cigarette smoking

Smoking is one of the major factors causing atherosclerosis. It results in elevated blood flow and blood pressure (BP) inside vessels. Tobacco smoking in any form, due to injecting toxins into the body, causes the development of cardiovascular disorders. Accordingly, this study investigates the effects of cessation of smoking on BP changes and hypertension incidence.

In the present cohort study, we assessed 8170 male workers in good health who worked for a steel manufacturing firm and underwent professional health checkups in 2019 at the company’s healthcare centers. They were reevaluated in 2021. The variables adjusted for baseline age, cigarette smoking, body mass index, exercise, alcohol consumption, systolic or diastolic BP, family history of hypertension, and changes in the body mass index along with alcohol consumption were investigated in the follow-up phase.

The adjusted relative risks of hypertension in subjects who had quit cigarette smoking for more than 1 and 1-3 years was 0.6 (95% confidence interval [CI], 0.2%, 1.9%) and 1.5 (95% CI, 0.8%, 2.8%) and 3.5 (95% CI, 1.7%, 7.4%) compared to the current smokers. The ascending trend of risk of hypertension for longer periods of cigarette smoking was observed in the subgroups of those who had maintained the weight as well as those who acquired high weight gain after smoking cessation.

Smoking cessation may cause elevated BP, hypertension, or both.

Smoking has many dangerous effects on health, one of which can be related to sleep. This study investigates the relationship between smoking and sleep duration in a city in the South of Iran.

This descriptive-analytical cross-sectional study is a part of the Bandare-Kong non-communicable disease cohort study, conducted on 3736 participants aged 35–70 years. Sleep data and smoking were extracted through a standard questionnaire based on self-reported information. The data were analyzed via the SPSS software (version 26) using the multivariable linear regression model. Meanwhile, P<0.05 was considered statistically significant.

Smoking is associated with longer sleep duration for both sexes. It is recommended to conduct longitudinal studies to assess the association between sleep quality components, including sleep duration and smoking in future studies.

The popularity of hookah usage is on the rise in contemporary societies. Some individuals believe that using a hookah is less harmful than smoking traditional cigarettes.

The objective of this study was to examine the prevalence of oral mucosal lesions among individuals who use hookah and cigarettes.

In a cross-sectional study conducted at Ahvaz Dental School, 102 individuals seeking examination and treatment for dental problems were recruited from spring 2022 to winter 2023 and categorized into three groups: Cigarette users (A), hookah users (B), and non-users of both (C). A thorough oral examination was performed on each patient to identify any oral mucosal lesions. If necessary, a biopsy was performed to confirm the diagnosis. The information for each patient was recorded on individual sheets and subsequently analyzed. To examine the relationship between qualitative variables, a chi-square test or Fisher's exact test was employed.

The most prevalent oral mucosal lesion observed in both group A (42%) and group B (27%) was hyperpigmentation of the oral mucosa. Notably, a premalignant lesion was exclusively observed in individuals belonging to group A (7%). Complaints of bad taste in the mouth were more common in tobacco users (in any form) than in non-users (P = 0.004).

Tobacco users (of any kind) have more oral lesions than non-smokers, although most of these lesions are harmless.

We aimed to review studies that evaluated the effect of cigarette smoking on orthodontic treatment methods and determine whether the smoke affected appliances in a way that could impair the effectiveness of the overall treatment strategy.

PubMed, Google Scholar, Cochrane Library, and Web of Science were scoured using pertinent keywords, reference searches, and citation searches in accordance with the PRISMA protocol regarding articles published from 2008 till 2022.

Ultimately, 7 papers were chosen for further analysis at the end of the selection protocol. Overall pooled odds ratio (OR) for the impact of cigarette smoking on orthodontic treatment was 0.25 (95% CI: 0.15, 0.43), with high statistical significance (P<0.00001) but also high heterogeneity (I² = 81%). The relative risk (RR) was 0.50 (95% CI: 0.38, 0.66), indicating a 50% greater risk of noticeable impact, with high statistical significance (P<0.00001) and high heterogeneity (I² = 79%), and the risk difference (RD), which was -0.33 (95% CI: -0.45, -0.21), suggesting a 33% higher risk of noticeable impact, with high statistical significance (P<0.00001) and high heterogeneity (I² = 81%). The high heterogeneity in all measures indicates significant variability in the results across the included studies.

All the 7 studies selected for our systematic review exhibited significant detrimental associations between smoking and orthodontic appliances and other modalities that were exposed to cigarette smoke. However, more studies need to be done in this regard, since the literature currently available on this relationship is quite poor and lacking in concrete evidence.

Sublingual varices are characterized by abnormally dilated veins. Some systemic conditions such as cardiovascular disease have been suggested to be associated with sublingual varices. Due to the convenience in examining the sublingual area, the present study aimed to assess the relationship between sublingual varices and hypertension.

In this descriptive-analytic study, 500 patients were categorized into two groups: those with sublingual varices and those without. Two oral medicine specialists assessed the lesions, and the blood pressure of all patients was measured while they were in a relaxed sitting position. Age and gender data were recorded for all participants. Statistical analysis included t-test, chi-square, and logistic regression, with significance set at P<0.05.

The frequency of sublingual varices was 21.8%. Mean systolic blood pressure was 139.68±19.01mmHg in patients with sublingual varices and 118.09±13.78mmHg in patients without the lesions (P=0.561). Mean diastolic blood pressure was 100.45±17.81mmHg and 80.31±12.08mmHg in patients with and without sublingual varices, respectively (P<0.001). Smoking was significantly more prevalent among patients who had the lesions (P<0.05). Gender (P=0.686) and age (P=0.875) showed no significant relationship with sublingual varices, while smoking and blood pressure levels were significantly associated with these varices (P<0.001).

It is advisable to monitor and manage blood pressure in patients with sublingual varices who may not be aware of their blood pressure status. Our results showed that smoking could be one of the predictive factors for sublingual varices.

Context: 

In recent decades, the tobacco epidemic has spread worldwide. The impact of tobacco control policies has been different among countries. This paper aims to explain how two countries, the United Kingdom (UK) and India, with different political, social, and cultural contexts, implemented theWorld Health Organization (WHO) Framework Convention on Tobacco Control.

Evidence Acquisition: 

A comparative study was done for tobacco control in UK and India in 2022. A review of literature in five databases, observational data and legal documents on tobacco use were undertaken. To identify and explain the factors that pose challenges to the implementation of tobacco control policies, country reports and health policy monitoring and research databases (in total, 27 papers and 16 reports) were reviewed.

Having different economic, social, and cultural backgrounds, a similar pathway to control the tobacco industry can be seen in UK and India. The factors that can explain the similar outcomes in two countries are the global pressure of WHO, increased awareness of people and policymakers, and a sense of urgency about the tobacco problem in both societies.

At different stages of tobacco control in both countries, various interest groups with different routes of political influence used veto opportunities to overturn political decisions in the policy process. Continuous analysis of interest groups and their status quo is necessary to restrict the tobacco industry in favor of public health. Governments should carefully recognize the stakeholders and stake challengers in the policy domain and balance their interests.

It seems necessary to understand the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), with its entering bronchoalveolar and brain cells, which have a high concentration of angiotensin-converting enzyme 2 (ACE2). Although the virus infects healthy people, the rate of infection and mortality is higher and significant in vulnerable people, such as drug users and addicts who have acute and chronic respiratory disease. It also places a heavy economic burden on families and societies around the world. Thus, researchers are aiming to provide prevention and treatment strategies to people at risk. The purpose of the present study was to collect studies on the rate of infection with coronavirus in people who abuse drugs. Besides, the role of the ACE2 receptor as a key factor in coronavirus infectivity in these people was investigated. Our narrative review on the relationship between COVID-19 and opioid abuse and smoking, with consideration of ACE2's role, contains original and human studies. According to the results of the current study, those who smoke or are dependent on opioids are much more likely to experience COVID-19-related respiratory side effects or even pass away.

Buerger’s disease, also known as Thromboangiitis Obliterans (TAO), is a progressive, inflammatory vascular disease with unknown etiology. To address the degree of T cell immunosenescence in this inflammatory disease, the frequency of senescent T cells expressing CD57 and/or CD153 (CD30L) in patients with TAO. In this study, nine male cigarette smoker patients with TAO, nine male healthy cigarette smokers, and nine male healthy non-smoker blood donors were enrolled. PBMCs were extracted from the blood of all participants and stored in liquid nitrogen before use. The percentages of senescent T cells were detected by flow cytometry. The results were analyzed using non-parametric statistical tests. The frequencies of senescent CD3+CD4+CD57+CD153+ and CD3+CD4+CD57-CD153+ T cells significantly increased in patients compared with the non-smoker controls (p=0.01 and p=0.04, respectively). The frequency of senescent CD3+CD4-CD57-CD153+ T cells was higher in patients compared with the smoker controls (p=0.02). In patients with TAO, CD57+CD153- cells were more frequent in CD3hiCD4- and CD3hiCD4+ T cells compared with the CD3loCD4- and CD3loCD4+ T cells (p=0.008 and p=0.0002, respectively). Conversely, the frequency of CD57-CD153+ T cells was significantly higher in CD3loCD4- T cells compared with the CD3hiCD4- T cells (p=0.004). The percentage of CD3+CD4+CD57+CD153- T cells correlated negatively with smoking level in smoker controls (p=0.02, Spearman r=-0.80). Elevated frequencies of senescent CD4+CD57+CD153+ and CD4+CD57-CD153+ T cells in patients compared with non-smoker and smoker controls suggest the contribution of immunosenescence in TAO.

Tobacco use by adolescents is one of the most devastating social challenges throughout the world, threatening the health of future generations and communities in all social, cultural, health, and environmental aspects. This study aims to evaluate the effectiveness of the prevention against Tobacco dependence (PAD) interventions among students in Varamin City in 2020.

This study utilized the findings from the initial phase of the Prevention against Tobacco Dependence (PAD) project, which was conducted using a cohort method in Varamin city (Tehran province). The study encompassed four phases and involved both male and female students. For the second phase, a sample of 780 ninth-grade students was chosen using stratified sampling, with 350 students (45%) serving as PAD-helpers. Data was collected using a modified version of a questionnaire developed by the World Health Organization (WHO).

In the students’ families, most fathers still used cigarettes (25.5%) and hookah (11.4%). In total, the prevalence of hookah, cigarette, and new tobacco product use among students was 35%, 15.9%, and 22.2%, respectively. The most important reason for smoking was curiosity (56.7%), and more than 71% of students believed that PAD project increased their knowledge about dangers of smoking. Based on t-test scores, there was a significant difference between PAD-helpers and non-PAD-helpers in terms of anti-smoking knowledge, attitude, and practice. Two variables of the level of knowledge and attitude towards smoking had a significant direct relationship with the variable of anti-smoking practice (p < 0.05).

This project contained effective interventions to raise the students’ knowledge and change their attitudes towards smoking, and these changes have been more evident among PAD-helpers and their anti-smoking practice.

Smoking is a preventable cause of morbidity and mortality with an increasing prevalence in developing countries. The present systematic review and meta-analysis aimed to estimate the prevalence of smoking among college and high school students in Iran.

Databases of Scopus, PubMed, Web of Science, Google Scholar, SID, and MagIran were searched with no time limitation. Observational studies published in Persian or English were included in the analysis. Time frame of the searches was from inception until 1 January 2021. The data was analyzed using random effects model, subgroup analysis, and meta-regression analysis. Heterogeneity among studies was examined using Cochran's Q test and I2 statistic.

A total of 63 articles with a sample size of 58742 were analyzed. The pooled smoking prevalence was found to be 13.56% (95% CI: 11.65-15.47). There was a significant increase in the prevalence of smoking among female students between 1998 and 2020. Regions 1 of Iran had the highest prevalence rates of smoking (Provinces of Alborz, Tehran, Qazvin, Mazandaran, Semnan, Golestan, and Qom). Smoking was more prevalent among college students (15.62%, 95% CI: 13.14-18.10) than in high school students (9.77%, 95% CI: 7.19-12.35).

Given the relatively high prevalence of smoking among Iranian college and high school students, it is necessary to inform them about the harmful effects of smoking through training programs.

Smoking is a public health problem that affects the adolescent population’s health. This study aimed to investigate the relationship between extroversion (compared with introversion) and transition in cigarette and hookah smoking stages in high‑school students to use the results in smoking prevention programs.

A sample of 2312 students aged 15–16 years in Tabriz were included in the study. Demographic characteristics, cigarette, hookah smoking status, and Eysenck’s extroversion questionnaires were completed by all students in the selected schools. Eight months later, cigarette and hookah smoking status were assessed again to determine transition in smoking stages. The marginal homogeneity (MH) test was used to compare the smoking status at the beginning and 8 months later. The generalized estimating equation (GEE) method with the ordinal link was applied to estimate the effect of extroversion on transition in smoking stages.

The mean (standard deviation) age of the students participating in the study was 15.5 (0.5) years. MH test results showed that, in general, transmission in the stages of both cigarette and hookah smoking in 8 months was significant in students (P‑value < 0.0001). Extrovert personality had a significant positive effect on the transition from lower stages to higher cigarette and hookah smoking stages according to the GEE with ordinal link (P = 0.01). In cigarette and hookah smoking, extrovert persons transited to higher stages 1.64 and 1.55 times more than introvert persons.

Being an extrovert person had a significant effect on the transitioning to higher stages of smoking cigarettes and hookah. In designing cognitive programs to prevent people from smoking or encourage them to quit smoking, considering this dimension of personality trait can be useful in the efficacy of the program.

Taxes are not only an important source of government revenue, but also one of the most important policy tools for tobacco control. The present study was designed to determine the optimal tax rate on cigarettes. A descriptive-analytical study was conducted using the survey data from the Statistics Center of Iran from 2015 to 2019. The survey is carried out every year at the national level and households are selected by three-stage stratified sampling method. The inclusion criteria for our study were based on household information in the study period and its completeness and legibility. The Poisson regression model was used to estimate the factors affecting the quantity of cigarette demand in households with smoker members. The optimal tax rate on cigarettes was calculated based on the concept of Laffer curve. Statistical analysis was performed using Stata version 15.1. The study was performed on 191,648 Iranian households. The cigarette price elasticity of demand was around -0.24. There were statistically significant relationships between the cigarette demand and variables including having a member of 15-18 years in the family; having male member of 19-64 years; having a female member of 19-64 years old; the study periods; age, education level; and job status of the household head (P<0.05). According to the Laffer curve simulation, if cigarette tax rate is increased to account for 219% of the retail price, that will maximize incremental tax revenues at around US$2.39 billion. The government can achieve public health goals as well as maximum tax revenues by raising cigarette taxes by almost 200% and raising the average price of a cigarette pack from $1 to about $3.

Cigarette and tobacco smoking are closely associated with chronic cardiovascular disease and lung cancer. We aimed to assess the prevalence and 5-year incidence rate (IR) of these two risk factors for cardiovascular diseases in Kerman, southeastern of Iran.

10015 individuals aged 15-80 were recruited to the study between 2014 and 2018 (Kerman coronary artery disease (CAD) risk factors study, KERCADRS) of which 2820 had also participated in the first phase (5 years earlier). We took fasting blood samples and collected demographic information and data on cigarette and water-pipe tobacco smoking (WPTS) through interviews. 

The overall prevalence of cigarette smoking increased from 8.1% in phase1 to 8.8% in phase 2. During the same period, the prevalence of WPTS increased from 10% to 14%, especially in the age groups of 15-45 years. The prevalence of opium dependance was higher among cigarette smokers compared to WPT users. The overall 5-year IR of cigarette and WPTS was 3.6 and 4.65 per 1000 person-years respectively. The highest IRs of cigarette smoking and WPTS were reported in the age group of 15-39 years, and IR of WPTS was higher among women. Obesity, diabetes, and hypertension associated with a reduced IRs of cigarette and WPTS. 

Over the past five years, the prevalence of cigarette smoking has increased slightly, but WPTS has increased more rapidly, especially among women. The highest prevalence of cigarette and WPT smoking was in the age groups of 15-39 years. Smoking is shifting from cigarette smoking to WPTS. Age- and gender-oriented interventions would help correct the unhealthy life style in the community and prevent further smoking-related morbidities and mortalities.

Cigarette smoke may play a direct role in proliferation of human pulmonary artery smooth muscle cells (HPASMCs). However, the mechanism involved and the effect of interventions remain unclear. We aimed to evaluate the effect of cigarette smoke extract (CSE) on HPASMCs, explore the role of inflammation and oxidative stress, and the effects of Tempol and PDTC in this process. HPASMCs were subjected to normal control (NC), CSE, CSE+Tempol (CSE+T), and CSE+PDTC (CSE+P) groups. Proliferation of HPASMCs was measured by CCK-8 and Western blot. TNF-α, IL-6, MDA, and SOD levels were determined by ELISA and commercial kits. Nuclear translocation of NF-κB p65 was evaluated by western blot. 1%, 2.5%, and 5% CSE all promoted proliferation of HPASMCs, and effect of 1% CSE was the most significant, however, 7.5% and 10% CSE inhibited viability of cells (all P<0.05). Compared with the NC group, TNF-α, IL-6, and MDA levels increased, SOD activity decreased (all P<0.05), and NF-κB p65 expression in nuclei increased (P=0.04) in the CSE group. Tempol and PDTC inhibited the proliferation of HPASMCs induced by CSE (all P<0.05). And compared with the CSE group, TNF-α, IL-6, and MDA levels in CSE+T and CSE+P groups decreased, while SOD activity increased (all P<0.05). Tempol reduced the expression of NF-κB p65 in nuclei but did not achieve a significant difference (P=0.08). PDTC inhibited the nuclear translocation of NF-κB p65 (P=0.03). CSE stimulates HPASMCs proliferation in a certain concentration range. The CSE-induced proliferation of HPASMCs involved excessive inflammatory response and oxidative stress. Tempol and PDTC attenuate these effects of CSE on HPASMCs.

 Fractional exhaled nitric oxide can be used as a biomarker of some respiratory diseases.

This study was conducted to compare exhaled nitric oxide in cigarette and water‑pipe smokers with nonsmokers.

This cross‑sectional study was conducted on 549 adult subjects as a sub‑study of Shahedieh cohort in Yazd. Participants were divided into 5 groups according to their smoking habits: non‑smokers (n = 202), cigarette smokers (n = 121), water‑pipe smokers (n = 129), cigarette ex‑smokers (n = 58), water‑pipe and cigarette smokers (n = 39). The smokers were also categorized into heavy and light smokers. Fractional exhaled nitric oxide was compared between the groups. Statistical Analysis Used: The data were analyzed by SPSS (ver. 20) using Kolmogorov‑Smirnov, Kruskal‑Wallis, and Mann‑Whitney U tests.

Fractional exhaled NO was lower in all smokers than nonsmokers, but cigarette smokers showed the least level of NO than other groups. Fractional exhaled NO was not significantly lower in water‑pipe smokers than nonsmokers.

Cigarette smoking significantly affect fractional exhaled NO, but water‑pipe smoking did not significantly affect exhaled NO level.

Cigarettes Smoking is a major social and global health problem. Cigarette smoking continues to be a major contributor to deteriorated health status across different age categories. Clarifying the impact of the cigarette smoking on young adults’ lungs health and functional aspects can serve eliminating further deterioration in health status and establishing proper management regimens. This study aimed to investigate the impact of cigarette smoking on lung health (age and functions) and functional performance in the university smoker students.

One hundred and Thirty eligible volunteer, current smoker students participated in this study to objectively evaluate their pulmonary functions (including forced vital capacity “FVC”, forced expiratory volume in one second “FEV1”, FEV1/FVC, peak expiratory flow rate “PEFr”), lung age and functional performance (via the 6‑minutes’ walk test “6MWT”) and compare “the observed” with “the predicted normal” mean values. Data were analyzed via SPSS program using the student t‑test.

There were significant differences (P < 0.05) between the “observed” and the “predicted normal” FVC, FEV1 , FEV1/FVC, PEFr, lung age, and the 6MWT mean values. The “observed” and the “predicted normal” FVC, FEV1 , FEV1/FVC, PEFr, lung age and the 6MWT mean values were [(4.47 ± 0.53, 4.77 ± 0.5 liter), (3.95 ± 0.42, 4.08 ± 0.4 liter), (88.74 ± 7.17, 85.59 ± 4.91%), (550.75 ± 114.96, 572.72 ± 53.02 liter/minute), (32.77 ± 9.44, 21.55 ± 1.37 year), (387.06 ± 56.47, 466.82 ± 18.45 meter)], respectively.

Cigarette smoking negatively impacts the lung age, functions, and functional performance of the university smoker students; the concept that can be used to encourage prevention and early smoking cessation.

Typically, blood pressure dips during sleep and increases during daytime. The blood pressure trend is affected by the autonomic nervous system. The activity of this system is observable in the low and high activity conditions. The aim of this study was to assess the effect of individual characteristics on systolic blood pressure (SBP) across day-night under low and high activity conditions.

The samples were 34 outpatients who were candidates for evaluation of 24 hours of blood pressure with an ambulatory. They were admitted to the heart clinic of Farshchian hospital, located in Hamadan province in the west of Iran. The hourly SBP during 24 hours was considered as a response variable. To determine the factors effecting SBP in each condition, the hidden semi-Markov model (HSMM), with 2 hidden states of low and high activity, was fitted to the data.

Males had lower SBP than females in both states. The effect of age was positive in the low activity state (β=0.30; p<0.001) and negative in high activity state (β= -0.21; p=0.001). The positive effect of cigarette smoking on SBP was seen in low activity state (β=5.02; p=0.029). The overweight and obese patients had higher SBP compared to others in high activity state (β=11.60; p<0.001 and β=5.87; p=0.032, respectively).

The SBP variability can be displayed by hidden states of low and high activity. Moreover, the effects of studied variables on SBP were different in low and high activity states.