Lauren Czaplicki, Sejal Saraf, Rana J Singh, Ashish K Pandey, Joanna E Cohen","doi":"10.18332/tid/205097","DOIUrl":"10.18332/tid/205097","url":null,"abstract":"<p><strong>Introduction: </strong>Approximately 21% of adults in India use smokeless tobacco and over half use khaini, a tobacco-lime mixture. Khaini is available in a variety of pack shapes and sizes, which can affect health warning label (HWL) size and placement. This study explored consumer perceptions of existing khaini packs and two proposed standard shape/size khaini packs across dimensions of HWL noticeability and harm perceptions.</p><p><strong>Methods: </strong>In March 2023, we conducted 24 focus groups (FGs) across India. Groups were equally numbered by residence, gender, and current khaini use. FGs were led by trained facilitators. Each FG discussed six existing khaini packs and two standard packs (paper sachet; tin cylinder). Data were collected in local languages, translated into English, and thematically analyzed.</p><p><strong>Results: </strong>All FGs discussed the limited visibility of HWLs on existing packs, noting that HWLs were often small, blurry, or printed too faintly to notice. Most (defined as ≥80%) FGs discussed how the HWLs on both standard packs were large and easy to see. FGs discussed how the standard packs appeared more harmful than existing packs due to the large, clearly printed HWL. Most FGs found that the standard tin cylinder was less harmful than the standard paper sachet due to its comparatively smaller HWL.</p><p><strong>Conclusions: </strong>Both standard khaini packs increased HWL noticeability and perceived harm compared to existing packs, and the standard paper sachet was seen as more harmful than the standard tin cylinder. Implementing the standard sachet pack could enhance HWL visibility and increase perceptions of harm among consumers.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"23 ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144544979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking and endometriosis: A narrative review.","authors":"Alexandre Vallée, Anis Feki, Loic Josseran, Jean-Marc Ayoubi","doi":"10.18332/tid/203429","DOIUrl":"10.18332/tid/203429","url":null,"abstract":"<p><p>Endometriosis is a chronic gynecological disorder affecting 6-10% of women of reproductive age. While its etiology is multifactorial, growing evidence suggests that tobacco smoking may contribute to its development and progression through inflammatory, oxidative, and hormonal mechanisms. This narrative review examines the relationship between tobacco smoking and endometriosis, integrating molecular insights to clarify potential biological pathways and highlight areas for future research. A search was conducted in PubMed/MEDLINE and Web of Science, including only original research articles published in English. Studies on both human and animal models were considered, without restrictions on participant age, to provide a comprehensive overview of tobacco-related mechanisms in endometriosis. Tobacco smoke components, such as nicotine and polycyclic aromatic hydrocarbons, can initiate and sustain an inflammatory response, leading to the release of pro-inflammatory cytokines and recruitment of immune cells. Tobacco smoking also induces oxidative stress, disrupting cellular functions and damaging DNA. Moreover, it can cause hormonal dysregulation and interfere with hormone-related signaling pathways. Epigenetic modifications, including DNA methylation and histone modifications, can also be induced by tobacco smoking. These changes affect the expression of genes involved in inflammation, cell proliferation, and hormone signaling, contributing to the pathogenesis of endometriosis. Future research should prioritize longitudinal studies with objective biomarkers to strengthen causal inference. Studies integrating omics approaches can further clarify tobacco-induced molecular alterations in endometriosis. Public health policies should incorporate targeted smoking prevention and cessation programs for women at risk.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"23 ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of gamification on smoking cessation: A systematic review and meta-analysis.","authors":"Dina Syazana Ho Imran Ho, Fathiah Jabir, Siti Norain Sallahuddin, Nur Atiqah Mohd Ahwan, Ghaneshinee Sathiyaseelan, Mohamad Izzi Zahari, Mohd Rohaizat Hassan, Azmawati Mohammed Nawi","doi":"10.18332/tid/203937","DOIUrl":"10.18332/tid/203937","url":null,"abstract":"<p><strong>Introduction: </strong>The rise of mobile health (mHealth) has led to increased adoption of mobile apps for smoking cessation. The integration of gamification has been found to be positively associated with higher app engagement, smokers' self-efficacy and motivation to quit. This systematic review and meta-analysis aimed to identify and assess the game elements incorporated into smoking cessation applications and evaluate the effectiveness of gamified interventions on smoking cessation outcomes.</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed, Web of Science, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and WHO International Clinical Trials Registry Platform (ICRTP) and ClinicalTrials.gov databases from inception to November 2024. Eligible studies included interventional trials comparing gamification-based smoking cessation strategies with non-gamified control groups. Two independent reviewers performed study screening, data extraction, and quality assessment using the Cochrane Handbook for Systematic Reviews. Outcomes were narratively synthesized, and comparable studies were pooled based on follow-up time and abstinence duration. A random-effects meta-analysis assessed smoking abstinence using relative risk (RR) as the effect measure. Heterogeneity was evaluated using Cochran's Q and I² index. The study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the reference number CRD42024611631.</p><p><strong>Results: </strong>Fifteen randomized controlled trials (RCTs) with a total of 5075 participants met the inclusion criteria. Key gamification elements included competition, milestone recognition, storytelling, and rewards. The pooled meta-analysis demonstrated a significant impact of gamified interventions on smoking abstinence. The strongest effects were observed within the first six months of intervention (RR=1.91; 95% CI: 1.47-2.47, p<0.001). Long-term effects remained significant beyond six months (RR=1.37; 95% CI: 1.05-1.79, p=0.02). Sensitivity analysis confirmed the robustness of these findings.</p><p><strong>Conclusions: </strong>Gamification-based interventions significantly improve smoking cessation outcomes, particularly in the short-term. However, the diminishing effects over time highlight the importance of long-term engagement. While these findings are promising, limitations such as heterogeneity in follow-up periods, reliance on some self-reported outcomes, and the inability to isolate specific gamification components may affect the generalizability of results. Leveraging gamification's potential can still transform smoking cessation efforts, offering scalable and engaging solutions for lasting behavioral change.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"23 ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}