Objective Stroke is the third leading cause of death worldwide,with the highest incidence in Asia,particularly in China,where smoking remains a major risk factor.The smoking prevalence in China is similar to that in A...Objective Stroke is the third leading cause of death worldwide,with the highest incidence in Asia,particularly in China,where smoking remains a major risk factor.The smoking prevalence in China is similar to that in Asia.Whether the risk estimates for smoking-related stroke in China and all Asian countries are still unknown which is worth evaluating.Thus,this study aims to compare the Relative Risk(RR)of smoking-attributed stroke among the Chinese and Asian populations.Methods A literature search was conducted from the inception to September 10,2022.Studies meeting the criteria were included.The articles were screened,and related information was extracted.Pooled RRs stratified by smoking status and sex were analyzed,including subgroup analyses for China,other Asian countries,and Asia overall.Finally,publication bias and sensitivity analyses were conducted.Results Thirty-seven articles on the Chinese population and 15 on other Asian populations were included,with a mean Newcastle-Ottawa scale(NOS)score of 7.25.About ever smokers,there had no statistical difference existed in both sexes and females between China and other Asian countries,while the RR of males in other Asian countries[2.31(1.38,3.86)]was higher than that in China[1.21(1.15,1.26)];further subgroup analysis indicated that other Asian countries had higher RR[3.76(3.02,4.67)]in the morbidity subgroup.The RRs of both sexes,males and females,between China and the whole of Asia were not statistically different.As for current and former smokers,no meaningful statistical difference was observed in the pooled RRs of both sexes,males and females,in China,other Asian countries,and all of Asia.Conclusion The RR of males ever smokers in China was smaller than that in other Asian countries due to the few articles of morbidity subgroup,but had no statistical difference with the whole of Asia;other groups of ever smokers,current smokers,and former smokers were not statistically significant with other Asian countries or the whole of Asia.展开更多
Adolescent smoking constitutes a critical public health challenge as early initiation increases the risk of premature mortality and smoking-related chronic diseases due to longer exposure and higher cumulative tobacco...Adolescent smoking constitutes a critical public health challenge as early initiation increases the risk of premature mortality and smoking-related chronic diseases due to longer exposure and higher cumulative tobacco use^([1]).Adolescents are especially prone to developing persistent smoking habits,with many adult smokers having started before the age of 18.In China,16.7%of secondary school students have tried smoking and 4.7%are current smokers,highlighting the critical need for targeted tobacco control interventions among the youth.展开更多
The Chinese government promotes smoking cessation through smoking cessation clinics(SCCs).This study aimed to identify factors associated with relapse and provide evidence to inform interventions that reduce relapse r...The Chinese government promotes smoking cessation through smoking cessation clinics(SCCs).This study aimed to identify factors associated with relapse and provide evidence to inform interventions that reduce relapse risk.Participants were SCC patients aged≥18 years who enrolled between June 2019 and December 2021,completed follow-up assessments at one and three months,and reported abstinence at one month.Short-term relapse was defined as self-reported smoking at the three-month follow-up.Treatments included counseling,first-line cessation medications,and traditional Chinese medicine(TCM).Logistic regression was used to identify factors associated with short-term relapse.Among 10,724 eligible SCC patients,11.6%experienced short-term relapse.Factors positively associated with relapse included the number of previous quit attempts(1–5 attempts:OR=1.422,95%CI:1.254–1.613,>5 attempts:OR=1.382,95%CI:1.057–1.808),high perceived difficulty in quitting(OR=1.297,95%CI:1.061–1.586),and moderate(OR=1.383,95%CI:1.174–1.629)or weak(OR=1.517,95%CI:1.251–1.841)willingness to quit.Factors negatively associated with relapse included having a college degree or higher(OR=0.796;95%CI:0.650–0.973),high confidence in quitting(OR=0.786;95%CI:0.629–0.983),and use of TCM(OR=0.276;95%CI:0.158–0.482).Enhancing self-efficacy in quitting appears crucial for preventing short-term relapse.The use of TCM may reduce relapse risk and warrants further investigation.展开更多
Objective The results of limited studies on the relationship between environmental pollution and dementia have been contradictory.We analyzed the combined effects of PM_(2.5)and smoking on the prevalence of dementia a...Objective The results of limited studies on the relationship between environmental pollution and dementia have been contradictory.We analyzed the combined effects of PM_(2.5)and smoking on the prevalence of dementia and cognitive impairment in an elderly community-dwelling Chinese population.Methods We assessed 24,117 individuals along with the annual average PM_(2.5)concentrations from 2012 to 2016.Dementia was confirmed in the baseline survey at a qualified clinical facility,and newly suspected dementia was assessed in 2017,after excluding cases of suspected dementia in 2015.National census data were used to weight the sample data to reflect the entire population in China,with multiple logistic regression performed to analyze the combined effects of PM_(2.5)and smoking frequency on dementia and cognitive impairment.Results Individuals exposed to the highest PM_(2.5)concentration and smoked daily were at higher risk of dementia than those in the lowest PM_(2.5)concentration group(OR,1.603;95%CI[1.626−1.635],P<0.0001)and in the nonsmoking group(OR,1.248;95%CI[1.244−1.252];P<0.0001).Moderate PM_(2.5)exposure and occasional smoking together increased the short-term risk of cognitive impairment.Highlevel PM_(2.5)exposure and smoking were associated with an increased risk of dementia,so more efforts are needed to reduce this risk through environmental protection and antismoking campaigns.Conclusion High-level PM_(2.5)exposure and smoking were associated with an increased risk of dementia.Lowering the ambient PM_(2.5),and smoking cessation are recommended to promote health.展开更多
Despite a global decline in tobacco use,smoking remains a leading cause of preventable death,with rising vaping rates among adolescents and young adults further complicating nicotine cessation efforts.Digital interven...Despite a global decline in tobacco use,smoking remains a leading cause of preventable death,with rising vaping rates among adolescents and young adults further complicating nicotine cessation efforts.Digital interventions,particularly chatbots,have gained attention for their potential to support tobacco and vaping cessation by simulating human-like conversations and providing instant feedback.However,evidence of their effectiveness is limited.The emergence of generative artificial intelligence(AI)chatbots,such as ChatGPT,offers a promising avenue for more personalised and effective cessation support.This article reviews existing literature on traditional chatbot interventions for cessation services,explores the potential of AI chatbots,namely ChatGPT,in continuing to support tobacco and vaping cessation efforts,and identifies areas for future research.It highlights the need to further monitor the reliability and accuracy of AI-generated content and to develop frameworks ensuring healthcare professionals receive adequate training in using these new tools effectively to support patients in quitting smoking and/or vaping.展开更多
Emerging evidence highlights the role of thyroid hormones in cancer,although findings are controversial.Research on thyroid-related traits in lung carcinogenesis is limited.Using UK Biobank data,we performed bidirecti...Emerging evidence highlights the role of thyroid hormones in cancer,although findings are controversial.Research on thyroid-related traits in lung carcinogenesis is limited.Using UK Biobank data,we performed bidirectional Mendelian randomization(MR)to assess causal associations between lung cancer risk and thyroid dysfunction(hypothyroidism and hyperthyroidism)or functional traits(free thyroxine[FT4]and normal-range thyroid-stimulating hormone[TSH]).Furthermore,in the smoking-behavior-stratified MR analysis,we evaluated the mediating effect of thyroid-related phenotypes on the association between smoking behaviors and lung cancer.We demonstrated significant associations between lung cancer risk and hypothyroidism(hazard ratio[HR]=1.14,95%confidence interval[CI]=1.03–1.26,P=0.009)and hyperthyroidism(HR=1.55,95%CI=1.29–1.87,P=1.90×10^(-6))in the UKB.Moreover,the MR analysis indicated a causal effect of thyroid dysfunction on lung cancer risk(ORinverse variance weighted[IVW]=1.09,95%CI=1.05–1.13,P=3.12×10^(-6)for hypothyroidism;ORIVW=1.08,95%CI=1.04–1.12,P=8.14×10^(-5)for hyperthyroidism).We found that FT4 levels were protective against lung cancer risk(ORIVW=0.93,95%CI=0.87–0.99,P=0.030).Additionally,the stratified MR analysis demonstrated distinct causal effects of thyroid dysfunction on lung cancer risk among smokers.Hyperthyroidism mediated the effect of smoking behaviors,especially the age of smoking initiation(17.66%mediated),on lung cancer risk.Thus,thyroid dysfunction phenotypes play causal roles in lung cancer development exclusively among smokers and act as mediators in the causal pathway from smoking to lung cancer.展开更多
Smoking is a well-established risk factor for periodontitis,yet the precise mechanisms by which smoking contributes to periodontal disease remain poorly understood.Recent advances in spatial transcriptomics have enabl...Smoking is a well-established risk factor for periodontitis,yet the precise mechanisms by which smoking contributes to periodontal disease remain poorly understood.Recent advances in spatial transcriptomics have enabled a deeper exploration of the periodontal tissue microenvironment at single-cell resolution,offering new opportunities to investigate these mechanisms.In this study,we utilized Visium HD single-cell spatial transcriptomics to profile gingival tissues from 12 individuals,including those with periodontitis,those with smoking-associated periodontitis,and healthy controls.Our analysis revealed that smoking disrupts the epithelial barrier integrity,induces fibroblast alterations,and dysregulates fibroblast–epithelial cell communication,thereby exacerbating periodontitis.The spatial analysis showed that endothelial cells and macrophages are in close proximity and interact,which further promotes the progression of smoking-induced periodontal disease.Importantly,we found that targeting the endothelial CXCL12 signalling pathway in smoking-associated periodontitis reduced the proinflammatory macrophage phenotype,alleviated epithelial inflammation,and reduced alveolar bone resorption.These findings provide novel insights into the pathogenesis of smoking-associated periodontitis and highlight the potential of targeting the endothelial–macrophage interaction as a therapeutic strategy.Furthermore,this study establishes an essential information resource for investigating the effects of smoking on periodontitis,providing a foundation for future research and therapeutic development for this prevalent and debilitating disease.展开更多
Smoking increases complications and mortality in people with diabetes.Quitting delivers major benefits,but physiological(weight gain,insulin sensitivity shifts)and psychological barriers make cessation harder in this ...Smoking increases complications and mortality in people with diabetes.Quitting delivers major benefits,but physiological(weight gain,insulin sensitivity shifts)and psychological barriers make cessation harder in this group.Our review article examined strategies tailored to people with diabetes.All smokers with diabetes should receive clear,personalized advice to quit,embedded in routine care.Among the available medications,varenicline has the strongest evidence in this population.Nicotine replacement therapy and bupropion may help but have limited diabetes-specific data,so they should be used with caution.Tobacco harm reduction(e-cigarettes,heated tobacco products)may facilitate switching away from combustible cigarettes and reduce exposure,although the long-term safety and efficacy in diabetes remain uncertain.Glucagon-like peptide-1 receptor agonists can aid weight and glycemic control and may indirectly support cessation.Digital tools(apps,wearables,and remote monitoring)offer real-time support and adherence tracking,although diabetes-specific effectiveness is still being established.Smoking cessation in people with diabetes requires urgent attention.Evidence-based interventions should be integrated into routine care,with particular attention given to early monitoring of glucose,body weight,and blood pressure after quitting,plus structured follow-up.More research should develop and test tailored,longterm strategies for this high-risk group,including pragmatic trials integrating harm reduction and digital support.展开更多
AIM:To determine whether chronic smoking affects fundus blood flow density using optical coherence tomography angiography(OCTA)based on artificial intelligence(AI).METHODS:All participants underwent a comprehensive op...AIM:To determine whether chronic smoking affects fundus blood flow density using optical coherence tomography angiography(OCTA)based on artificial intelligence(AI).METHODS:All participants underwent a comprehensive ophthalmological examination in this study.The subjects were categorized into two groups:control and smoker.Fundus data obtained through the novel OCTA device were compared.RESULTS:Utilizing deep learning denoising techniques removed background noise and smoothed vessel surfaces.OCTA showed a significant decrease in fundus blood flow density after AI-based denoising on the right eyes of 36 smokers(36 males,average age 44.17±9.85y)and ageand sex-matched participants who never smoked.The thickness of the retina in both control and smoker groups failed to show any statistically significant differences.Smoking was associated with decreased blood flow density in the macula and the optic disk.CONCLUSION:Utilizing AI-based denoising to improve the sensitivity of OCTA images can be highly beneficial.展开更多
I applaud Adekeye AP and the journal for publishing‘Smoking of Carica papaya in Nigeria:The rationale,the public health effects and policies for intervention’.It is important to draw attention to newly recognised us...I applaud Adekeye AP and the journal for publishing‘Smoking of Carica papaya in Nigeria:The rationale,the public health effects and policies for intervention’.It is important to draw attention to newly recognised uses of substances which might alter perception,mood,and/or behaviour.展开更多
Acute respiratory distress syndrome(ARDS)is a severe clinical condition characterized by acute respiratory failure due to widespread pulmonary inflammation and edema.The incidence of ARDS among intensive care unit(ICU...Acute respiratory distress syndrome(ARDS)is a severe clinical condition characterized by acute respiratory failure due to widespread pulmonary inflammation and edema.The incidence of ARDS among intensive care unit(ICU)patients is approximately 10%,with mortality rates ranging from 35%to 45%and exceeding 50%in severe cases.[1]Identifying and controlling risk factors for ARDS is critical for early prevention.Smoking remains a significant global public health issue,affecting one-third of adults and 40%of children through exposure to secondhand smoke.[2]In an animal study,cigarette smoke impaired lung endothelial barrier function through oxidative stress and exacerbated lipopolysaccharide-induced increases in vascular permeability in vivo.This finding is consistent with the pathological changes observed in ARDS.[3]Although many observational studies have suggested a potential link between smoking and ARDS,the causal relationship remains unclear.This study uses Mendelian randomization(MR)to explore whether smoking behavior causally influences ARDS and investigates the mechanisms by which smoking may contribute to ARDS development through transcriptomic analysis of the Gene Expression Omnibus(GEO)database.展开更多
Smoking cessation is challenging and lack of positive support is a known major barrier to quitting cigarettes.Previous studies have suggested that social influences might increase smokers' awareness of social norm...Smoking cessation is challenging and lack of positive support is a known major barrier to quitting cigarettes.Previous studies have suggested that social influences might increase smokers' awareness of social norms for appropriate behavior,which might lead to smoking cessation.Although social media use is increasing among young adults in the United States,research on the relationship between social media use and smoking cessation is lacking.Twitter has provided a rich source of information for researchers,but no overview exists as to how the field uses Twitter in smoking cessation research.To the best of our knowledge,this study conducted a data mining analysis of Twitter to assess barriers to smoking cessation.In conclusion,Twitter is a cost-effective tool with the potential to disseminate information on the benefits of smoking cessation and updated research to the Twitter community on a global scale.展开更多
Smoking Ban in Closed Public Spaces went into effect in Turkey on May 19, 2008. We aimed at investigating the status of smoking among hospital staff following the ban. The study was conducted with the staff of the uni...Smoking Ban in Closed Public Spaces went into effect in Turkey on May 19, 2008. We aimed at investigating the status of smoking among hospital staff following the ban. The study was conducted with the staff of the university hospital other than physicians. A questionnaire form investigating the status of smoking among hospital staff, the effects of the ban on smoking in closed public spaces, their thoughts that might affect their decisions to quit smoking or to decrease the number of cigarettes smoked was implemented. Prior to each interview, the participants read and signed the informed consent form. Mean and percentage distributions were used in the evaluation of the data. Of 60 individuals, 68% were female, mean age was 40.72 ~ 7.25. Of them 50% were active smokers. After the ban 55% of the smokers declared a decrease in the number of cigarettes they smoked, 37% said no change. The ban had no effect on smokers＇ decisions about quitting smoking. Social leadership and role model characteristics of healthcare professionals should be taken into consideration and the habit of smoking should be handled as a disease, and medical approaches including behavioral therapy should be given the necessary significance they deserve.展开更多
Objectives To investigate the effects of preoperative smoking and smoking cessation time on preoperative peripheral blood inflammatory indexes and postoperative hospitalization outcomes in male patients with lung canc...Objectives To investigate the effects of preoperative smoking and smoking cessation time on preoperative peripheral blood inflammatory indexes and postoperative hospitalization outcomes in male patients with lung cancer and surgery therapy.Methods We retrospectively enrolled 637 male patients who underwent curative-intent lung cancer resection between January 2014 and December 2016.Patients were classified as the current smokers,the never smokers,and the ex-smokers based on their smoking history,and the ex-smokers were allocated into five subgroups according to their smoking cessation times(CeT):CeT W6 weeks,6weeks<CeT W lyear,lyear<CeT<5years,5years<CeT<lOyears,CeT>10years.The preoperative peripheral blood white blood cells(WBCs),albumin,neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),intraoperative blood loss,30-day mortality,in-hospital days,hospitalization costs,intensive care un辻(ICU),admission days and placement time of closed thoracic drainage tube were compared among difTerent groups.Results There were significant differences in WBC(F=S.275,P<0.001)and albumin(F=2,470,P<0.05)among patients of current smokers,ex-smokers with different smoking cessation time,and never-smokers.The blood WBC count in current smokers(7.7 X 109/L)was significantly higher than that in ex・smokers(7.0 X 109/L)and never-smokers(5.9 X 109/L)(t=-2.145,P<0.05;t=-6.073,P<0.01,respectively).The level of peripheral blood albumin in current smokers(41.1 g/L)was lower than that in ex・smokers(42.1 g/L)and neve—smokers(43.2 g/L)(t=2.323,P<0.05;t=3.995,P<0.01,respectively).The level of peripheral blood NLR in current smokers(3.7)was higher than that in ex-smokers(3.1)and never smokers(2.8)(t—-1.836,P<0.05;t=-2.889,P<0.01,respectively).There was no significant difference in WBC,albumin and NLR among five subgroups of different smoking cessation time.No significant difference was observed in intraoperative blood loss,30-day mortality,hospitalization costs,hospital stay,ICU stay and placement time of closed thoracic drainage tube among groups either.Conclusion Smoking increases the preoperative inflammatory indexes in peripheral blood of lung cancer patients.Smoking cessation has beneficial effect on reducing levels of these inflammatory indexes,which may be not impacted by the time length of smoking cessation.Therefore,lung cancer patients should be encouraged to quit smoking at any time.展开更多
Objective Cigarette smoking is one of the established risk factors of atherosclerotic cardiovascular disease, however, its impact on lipids is not completely understood, especially in the Chinese population. Therefore...Objective Cigarette smoking is one of the established risk factors of atherosclerotic cardiovascular disease, however, its impact on lipids is not completely understood, especially in the Chinese population. Therefore, this study evaluated the impact of smoking status （non, former, and current smoking） on the distribution of lipoprotein subfractions in untreated patients with angina-like chest pain. Methods A total of 877 patients were consecutively enrolled and divided into nonsmoking （n = 528）, former smoking （n = 103）, and current smoking （n = 256） groups. Both low- and high-density lipoprotein cholesterol （LDL-C and HDL-C） subfractions were measured using the Quantimetrix Lipoprint System. The distributions of lipoprotein subfractions were evaluated among the groups. Results Compared with nonsmoking subjects, the current smoking group had significantly lower large/medium HDL-C （both P 〈 0.001） concentration and large HDL subfraction percentage but higher small HDL-C and medium LDL-C concentrations as well as medium LDL subfraction percentage. Importantly, former smoking subjects showed elevated levels of large HDL-C concentration, large HDL particle percentage, and mean LDL particle size and attenuation in small HDL/LDL percentages and small LDL-C concentration, but these levels did not reach the optimal status compared with those of the non-smoking group （data not shown）. Conclusion Smoking has an adverse impact on the lipoprotein subfractions, presented as lower large HDL particles besides higher small HDL and medium LDL particles, whereas smoking cessation could reverse these change to a certain degree.展开更多
A heated air circulation standard curing barn was used for baking tobacco leaves, and the effects of different yellowing conditions during the baking process on contents of neutral aroma components and smoking quality...A heated air circulation standard curing barn was used for baking tobacco leaves, and the effects of different yellowing conditions during the baking process on contents of neutral aroma components and smoking quality of upper leaves were studied by setting different yellowing time and color-fixing time. The results showed that during the baking process, only by prolonging the yellowing time by 24 h on the basis of control, the content of every kind of neutral aroma components in- creased obviously and the content of solanone increased by nearly 2.20 times. It was unfavorable for the degradation and accumulation of aroma components when only prolonging color-fixing time by 24 h. Prolonging both yellowing time and color- fixing time by 24 h mainly promoted the accumulation of chlorophyll degradation product neophytadiene, which increased by 33.24%, while the degradation and ac- cumulation of some aroma components were inhibited, indicating that only prolonging the yellowing time by 24 h could promote the accumulation of various kinds of neu- tral aroma components and improve the quality of tobacco leaves. The regression models were established of neutral aroma components in the first and second prin- cipal components to total aroma content, which were y=x＋0.053 47 （R^2=0.919 7） and y=x＋0.147 5 （R^2=0.698 4）, respectively, and they were verified to be feasible.展开更多
The purpose of this scoping review is to create a single narrative that describes the impact of smoking cessation on metabolic parameters in people with diabetes.It is generally well accepted that smoking enhances the...The purpose of this scoping review is to create a single narrative that describes the impact of smoking cessation on metabolic parameters in people with diabetes.It is generally well accepted that smoking enhances the harmful effects of elevated blood glucose levels,accelerating the vascular damage seen in patients with diabetes.Smoking cessation has clear benefits in terms of reducing cardiovascular morbidity and mortality.However,there is less evidence for the impact of smoking cessation on other diabetes-related complications.Studies in people with diabetes have shown improvement as well as temporary deterioration in glycemic control after ceasing smoking.Only a few studies have described the effect of quitting smoking on insulin resistance and lipid parameters,however,their results have been inconclusive.In this situation,healthcare professionals should not assume that cessation of smoking will improve metabolic parameters in patients with diabetes.It seems they should, first of all, emphasize the prevention of weight gain that may be associatedwith quitting smoking. The lack of data regarding the metabolic effects of smoking and smokingcessation in diabetes is very disappointing and this area needs to be addressed.展开更多
Despite ongoing efforts to reduce tobacco smoking, the smoking prevalence in many countries has remained stable for years. This may be a consequence of either lack of knowledge about effective ways to reduce smoking, ...Despite ongoing efforts to reduce tobacco smoking, the smoking prevalence in many countries has remained stable for years. This may be a consequence of either lack of knowledge about effective ways to reduce smoking, or failing treatment of tobacco addiction in healthcare. This study explored gaps in the current understanding of smoking cessation and the challenges facing tobacco addiction management in order to formulate recommendations for future research and healthcare practice. A narrative review was written to determine areas in which more research is needed as well as areas in which sufficient knowledge is already available. Recommendations for future research were prioritised using a Delphi-procedure. Recommendations for healthcare practice were confirmed by expert’s assessment. Smoking is not widely acknowledged as an addiction and a relatively small number of smokers ask help from a healthcare professional when trying to stop smoking. Most healthcare professionals recognise the importance of advising patients to stop smoking, but experience certain barriers to actually do this. Overall, healthcare professionals need to be convinced that tobacco smoking is an addiction and should be treated likewise. If all healthcare professionals systematically advise their patients to give up smoking, eventually more smokers will successfully stop smoking.展开更多
To investigate factors related to resumption of smoking by women after childbirth, the smoking habits of 241 postnatal women, who initially had stopped smoking after pregnancy, in a rural city in Aomori Prefecture, Ja...To investigate factors related to resumption of smoking by women after childbirth, the smoking habits of 241 postnatal women, who initially had stopped smoking after pregnancy, in a rural city in Aomori Prefecture, Japan, were studied at 5 - 6 days, 1 month, and 12 months after childbirth. At 1 month after childbirth, only nine women had resumed smoking, but a total of 40 women had resumed smoking after 12 months. Factors related to smoking resumption after childbirth included the switching from breast feeding to bottle feeding and the influence of smoking by their spouses. Spousal smoking is an important factor in the resumption of smoking by women after childbirth.展开更多
Objective： Analysis of abstinence rates of smokers per gender at 3, 6, 9 and 12 months in a Smoking Cessation Unit from January 2008 to December 2009. Methods： Descriptive retrospective study. Analysis of socio-demo...Objective： Analysis of abstinence rates of smokers per gender at 3, 6, 9 and 12 months in a Smoking Cessation Unit from January 2008 to December 2009. Methods： Descriptive retrospective study. Analysis of socio-demographic variables, smoking patterns, associated comorbidities, continuous abstinence rates, success, relapses, failure and dropping out. Results： 278 smokers started treatment （33%）; 55.4% males and 44.6% females （mean age of 48.3 and 44.06 years, respectively）. The main associated comorbidities were： psychiatric （38.7%）, cardiovascular （dyslipemia 25%） and respiratory （COPD （chronic obstructive pulmonary disease） 9.7%） in females; cardiovascular （dyslipemia 34.4%）, psychiatric （34.4%） and respiratory （COPD 19.5%） in males. VRN （Varenicline） was prescribed in 40.2% males and 32.2% females; NRT （nicotine replacement therapy） was used in 46.6% and 38.7%, respectively; bupropion was employed in 6.5% and 21.8%, respectively. Psychological counseling was offered only to 7.8% males and 8.1% females. The continuous abstinence rates in males at 3, 6, 9 and 12 months were 51.3%, 37.7%, 32.5% and 30.5%, respectively, and were 45.2%, 29.8%, 25.0% and 24.2% for females. Failure was 9.7% for females and 18.8% for males. Success was more frequent for those on VRN （n = 41 males; n = 12 females）. No relapses were indicated for 42 females and 71 males. The percentage of relapses was higher at 3 months （29.0% females, 19.5% males）. Conclusions： The study observed differences in treating abstinence between genders （in the abstinence rates and failure index）. This implies having to consider incorporating the gender variable into the diagnosis, treatment and prevention of smoking.展开更多
基金funded by the State Key Laboratory Special Fund(2060204)Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2023-I2M-2-001)Strengthen Capacity of Study and Application on the Burden of Disease in Health Care Systems in China:Establishment and Development of Chinese Burden of Disease Research and Dissemination Center(15-208)supported by the China Medical Board(CMB)。
文摘Objective Stroke is the third leading cause of death worldwide,with the highest incidence in Asia,particularly in China,where smoking remains a major risk factor.The smoking prevalence in China is similar to that in Asia.Whether the risk estimates for smoking-related stroke in China and all Asian countries are still unknown which is worth evaluating.Thus,this study aims to compare the Relative Risk(RR)of smoking-attributed stroke among the Chinese and Asian populations.Methods A literature search was conducted from the inception to September 10,2022.Studies meeting the criteria were included.The articles were screened,and related information was extracted.Pooled RRs stratified by smoking status and sex were analyzed,including subgroup analyses for China,other Asian countries,and Asia overall.Finally,publication bias and sensitivity analyses were conducted.Results Thirty-seven articles on the Chinese population and 15 on other Asian populations were included,with a mean Newcastle-Ottawa scale(NOS)score of 7.25.About ever smokers,there had no statistical difference existed in both sexes and females between China and other Asian countries,while the RR of males in other Asian countries[2.31(1.38,3.86)]was higher than that in China[1.21(1.15,1.26)];further subgroup analysis indicated that other Asian countries had higher RR[3.76(3.02,4.67)]in the morbidity subgroup.The RRs of both sexes,males and females,between China and the whole of Asia were not statistically different.As for current and former smokers,no meaningful statistical difference was observed in the pooled RRs of both sexes,males and females,in China,other Asian countries,and all of Asia.Conclusion The RR of males ever smokers in China was smaller than that in other Asian countries due to the few articles of morbidity subgroup,but had no statistical difference with the whole of Asia;other groups of ever smokers,current smokers,and former smokers were not statistically significant with other Asian countries or the whole of Asia.
基金supported by the World Health Organization Global Youth Tobacco Survey(WPDHP1206671)the Global Health Capacity Building and Tobacco Control Project:Tobacco Epidemic Monitoring and Comprehensive Tobacco Control Intervention。
文摘Adolescent smoking constitutes a critical public health challenge as early initiation increases the risk of premature mortality and smoking-related chronic diseases due to longer exposure and higher cumulative tobacco use^([1]).Adolescents are especially prone to developing persistent smoking habits,with many adult smokers having started before the age of 18.In China,16.7%of secondary school students have tried smoking and 4.7%are current smokers,highlighting the critical need for targeted tobacco control interventions among the youth.
文摘The Chinese government promotes smoking cessation through smoking cessation clinics(SCCs).This study aimed to identify factors associated with relapse and provide evidence to inform interventions that reduce relapse risk.Participants were SCC patients aged≥18 years who enrolled between June 2019 and December 2021,completed follow-up assessments at one and three months,and reported abstinence at one month.Short-term relapse was defined as self-reported smoking at the three-month follow-up.Treatments included counseling,first-line cessation medications,and traditional Chinese medicine(TCM).Logistic regression was used to identify factors associated with short-term relapse.Among 10,724 eligible SCC patients,11.6%experienced short-term relapse.Factors positively associated with relapse included the number of previous quit attempts(1–5 attempts:OR=1.422,95%CI:1.254–1.613,>5 attempts:OR=1.382,95%CI:1.057–1.808),high perceived difficulty in quitting(OR=1.297,95%CI:1.061–1.586),and moderate(OR=1.383,95%CI:1.174–1.629)or weak(OR=1.517,95%CI:1.251–1.841)willingness to quit.Factors negatively associated with relapse included having a college degree or higher(OR=0.796;95%CI:0.650–0.973),high confidence in quitting(OR=0.786;95%CI:0.629–0.983),and use of TCM(OR=0.276;95%CI:0.158–0.482).Enhancing self-efficacy in quitting appears crucial for preventing short-term relapse.The use of TCM may reduce relapse risk and warrants further investigation.
基金supported by the Major Programs of Public Health of the Chinese Ministry of Finance(grant number 131091106000150003)。
文摘Objective The results of limited studies on the relationship between environmental pollution and dementia have been contradictory.We analyzed the combined effects of PM_(2.5)and smoking on the prevalence of dementia and cognitive impairment in an elderly community-dwelling Chinese population.Methods We assessed 24,117 individuals along with the annual average PM_(2.5)concentrations from 2012 to 2016.Dementia was confirmed in the baseline survey at a qualified clinical facility,and newly suspected dementia was assessed in 2017,after excluding cases of suspected dementia in 2015.National census data were used to weight the sample data to reflect the entire population in China,with multiple logistic regression performed to analyze the combined effects of PM_(2.5)and smoking frequency on dementia and cognitive impairment.Results Individuals exposed to the highest PM_(2.5)concentration and smoked daily were at higher risk of dementia than those in the lowest PM_(2.5)concentration group(OR,1.603;95%CI[1.626−1.635],P<0.0001)and in the nonsmoking group(OR,1.248;95%CI[1.244−1.252];P<0.0001).Moderate PM_(2.5)exposure and occasional smoking together increased the short-term risk of cognitive impairment.Highlevel PM_(2.5)exposure and smoking were associated with an increased risk of dementia,so more efforts are needed to reduce this risk through environmental protection and antismoking campaigns.Conclusion High-level PM_(2.5)exposure and smoking were associated with an increased risk of dementia.Lowering the ambient PM_(2.5),and smoking cessation are recommended to promote health.
文摘Despite a global decline in tobacco use,smoking remains a leading cause of preventable death,with rising vaping rates among adolescents and young adults further complicating nicotine cessation efforts.Digital interventions,particularly chatbots,have gained attention for their potential to support tobacco and vaping cessation by simulating human-like conversations and providing instant feedback.However,evidence of their effectiveness is limited.The emergence of generative artificial intelligence(AI)chatbots,such as ChatGPT,offers a promising avenue for more personalised and effective cessation support.This article reviews existing literature on traditional chatbot interventions for cessation services,explores the potential of AI chatbots,namely ChatGPT,in continuing to support tobacco and vaping cessation efforts,and identifies areas for future research.It highlights the need to further monitor the reliability and accuracy of AI-generated content and to develop frameworks ensuring healthcare professionals receive adequate training in using these new tools effectively to support patients in quitting smoking and/or vaping.
基金funded by the National Natural Science Foundation of China(Grant Nos.82220108002 to F.C.,82273737 to R.Z.,82473728 to Y.W.)the US National Institutes of Health(Grant Nos.CA209414,HL060710,ES000002 to D.C.C.,CA209414,CA249096 to Y.L.)the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD).R.Z.was partially supported by the Qing Lan Project of the Higher Education Institutions of Jiangsu Province and the Outstanding Young-Level Academic Leadership Training Program of Nanjing Medical University.
文摘Emerging evidence highlights the role of thyroid hormones in cancer,although findings are controversial.Research on thyroid-related traits in lung carcinogenesis is limited.Using UK Biobank data,we performed bidirectional Mendelian randomization(MR)to assess causal associations between lung cancer risk and thyroid dysfunction(hypothyroidism and hyperthyroidism)or functional traits(free thyroxine[FT4]and normal-range thyroid-stimulating hormone[TSH]).Furthermore,in the smoking-behavior-stratified MR analysis,we evaluated the mediating effect of thyroid-related phenotypes on the association between smoking behaviors and lung cancer.We demonstrated significant associations between lung cancer risk and hypothyroidism(hazard ratio[HR]=1.14,95%confidence interval[CI]=1.03–1.26,P=0.009)and hyperthyroidism(HR=1.55,95%CI=1.29–1.87,P=1.90×10^(-6))in the UKB.Moreover,the MR analysis indicated a causal effect of thyroid dysfunction on lung cancer risk(ORinverse variance weighted[IVW]=1.09,95%CI=1.05–1.13,P=3.12×10^(-6)for hypothyroidism;ORIVW=1.08,95%CI=1.04–1.12,P=8.14×10^(-5)for hyperthyroidism).We found that FT4 levels were protective against lung cancer risk(ORIVW=0.93,95%CI=0.87–0.99,P=0.030).Additionally,the stratified MR analysis demonstrated distinct causal effects of thyroid dysfunction on lung cancer risk among smokers.Hyperthyroidism mediated the effect of smoking behaviors,especially the age of smoking initiation(17.66%mediated),on lung cancer risk.Thus,thyroid dysfunction phenotypes play causal roles in lung cancer development exclusively among smokers and act as mediators in the causal pathway from smoking to lung cancer.
基金supported by grants from the National Natural Science Foundation of China(Grant nos.82201011,82370958 and 81870770).
文摘Smoking is a well-established risk factor for periodontitis,yet the precise mechanisms by which smoking contributes to periodontal disease remain poorly understood.Recent advances in spatial transcriptomics have enabled a deeper exploration of the periodontal tissue microenvironment at single-cell resolution,offering new opportunities to investigate these mechanisms.In this study,we utilized Visium HD single-cell spatial transcriptomics to profile gingival tissues from 12 individuals,including those with periodontitis,those with smoking-associated periodontitis,and healthy controls.Our analysis revealed that smoking disrupts the epithelial barrier integrity,induces fibroblast alterations,and dysregulates fibroblast–epithelial cell communication,thereby exacerbating periodontitis.The spatial analysis showed that endothelial cells and macrophages are in close proximity and interact,which further promotes the progression of smoking-induced periodontal disease.Importantly,we found that targeting the endothelial CXCL12 signalling pathway in smoking-associated periodontitis reduced the proinflammatory macrophage phenotype,alleviated epithelial inflammation,and reduced alveolar bone resorption.These findings provide novel insights into the pathogenesis of smoking-associated periodontitis and highlight the potential of targeting the endothelial–macrophage interaction as a therapeutic strategy.Furthermore,this study establishes an essential information resource for investigating the effects of smoking on periodontitis,providing a foundation for future research and therapeutic development for this prevalent and debilitating disease.
文摘Smoking increases complications and mortality in people with diabetes.Quitting delivers major benefits,but physiological(weight gain,insulin sensitivity shifts)and psychological barriers make cessation harder in this group.Our review article examined strategies tailored to people with diabetes.All smokers with diabetes should receive clear,personalized advice to quit,embedded in routine care.Among the available medications,varenicline has the strongest evidence in this population.Nicotine replacement therapy and bupropion may help but have limited diabetes-specific data,so they should be used with caution.Tobacco harm reduction(e-cigarettes,heated tobacco products)may facilitate switching away from combustible cigarettes and reduce exposure,although the long-term safety and efficacy in diabetes remain uncertain.Glucagon-like peptide-1 receptor agonists can aid weight and glycemic control and may indirectly support cessation.Digital tools(apps,wearables,and remote monitoring)offer real-time support and adherence tracking,although diabetes-specific effectiveness is still being established.Smoking cessation in people with diabetes requires urgent attention.Evidence-based interventions should be integrated into routine care,with particular attention given to early monitoring of glucose,body weight,and blood pressure after quitting,plus structured follow-up.More research should develop and test tailored,longterm strategies for this high-risk group,including pragmatic trials integrating harm reduction and digital support.
基金Supported by the Shanghai Health Commission(No.202240097).
文摘AIM:To determine whether chronic smoking affects fundus blood flow density using optical coherence tomography angiography(OCTA)based on artificial intelligence(AI).METHODS:All participants underwent a comprehensive ophthalmological examination in this study.The subjects were categorized into two groups:control and smoker.Fundus data obtained through the novel OCTA device were compared.RESULTS:Utilizing deep learning denoising techniques removed background noise and smoothed vessel surfaces.OCTA showed a significant decrease in fundus blood flow density after AI-based denoising on the right eyes of 36 smokers(36 males,average age 44.17±9.85y)and ageand sex-matched participants who never smoked.The thickness of the retina in both control and smoker groups failed to show any statistically significant differences.Smoking was associated with decreased blood flow density in the macula and the optic disk.CONCLUSION:Utilizing AI-based denoising to improve the sensitivity of OCTA images can be highly beneficial.
文摘I applaud Adekeye AP and the journal for publishing‘Smoking of Carica papaya in Nigeria:The rationale,the public health effects and policies for intervention’.It is important to draw attention to newly recognised uses of substances which might alter perception,mood,and/or behaviour.
基金funded by the Hunan Provincial Natural Science Foundation of China(2024JJ2038,2024JJ9161)the Central Government Guides Local Science and Technology Development Fund Projects(2024ZYC031)+4 种基金the Hunan Health High-Level Talent Project(R2023073)the National Key Clinical Specialty Scientific Research Project(Z2023114)the Young Doctor Foundation of Hunan Provincial People’s Hospital(BSJJ202209)the Key Cultivation Project of Hunan Provincial People’s Hospital(RS2022A06)the Clinical Research Center for Emergency and Critical Care in Hunan Province(2021SK4011).
文摘Acute respiratory distress syndrome(ARDS)is a severe clinical condition characterized by acute respiratory failure due to widespread pulmonary inflammation and edema.The incidence of ARDS among intensive care unit(ICU)patients is approximately 10%,with mortality rates ranging from 35%to 45%and exceeding 50%in severe cases.[1]Identifying and controlling risk factors for ARDS is critical for early prevention.Smoking remains a significant global public health issue,affecting one-third of adults and 40%of children through exposure to secondhand smoke.[2]In an animal study,cigarette smoke impaired lung endothelial barrier function through oxidative stress and exacerbated lipopolysaccharide-induced increases in vascular permeability in vivo.This finding is consistent with the pathological changes observed in ARDS.[3]Although many observational studies have suggested a potential link between smoking and ARDS,the causal relationship remains unclear.This study uses Mendelian randomization(MR)to explore whether smoking behavior causally influences ARDS and investigates the mechanisms by which smoking may contribute to ARDS development through transcriptomic analysis of the Gene Expression Omnibus(GEO)database.
文摘Smoking cessation is challenging and lack of positive support is a known major barrier to quitting cigarettes.Previous studies have suggested that social influences might increase smokers' awareness of social norms for appropriate behavior,which might lead to smoking cessation.Although social media use is increasing among young adults in the United States,research on the relationship between social media use and smoking cessation is lacking.Twitter has provided a rich source of information for researchers,but no overview exists as to how the field uses Twitter in smoking cessation research.To the best of our knowledge,this study conducted a data mining analysis of Twitter to assess barriers to smoking cessation.In conclusion,Twitter is a cost-effective tool with the potential to disseminate information on the benefits of smoking cessation and updated research to the Twitter community on a global scale.
文摘Smoking Ban in Closed Public Spaces went into effect in Turkey on May 19, 2008. We aimed at investigating the status of smoking among hospital staff following the ban. The study was conducted with the staff of the university hospital other than physicians. A questionnaire form investigating the status of smoking among hospital staff, the effects of the ban on smoking in closed public spaces, their thoughts that might affect their decisions to quit smoking or to decrease the number of cigarettes smoked was implemented. Prior to each interview, the participants read and signed the informed consent form. Mean and percentage distributions were used in the evaluation of the data. Of 60 individuals, 68% were female, mean age was 40.72 ~ 7.25. Of them 50% were active smokers. After the ban 55% of the smokers declared a decrease in the number of cigarettes they smoked, 37% said no change. The ban had no effect on smokers＇ decisions about quitting smoking. Social leadership and role model characteristics of healthcare professionals should be taken into consideration and the habit of smoking should be handled as a disease, and medical approaches including behavioral therapy should be given the necessary significance they deserve.
基金Fund supported by the National Key R&D Program of China(No.2018YFC2001800)~~。
文摘Objectives To investigate the effects of preoperative smoking and smoking cessation time on preoperative peripheral blood inflammatory indexes and postoperative hospitalization outcomes in male patients with lung cancer and surgery therapy.Methods We retrospectively enrolled 637 male patients who underwent curative-intent lung cancer resection between January 2014 and December 2016.Patients were classified as the current smokers,the never smokers,and the ex-smokers based on their smoking history,and the ex-smokers were allocated into five subgroups according to their smoking cessation times(CeT):CeT W6 weeks,6weeks<CeT W lyear,lyear<CeT<5years,5years<CeT<lOyears,CeT>10years.The preoperative peripheral blood white blood cells(WBCs),albumin,neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),intraoperative blood loss,30-day mortality,in-hospital days,hospitalization costs,intensive care un辻(ICU),admission days and placement time of closed thoracic drainage tube were compared among difTerent groups.Results There were significant differences in WBC(F=S.275,P<0.001)and albumin(F=2,470,P<0.05)among patients of current smokers,ex-smokers with different smoking cessation time,and never-smokers.The blood WBC count in current smokers(7.7 X 109/L)was significantly higher than that in ex・smokers(7.0 X 109/L)and never-smokers(5.9 X 109/L)(t=-2.145,P<0.05;t=-6.073,P<0.01,respectively).The level of peripheral blood albumin in current smokers(41.1 g/L)was lower than that in ex・smokers(42.1 g/L)and neve—smokers(43.2 g/L)(t=2.323,P<0.05;t=3.995,P<0.01,respectively).The level of peripheral blood NLR in current smokers(3.7)was higher than that in ex-smokers(3.1)and never smokers(2.8)(t—-1.836,P<0.05;t=-2.889,P<0.01,respectively).There was no significant difference in WBC,albumin and NLR among five subgroups of different smoking cessation time.No significant difference was observed in intraoperative blood loss,30-day mortality,hospitalization costs,hospital stay,ICU stay and placement time of closed thoracic drainage tube among groups either.Conclusion Smoking increases the preoperative inflammatory indexes in peripheral blood of lung cancer patients.Smoking cessation has beneficial effect on reducing levels of these inflammatory indexes,which may be not impacted by the time length of smoking cessation.Therefore,lung cancer patients should be encouraged to quit smoking at any time.
基金partly supported by National Natural Scientific Foundation(81241121)Capital Special Foundation of Clinical Application Research(Z121107001012015)+1 种基金Capital Health Development Fund(2011400302,2016-1-4035)Beijing Natural Scientific Foundation(7131014)
文摘Objective Cigarette smoking is one of the established risk factors of atherosclerotic cardiovascular disease, however, its impact on lipids is not completely understood, especially in the Chinese population. Therefore, this study evaluated the impact of smoking status （non, former, and current smoking） on the distribution of lipoprotein subfractions in untreated patients with angina-like chest pain. Methods A total of 877 patients were consecutively enrolled and divided into nonsmoking （n = 528）, former smoking （n = 103）, and current smoking （n = 256） groups. Both low- and high-density lipoprotein cholesterol （LDL-C and HDL-C） subfractions were measured using the Quantimetrix Lipoprint System. The distributions of lipoprotein subfractions were evaluated among the groups. Results Compared with nonsmoking subjects, the current smoking group had significantly lower large/medium HDL-C （both P 〈 0.001） concentration and large HDL subfraction percentage but higher small HDL-C and medium LDL-C concentrations as well as medium LDL subfraction percentage. Importantly, former smoking subjects showed elevated levels of large HDL-C concentration, large HDL particle percentage, and mean LDL particle size and attenuation in small HDL/LDL percentages and small LDL-C concentration, but these levels did not reach the optimal status compared with those of the non-smoking group （data not shown）. Conclusion Smoking has an adverse impact on the lipoprotein subfractions, presented as lower large HDL particles besides higher small HDL and medium LDL particles, whereas smoking cessation could reverse these change to a certain degree.
基金Supported by Major Special Project of Strong-flavor Characteristic High-quality Tobacco Development of China National Tobacco Company(110201101001 TS-01)China Tobacco Project of Jilin Province(JY2013001)~~
文摘A heated air circulation standard curing barn was used for baking tobacco leaves, and the effects of different yellowing conditions during the baking process on contents of neutral aroma components and smoking quality of upper leaves were studied by setting different yellowing time and color-fixing time. The results showed that during the baking process, only by prolonging the yellowing time by 24 h on the basis of control, the content of every kind of neutral aroma components in- creased obviously and the content of solanone increased by nearly 2.20 times. It was unfavorable for the degradation and accumulation of aroma components when only prolonging color-fixing time by 24 h. Prolonging both yellowing time and color- fixing time by 24 h mainly promoted the accumulation of chlorophyll degradation product neophytadiene, which increased by 33.24%, while the degradation and ac- cumulation of some aroma components were inhibited, indicating that only prolonging the yellowing time by 24 h could promote the accumulation of various kinds of neu- tral aroma components and improve the quality of tobacco leaves. The regression models were established of neutral aroma components in the first and second prin- cipal components to total aroma content, which were y=x＋0.053 47 （R^2=0.919 7） and y=x＋0.147 5 （R^2=0.698 4）, respectively, and they were verified to be feasible.
基金Department of Clinical and Experimental Medicine of the University of Catania,No.6C813202024/1_3_02_07_01/2020。
文摘The purpose of this scoping review is to create a single narrative that describes the impact of smoking cessation on metabolic parameters in people with diabetes.It is generally well accepted that smoking enhances the harmful effects of elevated blood glucose levels,accelerating the vascular damage seen in patients with diabetes.Smoking cessation has clear benefits in terms of reducing cardiovascular morbidity and mortality.However,there is less evidence for the impact of smoking cessation on other diabetes-related complications.Studies in people with diabetes have shown improvement as well as temporary deterioration in glycemic control after ceasing smoking.Only a few studies have described the effect of quitting smoking on insulin resistance and lipid parameters,however,their results have been inconclusive.In this situation,healthcare professionals should not assume that cessation of smoking will improve metabolic parameters in patients with diabetes.It seems they should, first of all, emphasize the prevention of weight gain that may be associatedwith quitting smoking. The lack of data regarding the metabolic effects of smoking and smokingcessation in diabetes is very disappointing and this area needs to be addressed.
文摘Despite ongoing efforts to reduce tobacco smoking, the smoking prevalence in many countries has remained stable for years. This may be a consequence of either lack of knowledge about effective ways to reduce smoking, or failing treatment of tobacco addiction in healthcare. This study explored gaps in the current understanding of smoking cessation and the challenges facing tobacco addiction management in order to formulate recommendations for future research and healthcare practice. A narrative review was written to determine areas in which more research is needed as well as areas in which sufficient knowledge is already available. Recommendations for future research were prioritised using a Delphi-procedure. Recommendations for healthcare practice were confirmed by expert’s assessment. Smoking is not widely acknowledged as an addiction and a relatively small number of smokers ask help from a healthcare professional when trying to stop smoking. Most healthcare professionals recognise the importance of advising patients to stop smoking, but experience certain barriers to actually do this. Overall, healthcare professionals need to be convinced that tobacco smoking is an addiction and should be treated likewise. If all healthcare professionals systematically advise their patients to give up smoking, eventually more smokers will successfully stop smoking.
文摘To investigate factors related to resumption of smoking by women after childbirth, the smoking habits of 241 postnatal women, who initially had stopped smoking after pregnancy, in a rural city in Aomori Prefecture, Japan, were studied at 5 - 6 days, 1 month, and 12 months after childbirth. At 1 month after childbirth, only nine women had resumed smoking, but a total of 40 women had resumed smoking after 12 months. Factors related to smoking resumption after childbirth included the switching from breast feeding to bottle feeding and the influence of smoking by their spouses. Spousal smoking is an important factor in the resumption of smoking by women after childbirth.
文摘Objective： Analysis of abstinence rates of smokers per gender at 3, 6, 9 and 12 months in a Smoking Cessation Unit from January 2008 to December 2009. Methods： Descriptive retrospective study. Analysis of socio-demographic variables, smoking patterns, associated comorbidities, continuous abstinence rates, success, relapses, failure and dropping out. Results： 278 smokers started treatment （33%）; 55.4% males and 44.6% females （mean age of 48.3 and 44.06 years, respectively）. The main associated comorbidities were： psychiatric （38.7%）, cardiovascular （dyslipemia 25%） and respiratory （COPD （chronic obstructive pulmonary disease） 9.7%） in females; cardiovascular （dyslipemia 34.4%）, psychiatric （34.4%） and respiratory （COPD 19.5%） in males. VRN （Varenicline） was prescribed in 40.2% males and 32.2% females; NRT （nicotine replacement therapy） was used in 46.6% and 38.7%, respectively; bupropion was employed in 6.5% and 21.8%, respectively. Psychological counseling was offered only to 7.8% males and 8.1% females. The continuous abstinence rates in males at 3, 6, 9 and 12 months were 51.3%, 37.7%, 32.5% and 30.5%, respectively, and were 45.2%, 29.8%, 25.0% and 24.2% for females. Failure was 9.7% for females and 18.8% for males. Success was more frequent for those on VRN （n = 41 males; n = 12 females）. No relapses were indicated for 42 females and 71 males. The percentage of relapses was higher at 3 months （29.0% females, 19.5% males）. Conclusions： The study observed differences in treating abstinence between genders （in the abstinence rates and failure index）. This implies having to consider incorporating the gender variable into the diagnosis, treatment and prevention of smoking.
