BACKGROUND: Several jurisdictions have pursued reforms that regulate cannabis production and/or sale for adult (non-medical) use. Looking at outcomes of such reforms across multiple jurisdictions may help to identify outcomes that are inherent to non-criminal cannabis supply, as well as provide insight into the outcomes of specific regulation models. METHODS: We identified nine indicators of cannabis policy outcomes and aggregated them into three domains (social outcomes, outcomes in cannabis use, health-related outcomes). We assessed these outcomes across five jurisdictions with different models of regulating cannabis supply (Netherlands, Spain, U.S. states that legalized cannabis, Uruguay, and Canada). We used a three-level systematic literature review, prioritising studies with quasi-experimental design (i.e. comparative and longitudinal). We categorised the studies according to their design and the type of outcome (increase, decrease, or no outcome). RESULTS: Across long-standing as well as recent cannabis supply regimes, and across different models of cannabis supply, our review identified common outcomes: a decrease in cannabis-related arrests, an increase in adult (but not adolescent) cannabis use, and increase in healthcare utilization (not traffic-related). Negative health-related outcomes were most consistently found for the U.S. states that legalised cannabis for adult non-medicinal use (there were limitations to nuancing cannabis supply models across U.S. states). In the remaining jurisdictions (the Netherlands, Spain, Canada, Uruguay), the design or time-frame of the identified studies was limited, and studies on certain outcomes were lacking. CONCLUSIONS: Regulating cannabis supply may be associated with benefits in the social area and with potential harms regarding public health; there may though be trade-offs depending on the choice of a cannabis regulation model. Jurisdictions may attempt to mix and match the present models of cannabis regulation to achieve the best ratio of benefits and harms. More research into the specific parameters influencing cannabis policy outcomes is needed.
- Klíčová slova
- cannabis legalization, cannabis supply regulation, literature review, policy analysis, quasi-experimental design,
- MeSH
- Cannabis * MeSH
- dospělí MeSH
- kontrola léčiv a omamných látek * zákonodárství a právo MeSH
- kouření marihuany * zákonodárství a právo epidemiologie MeSH
- lidé MeSH
- obchod zákonodárství a právo MeSH
- užívání marihuany * zákonodárství a právo MeSH
- zákonodárství lékové * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- systematický přehled MeSH
- Geografické názvy
- Kanada MeSH
- Nizozemsko MeSH
- Spojené státy americké MeSH
- Uruguay MeSH
INTRODUCTION: While smoking has been consistently identified as a significant contributor to postoperative complications, the existing literature on its association with postoperative pulmonary complications remains conflicting. AIM: We examined the association of preoperative smoking with the occurrence of postoperative pulmonary complications (PPCs). METHODS: Post hoc analysis of an observational study in 146 hospitals across 29 countries. We included patients at increased risk of PPCs, according to the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score (≥ 26 points). The primary endpoint was the occurrence of one or more predefined PPCs in the first five postoperative days, including unplanned postoperative need for supplementary oxygen, respiratory failure, unplanned need for invasive ventilation, ARDS, pneumonia and pneumothorax. Secondary endpoints included length of hospital stay and in-hospital mortality. We performed propensity score matching to correct for factors with a known association with postoperative outcomes. RESULTS: Out of 2632 patients, 531 (20.2 %) patients were smokers and 2102 (79.8 %) non-smokers. At five days after surgery, 101 (19.0 %) smokers versus 404 (19.2) non-smokers had developed one or more PPCs (P = 0.95). Respiratory failure was more common in smokers (5.1 %) than non-smokers (3.0 %) (P = 0.02), while rates of other PPCs like need for supplementary oxygen, invasive ventilation, ARDS, pneumonia, or pneumothorax did not differ between the groups. Length of hospital stay and mortality was not different between groups. Propensity score matching did not change the findings. CONCLUSION: The occurrence of PPCs in smokers is not different from non-smokers. FUNDING: This analysis was performed without additional funding. LAS VEGAS was partially funded and endorsed by the European Society of Anaesthesiology through their Clinical Trial Network and the Amsterdam University Medical Centers, Amsterdam, The Netherlands. REGISTRATION: LAS VEGAS was registered at Clinicaltrials.gov (NCT01601223). PRIOR PRESENTATION: Preliminary study results have been presented at the Euroanaesthesia 2024 International Congress, in Munich, Germany.
- Klíčová slova
- Anaesthesia, Intraoperative ventilation, PPCs, Postoperative outcome, Postoperative pulmonary complications, Respiratory complications, Smoking,
- MeSH
- délka pobytu statistika a číselné údaje MeSH
- kouření * škodlivé účinky epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mortalita v nemocnicích MeSH
- plicní nemoci * epidemiologie etiologie MeSH
- pooperační komplikace * epidemiologie etiologie MeSH
- předoperační období MeSH
- rizikové faktory MeSH
- senioři MeSH
- tendenční skóre MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
Nucleotide excision repair (NER) is crucial for repairing bulky lesions and crosslinks in DNA caused by exogenous and endogenous genotoxins. The number of studies that have considered DNA repair as a biomarker is limited, and therefore one of the primary objectives of the European COST Action hCOMET (CA15132) was to assemble and analyse a pooled database of studies with data on NER activity. The database comprised 738 individuals, gathered from 5 laboratories that ran population studies using the comet-based in vitro DNA repair assay. NER activity data in peripheral blood mononuclear cells were normalized and correlated with various host-related factors, including sex, age, body mass index (BMI), and smoking habits. This multifaceted analysis uncovered significantly higher NER activity in female participants compared to males (1.08 ± 0.74 vs. 0.92 ± 0.71; P = .002). Higher NER activity was seen in older subjects (>30 years), and the effect of age was most pronounced in the oldest females, particularly those over 70 years (P = .001). Females with a normal BMI (<25 kg/m2) exhibited the highest levels of NER, whereas the lowest NER was observed in overweight males (BMI ≥ 25 kg/m2). No independent effect of smoking was found. After stratification by sex and BMI, higher NER was observed in smoking males (P = .017). The biological implication of higher or lower repair capacity remains unclear; the inclusion of DNA repair as a biomarker in molecular epidemiological trials should elucidate the link between health and disease status.
- Klíčová slova
- BMI, DNA repair, age, biomarkers, comet assay, nucleotide excision repair, sex,
- MeSH
- dospělí MeSH
- excizní oprava MeSH
- index tělesné hmotnosti MeSH
- kometový test MeSH
- kouření MeSH
- leukocyty mononukleární metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- oprava DNA * MeSH
- poškození DNA MeSH
- senioři MeSH
- sexuální faktory MeSH
- věkové faktory MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The aim of this study was to determine prevalence of smokers and ex-smokers in the older diabetes population in Europe and to evaluate the relationship with various sociodemographic and lifestyle risk factors. This epidemiological study used Wave 8 of the multidisciplinary and cross-national SHARE database, which includes cross-sectional data on health, socio-economic status and social and family networks of individuals aged 50 and over from 27 European countries. Among the 6,903 participants with diabetes, 12.2% were current smokers, 29.9% were former smokers and 57.9% had never smoked. Among countries' diabetes populations, the highest prevalence of ex-smokers (57.6%) with a low prevalence of smokers (9.5%) was seen in the Netherlands. The highest prevalence of never-smokers (84.2%) was found in Latvia, with the lowest prevalence of ex-smokers (7.9%). Austria had the highest prevalence of current smokers (17.9%) along with a below-average prevalence of ex-smokers (26.5%) was seen in Austria. Normal weight, being overweight, lower education, living without a partner, living in larger cities, drinking alcohol in the last 7 days, lower age, and being male were associated with a higher risk of being a current smoker. The study shows high prevalence of smoking among the older diabetes population in Europe and provides data on the association of smoking with several risk factors and country-specific differences in smoking prevalence.
- Klíčová slova
- Diabetes, European population, Risk factors, SHARE, Smoking, Smoking cessation,
- MeSH
- diabetes mellitus * epidemiologie MeSH
- kouření * epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- odvykání kouření * statistika a číselné údaje MeSH
- prevalence MeSH
- průřezové studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- životní styl MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa epidemiologie MeSH
Tobacco smoke, alone or combined with alcohol, is the predominant cause of head and neck cancer (HNC). We explore how tobacco exposure contributes to cancer development by mutational signature analysis of 265 whole-genome sequenced HNC samples from eight countries. Six tobacco-associated mutational signatures were detected, including some not previously reported. Differences in HNC incidence between countries corresponded with differences in mutation burdens of tobacco-associated signatures, consistent with the dominant role of tobacco in HNC causation. Differences were found in the burden of tobacco-associated signatures between anatomical subsites, suggesting that tissue-specific factors modulate mutagenesis. We identified an association between tobacco smoking and alcohol-related signatures, indicating a combined effect of these exposures. Tobacco smoking was associated with differences in the mutational spectra, repertoire of driver mutations in cancer genes and patterns of copy number change. Our results demonstrate the multiple pathways by which tobacco smoke can influence the evolution of cancer cell clones.
- MeSH
- kouření tabáku * škodlivé účinky MeSH
- kouření škodlivé účinky MeSH
- lidé MeSH
- mutace MeSH
- mutageneze * genetika MeSH
- nádory hlavy a krku * genetika etiologie epidemiologie MeSH
- sekvenování celého genomu MeSH
- variabilita počtu kopií segmentů DNA MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: Familial risk of lung cancer (LC) is at the level of many common cancers (ca 2.0) but as cigarette smoking is the main cause of LC, it has remained undefined to what extent smoking contributes to the familial risk. We take advantage of the natural experiment of divorce. In Sweden, it has been customary that children stay with their mother after divorce. We thus hypothesize that only maternal half-siblings share the childhood environment to the same extent than full siblings. METHODS: We used Swedish nation-wide data on family structures and cancers up to year 2021 to determined LC risk (standardized incidence ratio, SIR with 95% confidence intervals) in maternal and paternal half-siblings and in full siblings. RESULTS: Familial risk for LC in maternal half-siblings was 2.21 (1.76-2.77) which was not different from that of full siblings 2.23 (2.22-2.44). For paternal half-siblings the risk was 1.56 (1.21-2.01). For adenocarcinoma the risks were for full siblings 2.36 (2.23-2.51), for maternal half-siblings 2.55 (1.93-3.35) and for paternal half-siblings 1.33 (0.94-1.87). CONCLUSIONS: The results showed that familial risk for LC was equal in full siblings and in maternal half-siblings; the risks for paternal half-siblings were lower and for adenocarcinoma significantly lower than those for full siblings. The results suggest that smoking is a major contributor to familial risk of LC in this setting. Smoking starts at an early age and anti-smoking campaigns should target childhood environment for prevention of smoking initiation.
- Klíčová slova
- Adenocarcinoma, Childhood environment, Familial cancer, Maternal half-sibling,
- MeSH
- dospělí MeSH
- incidence MeSH
- kouření škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- matky MeSH
- nádory plic * epidemiologie etiologie prevence a kontrola MeSH
- otcové MeSH
- rizikové faktory MeSH
- senioři MeSH
- sourozenci * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Švédsko epidemiologie MeSH
IMPORTANCE: Cigarette smoking is a strong risk factor for mortality in patients diagnosed with head and neck squamous cell carcinoma (HNSCC). However, little evidence supports which smoking metric best models the association between smoking and survival in HNSCC. OBJECTIVE: To determine which smoking metric best models a linear association between smoking exposure and overall survival (OS) in patients with HNSCC. DESIGN, SETTING, AND PARTICIPANTS: A retrospective multicenter cohort study of 6 clinical epidemiological studies was performed. Five were part of the Human Papillomavirus, Oral and Oropharyngeal Cancer Genomic Research (VOYAGER) consortium. Participants included patients 18 years and older with pathologically confirmed HNSCC. Data were collected from January 2002 to December 2019, and data were analyzed between January 2022 to November 2024. MAIN OUTCOMES AND MEASURES: The primary outcome was OS. The performance of 8 smoking metrics, including pack-years, duration, and log cig-years (calculated as log10[cigarettes smoked per day + 1] × number of years smoked) for modeling OS were compared. Metric performance was measured by the strength of association in Cox proportional hazard models, linearity based on P for linear trend, Akaike information criterion (AIC; lower value indicates better model fit), and visual assessment of spline curves. Secondary outcomes included modeling OS in clinicodemographic subgroups and HNSCC anatomic subsites. Exploratory outcomes included cancer-specific survival and noncancer survival. RESULTS: In total, 8875 patients with HNSCC (2114 [24%] female; median [IQR] age, 61 [54-69] years) were included. Of 8 smoking metrics evaluated, smoking duration (adjusted hazard ratio [aHR], 1.11 [95% CI, 1.03-1.19]) and log cig-years (aHR, 1.11 [95% CI, 1.04-1.18]) had the highest aHRs; both had a statistically significant linear association with OS. Log cig-years had the lowest AIC linear value and the most visually linear spline curve when modeling OS. Duration and log cig-years outperformed pack-years for modeling OS regardless of age, smoking status, and cancer stage. Both performed well in lip and oral cavity, laryngeal (only duration was significant), and human papillomavirus-negative oropharyngeal subsites. In an exploratory analysis, duration had the highest aHR (1.15 [95% CI, 1.02-1.29]), and log cig-years had the lowest AIC linear value when modeling noncancer survival. CONCLUSIONS AND RELEVANCE: In this cohort study, smoking duration and log cig-years best modeled a linear relationship with OS for patients with HNSCC. Both metrics maintained robust performance within specific clinicodemographic subgroups and anatomic subsites. Although most HNSCC survival models control for smoking exposure using smoking status or pack-years, duration and log cig-years may be superior metrics to account for the effects of smoking on survival.
- MeSH
- dlaždicobuněčné karcinomy hlavy a krku * mortalita MeSH
- kouření cigaret * škodlivé účinky MeSH
- kouření * škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- nádory hlavy a krku * mortalita MeSH
- proporcionální rizikové modely MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
Waterpipe smoking (WPS) has adverse health effects that include endothelial dysfunction with mechanisms involving oxidative stress and inflammation. Nonetheless, there is a scarcity of data on the direct impact of WPS on endothelial function. In this study, we assessed the in vitro effects of waterpipe smoke extract (WPSE) on aortic endothelial cell lines, namely the TeloHAEC. The WPSE markedly caused concentration- and time-dependent decreases in cellular viability. When compared with the control, at a concentration of 20 % and an incubation period of 48 h, the WPSE significantly increased the levels of lactate dehydrogenase, and markers of oxidative stress including thiobarbituric acid reactive substances, superoxide dismutase, catalase, and reduced glutathione. Moreover, the concentrations of proinflammatory cytokine (tumor necrosis factor alpha), and adhesion molecules (E-selectin and intercellular adhesion molecule-1) were also significantly augmented. Likewise, WPSE triggered mitochondrial dysfunction, DNA oxidative damage, as well as apoptosis in TeloHAEC cells. Similarly, cells cultured with WPSE have shown increased expression of phosphorylated nuclear factor-kappaB and hypoxia-inducible factor 1-alpha (HIF-1alpha). In conclusion, our study showed that WPSE triggers endothelial inflammation, oxidative stress, DNA damage, mitochondrial dysfunction, and apoptosis via mechanisms involving the activation of nuclear factor-kappaB and HIF-1alpha. Key words Waterpipe smoking, Aortic endothelial cells, Inflammation, Oxidative Stress.
- MeSH
- aorta * účinky léků metabolismus cytologie patologie MeSH
- apoptóza účinky léků MeSH
- buněčné linie MeSH
- endoteliální buňky * účinky léků metabolismus patologie MeSH
- kouř * škodlivé účinky MeSH
- kouření vodní dýmky * škodlivé účinky MeSH
- lidé MeSH
- oxidační stres účinky léků fyziologie MeSH
- viabilita buněk účinky léků fyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- kouř * MeSH
BACKGROUND: Increased lung cancer risks for low socioeconomic status (SES) groups are only partially attributable to smoking habits. Little effort has been made to investigate the persistent risks related to low SES by quantification of potential biases. METHODS: Based on 12 case-control studies, including 18 centers of the international SYNERGY project (16,550 cases, 20,147 controls), we estimated controlled direct effects (CDE) of SES on lung cancer via multiple logistic regression, adjusted for age, study center, and smoking habits and stratified by sex. We conducted mediation analysis by inverse odds ratio weighting to estimate natural direct effects and natural indirect effects via smoking habits. We considered misclassification of smoking status, selection bias, and unmeasured mediator-outcome confounding by genetic risk, both separately and by multiple quantitative bias analyses, using bootstrap to create 95% simulation intervals (SI). RESULTS: Mediation analysis of lung cancer risks for SES estimated mean proportions of 43% in men and 33% in women attributable to smoking. Bias analyses decreased the direct effects of SES on lung cancer, with selection bias showing the strongest reduction in lung cancer risk in the multiple bias analysis. Lung cancer risks remained increased for lower SES groups, with higher risks in men (fourth vs. first [highest] SES quartile: CDE, 1.50 [SI, 1.32, 1.69]) than women (CDE: 1.20 [SI: 1.01, 1.45]). Natural direct effects were similar to CDE, particularly in men. CONCLUSIONS: Bias adjustment lowered direct lung cancer risk estimates of lower SES groups. However, risks for low SES remained elevated, likely attributable to occupational hazards or other environmental exposures.
- MeSH
- analýza mediace MeSH
- dospělí MeSH
- kouření * epidemiologie škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- logistické modely MeSH
- nádory plic * epidemiologie etiologie MeSH
- rizikové faktory MeSH
- senioři MeSH
- společenská třída * MeSH
- studie případů a kontrol MeSH
- výběrový bias MeSH
- zkreslení výsledků (epidemiologie) MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Oral microorganisms are closely related to oral health, the occurrence of some oral diseases is associated with changes in the oral microbiota, and many studies have demonstrated that traditional smoking can affect the oral microbial community. However, due to the short time since the emergence of e-cigarettes, fewer studies are comparing oral microorganisms for users of e-cigarettes versus cigarettes. We collected saliva from 40 non-smokers (NS), 46 traditional cigarette smokers (TS), and 27 e-cigarette consumers (EC), aged between 18 and 35 years. We performed 16S rRNA gene sequencing on the saliva samples collected to study the effects of e-cigarettes versus traditional cigarettes on the oral microbiome. The results showed that compared with the NS group, the alpha diversity of oral flora in saliva was altered in the TS group, with no significant change in the e-cigarette group. Compared with the NS and EC groups, the relative abundance of Actinomyces and Prevotella was increased in the TS group. However, compared with the NS and TS groups, the relative abundance of Veillonella was increased, and the relative abundance of Porphyromonas and Peptostreptococcus was decreased in the EC group. These results showed that both e-cigarettes and traditional cigarettes could alter the structure and composition of oral microbiota. The use of traditional cigarettes promotes the growth of some anaerobic bacteria, which may contribute to dental decay and bad breath over time. E-cigarettes have a different effect on the structure and composition of the oral microbial community compared to conventional cigarettes. In order to better understand the effects of e-cigarettes and traditional cigarettes on users' mouths, future studies will investigate the relationship between diseases such as dental caries and periodontitis and changes in oral microbial species levels.
- Klíčová slova
- 16S rRNA, Electronic cigarettes, Oral flora, Traditional cigarettes,
- MeSH
- Bacteria * klasifikace genetika izolace a purifikace MeSH
- dospělí MeSH
- kouření * MeSH
- kuřáci MeSH
- lidé MeSH
- mikrobiota * MeSH
- mladiství MeSH
- mladý dospělý MeSH
- pilotní projekty MeSH
- RNA ribozomální 16S genetika MeSH
- sliny mikrobiologie MeSH
- systémy dodávající nikotin elektronicky MeSH
- tabákové výrobky MeSH
- ústa * mikrobiologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Názvy látek
- RNA ribozomální 16S MeSH