Tobacco Induced Diseases最新文献

{"title":"Global, regional, and national burden of acute myeloid leukemia attributable to tobacco from 1990 to 2021, with future forecasts to 2050: A secondary dataset analysis of the Global Burden of Disease 2021 study.","authors":"Jianhua Zhang, Linghua Zhao, Yao Chao, Zhijuan Zhang, Jianli Guo","doi":"10.18332/tid/218783","DOIUrl":"10.18332/tid/218783","url":null,"abstract":"<p><strong>Introduction: </strong>Acute myeloid leukemia (AML) is a major public health problem. However, the epidemiological pattern of the burden of AML attributable to tobacco globally remains unclear. This study aimed to characterize the global, regional, and national burden of AML attributable to tobacco from 1990 to 2021 and to forecast it to 2050.</p><p><strong>Methods: </strong>Data were sourced from the Global Burden of Disease (GBD) study 2021, and secondary dataset analysis was used in the present research. Age-standardized rates of tobacco-attributable AML deaths and disability-adjusted life years (DALYs) were analyzed, with estimated annual percentage change (EAPC) calculated. Age-period-cohort (APC) analysis was performed to quantify the age, period, and birth cohort effects on AML attributable to tobacco. A Bayesian APC model was subsequently us ed to project the disease burden of attributable to tobacco between 2022 and 2050.</p><p><strong>Results: </strong>From 1990 to 2021, the burden of AML attributable to tobacco globally presented downward trends. The age-standardized death rate (ASDR) decreased from 0.214 [95% uncertainty interval (UI): 0.08-0.35] per 100000 people in 1990 to 0.176 (95% UI: 0.062-0.307) per 100000 people in 2021. The high sociodemographic index (SDI) regions had the highest ASDR and age-standardized DALYs rate for AML attributable to tobacco in 2021. The greatest burden of AML attributable to tobacco was the age group of 70-74 years among the risk factors of AML; tobacco shared at 11.5% of global deaths. As for the age effect, death due to AML attributable to tobacco increased with age, rising slowly before 40 years of age and accelerating sharply thereafter. The ASDR for males decreased from 0.3 per 100000 people in 2021 to 0.24 per 100000 people in 2022.</p><p><strong>Conclusions: </strong>Although the burden of AML attributable to tobacco had been on a downward trend from 1990 to 2021, it is particularly prominent in high SDI regions, high-income regions, and the elderly population.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"24 ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593030","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":"Geographical accessibility to smoking cessation treatment facilities across 335 medical areas in Japan: A nationwide cross-sectional descriptive study using large-scale geospatial data.","authors":"Yuki Egashira, Ryo Watanabe","doi":"10.18332/tid/222677","DOIUrl":"10.18332/tid/222677","url":null,"abstract":"<p><strong>Introduction: </strong>Geographical research on tobacco control has focused predominantly on tobacco retail environments, whereas spatial accessibility studies using methods such as Enhanced Two-Step Floating Catchment Area (E2SFCA) have examined primary care but rarely smoking cessation services. This study aimed to evaluate the geographical accessibility of smoking cessation clinics and hospitals across Japan's secondary medical areas (SMAs) in a cross-sectional ecological spatial analysis using large-scale spatial data.</p><p><strong>Methods: </strong>Accessibility scores (AS) were calculated at 422804 grids nationwide using E2SFCA. Demand was defined as the smoking rate-adjusted population, and supply comprised approximately 19000 facilities registered under Japan's insurance-covered smoking cessation program. A regional typology was developed using Ward's hierarchical cluster analysis. The distribution of standardized claim ratios (SCRs) from nationwide claims data (2018-2022) was examined descriptively across clusters.</p><p><strong>Results: </strong>Of the 335 SMAs, 319 were analyzed after excluding 16 areas with missing SCR data. The median AS varied substantially across areas (range: 286-5626). Three clusters emerged: Cluster 1, 'Low accessibility-High disparity' (24.1%); Cluster 2, 'Moderate accessibility-Low disparity' (62.4%); and Cluster 3, 'High accessibility-Low disparity' (13.5%). Clusters 2 and 3 showed similar Gini coefficients, differing primarily in AS levels. Cluster 3 showed descriptively higher SCR values (median: 117) compared with Clusters 1 and 2 (median: 93-95).</p><p><strong>Conclusions: </strong>This study demonstrates substantial geographical disparities in the accessibility of smoking cessation services in Japan. Regions with higher accessibility tended to exhibit lower intra-regional disparities. For the implementation of the WHO FCTC Article 14, ensuring an equitable geographical distribution of services may be as important as expanding the overall number of facilities.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"24 ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550498","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":"Association between secondhand smoke exposure and hyperuricemia among never smokers: A cross-sectional analysis of NHANES data.","authors":"Yahui Liang, Tian Zhou, Aoran Yang, Dan Wang, Wenyue Zhang, Weijun Gong","doi":"10.18332/tid/220846","DOIUrl":"10.18332/tid/220846","url":null,"abstract":"<p><strong>Introduction: </strong>Secondhand smoke (SHS) exposure is recognized as an important contributor to multiple adverse health outcomes, including hyperuricemia. However, the association between SHS exposure and hyperuricemia remains inconclusive. This study aimed to examine the relationship between SHS exposure and hyperuricemia using serum cotinine concentration as an objective biomarker.</p><p><strong>Methods: </strong>Data were obtained from the National Health and Nutrition Examination Survey (NHANES) collected between 1999 and 2020. A cross-sectional analysis was performed among 18610 adults who self-reported never smoking (never smokers). Participants were categorized into four groups based on serum cotinine concentrations: non-exposure (<0.05 ng/mL), low-exposure (0.05-0.99 ng/mL), moderate-exposure (1-10 ng/mL), and heavy-exposure (>10 ng/mL). Associations between SHS exposure and hyperuricemia were evaluated using multivariable logistic regression analysis models and smooth curve fitting.</p><p><strong>Results: </strong>After adjusting for potential confounders, the adjusted odds ratios (AOR) for hyperuricemia in the low-, moderate-, and heavy-exposure groups, compared with the non-exposure group, were 1.34 (95% CI: 1.18-1.53), 1.48 (95% CI: 1.08-2.02), and 1.97 (95% CI: 1.27-3.05), respectively. A non-linear positive saturation association was observed between log2-transformed serum cotinine concentrations and the prevalence of hyperuricemia. The inflection point was identified at approximately -3.37 ng/mL, with an AOR of 1.15 (95% CI: 1.08-1.22). Subgroup analysis revealed consistent associations across all demographic and clinical stratifications.</p><p><strong>Conclusions: </strong>Among never smokers, SHS exposure was significantly associated with an increased risk of hyperuricemia. A threshold effect was identified at a serum cotinine concentration of -3.37 ng/mL. These findings provide a direction for further study on the relationship between SHS exposure and hyperuricemia.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"24 ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550500","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":"Examining the potential causal relationships among smoking, blood DNA methylation, and type 2 diabetes development: A Mendelian randomization study.","authors":"Wenhua Li, Yixiao Li, Pan Dong, Jiaxin Tang, Siyang Liu, Ling Tu, Xizhen Xu","doi":"10.18332/tid/216384","DOIUrl":"10.18332/tid/216384","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes (T2D) is a major global health burden with rising prevalence and significant morbidity and mortality. Smoking has been recognized as an independent risk factor for T2D, but the exact underlying mechanisms are not yet fully understood.</p><p><strong>Methods: </strong>We conducted a two-sample Mendelian randomization (MR) study to investigate the effects of smoking behaviors and smoking-related DNA methylation on type 2 diabetes (T2D) risk. This secondary analysis was based on publicly available summary statistics. Smoking traits were obtained from a large meta-GWAS of over 1.2 million individuals of European ancestry. DNA methylation data were derived from the CHARGE Consortium EWAS (n=15907) and mQTLs from the GoDMC (n=27750). T2D outcome data were obtained from a European GWAS including 74124 cases and 824006 controls. Replication was performed in FinnGen (17268 cases, 184778 controls) and BioBank Japan (40250 cases, 170615 controls). Stringently selected genetic instruments were applied, and causal effects were estimated primarily using two-sample MR with inverse-variance weighted analysis, complemented by MR-Egger and weighted median approaches, and further validated by colocalization analysis.</p><p><strong>Results: </strong>In our genomic analysis, we presented convincing evidence supporting the association between genetically predicted smoking initiation and an increased susceptibility to T2D. In epigenetic analysis, we identified methylation at 21 smoking-related CpG sites associated with T2D risk. Subsequently, 14 of these CpG sites were validated using the FinnGen dataset, and 12 of them were validated using the BBJ dataset. Furthermore, we observed strong colocalization evidence for four CpG sites, including cg23756272 (<i>BCL2</i>), cg03864215 (<i>KCNJ11</i>), cg09861057 (<i>TDRD10</i>) and cg10672416 (<i>C12orf65</i>), and T2D risk.</p><p><strong>Conclusions: </strong>This research provides novel findings of the impact of smoking on T2D susceptibility, highlighting the role of epigenetic DNA methylation.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"24 ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550528","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":"Association between household secondhand smoke exposure and ADHD in US children aged 4-15 years: Evidence from NHANES 1999-2004.","authors":"Yongzheng Bao, Wanchao Zhang, Chunhui Wang, Xia Zhang, Xiaoju Hou, Zhibang Hu","doi":"10.18332/tid/222368","DOIUrl":"10.18332/tid/222368","url":null,"abstract":"<p><strong>Introduction: </strong>Household tobacco smoke (or secondhand smoke, SHS) exposure is a common type of environmental exposure among children, and it may be associated with the development of attention deficit hyperactivity disorder (ADHD); however, current findings remain inconsistent. This study aimed to examine the association between household SHS exposure and ADHD among US children, and to provide an epidemiological foundation for ADHD prevention and tobacco-control interventions targeting pediatric populations.</p><p><strong>Methods: </strong>This is a secondary analysis of pooled secondary data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004. ADHD cases were identified through questionnaire-based assessments, and participants were categorized into exposed and non-exposed groups according to whether or not any household member smoked inside the home. Weighted multivariate logistic regression models were employed to evaluate the association between household SHS exposure and ADHD. In addition, subgroup and sensitivity analyses were conducted.</p><p><strong>Results: </strong>A total of 6790 children were included in the analysis, of whom 452 (7.97%) were classified as having ADHD. The prevalence of household SHS exposure was significantly higher among children with ADHD compared to those without (36.25% vs 22.77%, p<0.001). After adjustment for multiple confounding variables, household SHS exposure remained significantly associated with ADHD (OR=1.583; 95% CI: 1.166-2.150). Subgroup analyses stratified by sex, age, race, poverty-income ratio (PIR), body mass index (BMI), and birth weight showed that the association remained generally consistent across all strata (all p for interaction >0.05). Sensitivity analyses further confirmed the positive association between household SHS exposure and ADHD (all p<0.05).</p><p><strong>Conclusions: </strong>Household SHS exposure was significantly associated with ADHD among US children within our cross-sectional analysis. Future prospective investigations are required to clarify the causal relationship underlying this association.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"24 ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13377825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580155","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":"Associations of serum cotinine and dietary inflammatory and antioxidant profiles with appendicular skeletal muscle mass in US adults: A cross-sectional study of data from NHANES 2011-2018.","authors":"Shifu Bao, Nai Mu, Shuxing Xing, Zheng Zhou","doi":"10.18332/tid/222623","DOIUrl":"10.18332/tid/222623","url":null,"abstract":"<p><strong>Introduction: </strong>Tobacco exposure accelerates biological aging, but its specific association with appendicular skeletal muscle mass - and the potential modifying role of dietary patterns - remains incompletely characterized. This study aimed to investigate the association between serum cotinine and appendicular skeletal muscle mass index (ASMI), and to evaluate the mediating and modifying roles of dietary inflammatory and antioxidant profiles.</p><p><strong>Methods: </strong>This secondary analysis of cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018 included 10291 US adults. Serum cotinine and dual-energy X-ray absorptiometry-derived ASMI were measured. Dietary quality was evaluated using the Dietary Inflammatory Index (DII) and Composite Dietary Antioxidant Index (CDAI). Associations were evaluated using multivariable survey-weighted generalized linear models, restricted cubic splines (RCS), and mediation analyses.</p><p><strong>Results: </strong>In fully adjusted models, higher log10-transformed serum cotinine was independently associated with decreased ASMI (β= -0.02; 95% CI: -0.03 - -0.01; p=0.02). RCS analysis revealed a significant non-linear association (p for non-linearity <0.05). Mediation analyses demonstrated that DII and CDAI accounted for 30.6% and 13.3% of the total association, respectively. Furthermore, this inverse association was pronounced among participants with pro-inflammatory diets (β= -0.08, 95% CI: -0.156 - -0.004, p<0.001) but was attenuated and no longer statistically significant among those consuming anti-inflammatory and antioxidant-rich diets.</p><p><strong>Conclusions: </strong>Higher serum cotinine is independently associated with decreased ASMI. This association is partially mediated by dietary inflammatory and antioxidant profiles, and is significantly modified by overall dietary quality. Optimizing nutritional profiles may offer a potential strategy to mitigate tobacco-associated skeletal muscle depletion, though prospective validation is warranted.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"24 ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13377826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580190","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":"Digital gamification and serious games for preventing e-cigarette use in adolescents: A systematic review without meta-analysis (SWiM).","authors":"Siti Idayu Hasan, Ruthashini R Selvasingam, Farizah Mohd Hairi","doi":"10.18332/tid/214070","DOIUrl":"10.18332/tid/214070","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescent e-cigarette use has reached alarming levels worldwide, creating a major public health concern. Digital gamification and serious games have emerged as an innovative approach to engage youth in e-cigarette prevention through interactive and immersive technologies. However, existing reviews on gamification and serious games for health have not specifically examined theoretical frameworks or behavioral outcomes in digital gamification for e-cigarette prevention among adolescents. This systematic review aims to assess the effectiveness of digital gamification and serious game interventions for e-cigarette prevention in adolescents and to identify the theoretical foundations underlying these interventions.</p><p><strong>Methods: </strong>Eight electronic databases were searched (MEDLINE, CINAHL, Psychology and Behavioral Sciences Collection, Education Research Complete, Scopus, PubMed, Web of Science, and Google Scholar) up to 25 October 2025. Inclusion criteria covered randomized and nonrandomized studies involving adolescents (aged 10-19 years) using digital gamification and serious games for vape prevention or cessation. Study quality was assessed and a narrative synthesis was conducted.</p><p><strong>Results: </strong>Twelve studies met the inclusion criteria. Most reported improvements in knowledge, risk perception, and self-efficacy among adolescents. Theoretical frameworks included the Theory of Planned Behavior, Social Cognitive Theory, and the Attention, Relevance, Confidence, and Satisfaction motivation model. Study quality ranged from weak to strong.</p><p><strong>Conclusions: </strong>Digital gamification and serious games show promise in supporting e-cigarette prevention among youth. Interventions grounded in behavioral theory and incorporating social and motivational elements are most effective.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"24 ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13377530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580200","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":"Effect of smoking on dental pulp responses to thermal and electrical sensibility tests.","authors":"Emre Çulha, Özge Yüksekkaya, İrfan Yüksekkaya, Oğuz Burhan Çetinkaya","doi":"10.18332/tid/224444","DOIUrl":"10.18332/tid/224444","url":null,"abstract":"<p><strong>Introduction: </strong>Smoking is associated with vascular constriction and neural alterations that may influence pulpal blood flow and sensory responses. However, the relationship between cigarette consumption and dental pulp sensibility to thermal and electrical stimuli remains incompletely understood. This cross-sectional study aimed to evaluate the association between daily cigarette consumption and the dental pulp sensibility of maxillary central incisors assessed using a cold test and electric pulp test (EPT).</p><p><strong>Methods: </strong>Eighty-eight systemically healthy participants aged 18-40 years were allocated into four groups according to daily cigarette consumption: non-smokers, 1-10, 11-20, and >20 cigarettes/day (n=22 per group). Pulp sensibility was assessed using EPT (stimulus range: 0-64) and cold testing (response time in seconds). Group comparisons were performed using Kruskal-Wallis and Mann-Whitney U tests, followed by Dunn's post hoc analysis where appropriate (p<0.05).</p><p><strong>Results: </strong>Mean EPT stimulus thresholds increased progressively with higher daily cigarette consumption, ranging from 4.27 ± 1.32 in non-smokers to 7.23 ± 1.80 in heavy smokers (p=0.001). Similarly, cold test response times were significantly prolonged with increasing cigarette intake (0.51 ± 0.31 s in non-smokers vs 1.07 ± 0.33 s in heavy smokers; p=0.001). In contrast, smoking duration was not significantly associated with either EPT thresholds (p=0.832) or cold test response times (p=0.258).</p><p><strong>Conclusions: </strong>Dental pulp sensibility responses were increasingly attenuated with higher daily cigarette consumption, whereas smoking duration showed no significant association with test outcomes. These findings suggest that the daily quantity of cigarettes consumed may be a more relevant factor than smoking duration when interpreting pulp sensibility test results. Clinicians should consider smoking status as a potential modifier during pulp sensibility assessment.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"24 ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498065","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":"Time to first cigarette after waking and risk of incident chronic respiratory diseases in males: A prospective national cohort study.","authors":"Jianping Liu, KaiWang Cui, Xia Luo, Xiangwen Gong, Yong Liu","doi":"10.18332/tid/224236","DOIUrl":"10.18332/tid/224236","url":null,"abstract":"<p><strong>Introduction: </strong>While cumulative smoking exposure is a well-established risk factor of chronic respiratory disease (CRD), a behavioral indicator of nicotine dependence, the time to first cigarette after waking (TTFC) may provide additional prognostic information. However, prospective evidence linking TTFC to incident CRD, particularly in Chinese populations, remains limited. This study aims to investigate the association between TTFC and incident CRD risk in middle-aged and older men.</p><p><strong>Methods: </strong>This prospective cohort study included 5198 Chinese men aged ≥45 years without baseline CRD who were enrolled in the China Health and Retirement Longitudinal Study (CHARLS). TTFC was categorized as >60, 31-60, 6-30, and <6 minutes after waking, with never smokers as the reference group. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident CRD. Laplace regression was applied to evaluate differences in median disease onset time. Joint effects of TTFC and smoking pack-years were also assessed.</p><p><strong>Results: </strong>During 44105 person-years of follow-up, 856 incident CRD cases occurred (incidence rate: 19.41 per 1000 person-years). Earlier, TTFC was associated with progressively higher CRD risk in a dose-response manner (p for trend=0.025). Compared with never smokers, participants with TTFC <6 minutes had a significantly higher CRD risk (HR=1.31; 95% CI: 1.02-1.66). Laplace regression showed that TTFC <6 minutes was associated with 0.75 years earlier median disease onset (95% CI: -1.45 - -0.06). Joint exposure analysis indicated that participants with both early TTFC and heavy smoking exposure had the highest risk (HR=1.30; 95% CI: 1.10-1.51), with evidence of additive interaction (attributable proportion, AP=0.177; 95% CI: 0.005-0.349).</p><p><strong>Conclusions: </strong>Earlier TTFC is independently associated with increased risk and earlier onset of CRD among Chinese middle-aged and older men. TTFC may serve as a simple and potentially informative behavioral marker for identifying smokers with a higher risk of CRD.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"24 ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438160","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":"Knowledge and attitudes toward e-cigarettes as smoking cessation aids among Saudi Arabian medical students: A cross-sectional study.","authors":"Nahed S Alharthi","doi":"10.18332/tid/221537","DOIUrl":"10.18332/tid/221537","url":null,"abstract":"<p><strong>Introduction: </strong>E-cigarettes have garnered global attention as a potential aid for smoking cessation, yet their safety and efficacy remain subjects of ongoing debate. This cross-sectional study aimed to evaluate the knowledge and attitudes of medical students in Saudi Arabia regarding e-cigarettes as a smoking cessation tool.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between September 2023 and January 2024 among 242 medical students in a tertiary institution in Saudi Arabia. Eligible participants were currently enrolled medical students who consented to participate, while incomplete responses were excluded. Data were collected using a structured questionnaire, and associations between variables were analyzed using chi-squared tests and multivariate logistic regression models, with p<0.05 as the criterion for statistical significance.</p><p><strong>Results: </strong>Among respondents, 33.2% had tried e-cigarettes, and 17.8% identified as smokers. Younger participants (≤39 years), males, and those in earlier academic years exhibited significantly better knowledge and more favorable attitudes (p<0.001). Participants with exposure to cigarette or e-cigarette smoking through family or friends, demonstrated higher knowledge scores (p<0.0072 and p<0.001, respectively). High GPA was significantly associated with better knowledge (p<0.001) and more positive attitudes (p=0.0473). At the same time, positive attitudes were also more common among students with chronic diseases (p<0.001) and those with a family history of mental disorders (p<0.001).</p><p><strong>Conclusions: </strong>Gender, academic exposure, and firsthand smoking experiences significantly shape medical students' perceptions of e-cigarettes. These findings suggest a need for targeted educational interventions to enhance evidence-based understanding and better prepare future physicians for smoking cessation counseling.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"24 ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438149","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}