smoking

Many of these injuries are preventable by taking simple steps to make your home safer and knowing what to do when a fire occurs. Most accidental home fires start from cooking, heating equipment, electrical items, or smoking materials. Never leave food unattended on the stove while cooking. Use the back burners, when possible, to keep the hot stove surface and the hot pots and pans out of young children’s reach. Keep a fire extinguisher readily available in the kitchen, and make sure all caregivers know how to use it. Place space heaters away from anything that can catch fire, and always turn them off before going to bed or leaving the room. Ensure fireplaces and wood stoves are screened so that young children are not accidentally burned. This ensures embers stay inside, too. To prevent electrical fires, cover all unused electrical outlets, avoid overloading outlets, and replace any old cords. If you smoke, avoid doing so in the home, especially in bed. Carefully dispose of smoking waste, such as cigarette butts, used matches, and ashes.

If there is a fire, a smoke alarm can warn you to leave the home early and safely. Ensure that a smoke alarm is present on each floor and near every bedroom, avoiding areas like the kitchen to prevent false alarms. Check your smoke alarms monthly and change the batteries once a year unless your alarm has long-life batteries. If you need help, the local fire department can check your fire alarms and can often provide free new ones or replacements. Families with caregivers or children with hearing impairments should use alarms that include flashing lights.

Carbon monoxide is a poisonous gas created from fuel-burning heaters, cars, generators, and appliances. Many smoke alarms are combined with carbon monoxide detectors. If your smoke alarms are not, install a separate carbon monoxide detector on each floor of your home.

A fire escape plan prepares families to understand how to safely exit each room in the home during a fire. To create a fire escape plan, draw a simple map of your home showing 2 escape routes from each room. If you live in an apartment, talk to your children about the importance of using the stairs and avoiding elevators during fires. Establish a common meeting place outside the house. Review the plan with your whole family and with caregivers, such as babysitters, so everyone knows what to do. Practice your escape plan every 6 months so everyone becomes familiar. Children younger than 5 years will need a caregiver to help them during a fire.

Author/s:

Mickey A Emmanuel, Mikhail Goldenberg, Lindsay A Thompson

What Is Atrial Fibrillation?

Erin Blanchette — Wed, 30 Apr 2025 21:32:57 +0000

Date Added:

April 30, 2025

Journal/Publication:

JAMA

Publisher:

American Medical Association

Publication Date:

April 24, 2025

URL:

What Is Atrial Fibrillation?

Type:

Patient Education Materials

Format:

Article

DOI (1):

10.1001/jama.2025.2888

Keywords

atrial fibrillation

Cardiology

Patient Information

jama Patient Information

Rhythm Disorders

PMID (1):

40272794

MeSH

myocardial infarction

hypertension

stroke

sleep apnea syndromes

Information for patients about atrial fibrillation. James W. Mold, MD, MPH

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Atrial fibrillation is an abnormal heart rhythm that can cause stroke, heart failure, heart attack, chronic kidney disease, dementia, and death.

Atrial fibrillation is classified as paroxysmal (intermittent episodes lasting 7 days or less), persistent (lasting more than 7 days), long-standing persistent (lasting more than 1 year), or permanent.1

In the US, atrial fibrillation affects about 10.55 million people and is more common among men than women. Other risk factors include older age, smoking, high blood pressure, diabetes, heart disease, high alcohol consumption, sleep apnea, an overactive thyroid gland, and possibly genetic factors.

Author/s:

Rebecca Voelker

Lateral epicondylosis

Saige Blanchard — Mon, 28 Feb 2022 06:00:00 +0000

Date Added:

February 28, 2022

Journal/Publication:

Canadian Medical Association Journal

Publisher:

CMA Impact Inc.

Publication Date:

February 22, 2022

Issue:

Volume:

194

URL:

Lateral epicondylosis

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

https://doi.org/10.1503/cmaj.211047

Keywords

Tennis Elbow

Elbow

Condition

Common Extensor Origin

MeSH

A quick and dirty summary of the diagnosis and management of tennis elbow from out Canadian colleagues. James W. Mold, MD, MPH

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Lateral epicondylosis tennis elbow is a degenerative noninflammatory condition of the common extensor origin at the lateral epicondyle of the elbow Tennis elbow has a prevalence of 1 3 peaking at age 35 50 years 1 It is associated with smoking and with a combination of repetitive and forceful manual activities 2

Author/s:

Li, Y., Liu, F., Badre, A.

Volunteering and Subsequent Health and Well-Being in Older Adults: An Outcome-Wide Longitudinal Approach

Brian Desmarais — Thu, 18 Jun 2020 18:35:18 +0000

Date Added:

June 18, 2020

Journal/Publication:

American Journal of Preventive Medicine

Publication Date:

June 5, 2020

URL:

Volunteering and Subsequent Health and Well-Being in Older Adults: An Outcome-Wide Longitudinal Approach

Type:

Clinical Research Results

Format:

Article

DOI (1):

doi: 10.1016/j.amepre.2020.03.004.

Keywords

MeSH

Personal Satisfaction

Evidence that volunteering has real health benefits. James W. Mold, MD, MPH

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ntroduction: Growing evidence documents strong associations between volunteering and favorable health and well-being outcomes. However, epidemiological studies have not evaluated whether changes in volunteering are associated with subsequent health and well-being outcomes.

Methods: Data were from 12,998 participants in the Health and Retirement Study-a large, diverse, prospective, and nationally representative cohort of U.S. adults aged >50 years. Using multiple logistic, linear, and generalized linear regression models, this study evaluated if changes in volunteering (between t0, 2006/2008 and t1, 2010/2012) were associated with 34 indicators of physical health, health behaviors, and psychosocial well-being (in t2, 2014/2016). Models adjusted for sociodemographics, physical health, health behaviors, psychosocial factors, and personality, as well as volunteering and all outcomes in the prebaseline wave (t0, 2006/2008). Results accounted for multiple testing and data were analyzed in 2019.

Results: During the 4-year follow-up period, participants who volunteered ≥100 hours/year (versus 0 hours/year) had a reduced risk of mortality and physical functioning limitations, higher physical activity, and better psychosocial outcomes (higher: positive affect, optimism, and purpose in life; lower: depressive symptoms, hopelessness, loneliness, and infrequent contact with friends). Volunteering was not associated with other physical health outcomes (diabetes, hypertension, stroke, cancer, heart disease, lung disease, arthritis, overweight/obesity, cognitive impairment, and chronic pain), health behaviors (binge drinking, smoking, and sleep problems), or psychosocial outcomes (life satisfaction, mastery, health/financial mastery, depression, negative affect, perceived constraints, and contact with other family/children).

Conclusions: With further research, volunteering is an activity that physicians might suggest to their willing and able patients as a way of simultaneously enhancing health and society.

Author/s:

Kim, E.S., Whillans, A.V., Lee, M.T., Chen, Y., VanderWeele, T.J.

Mobile phone text messaging and app-based interventions for smoking cessation

John Bayhi — Wed, 13 Nov 2019 18:55:26 +0000

Date Added:

November 13, 2019

Journal/Publication:

The Cochrane Database of Systematic Reviews

Publisher:

John Wiley & Sons, Inc.

Publication Date:

October 22, 2019

URL:

Mobile phone text messaging and app‐based interventions for smoking cessation

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1002/14651858.CD006611.pub5

Keywords

PMID (1):

31638271

MeSH

It looks like primary care practices are going to want/need to be able to send automatic text message prompts and reminders to a patient trying to quit smoking. James W. Mold, MD, MPH

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Abstract

Background

Mobile phone‐based smoking cessation support (mCessation) offers the opportunity to provide behavioural support to those who cannot or do not want face‐to‐face support. In addition, mCessation can be automated and therefore provided affordably even in resource‐poor settings. This is an update of a Cochrane Review first published in 2006, and previously updated in 2009 and 2012.

Objectives

To determine whether mobile phone‐based smoking cessation interventions increase smoking cessation rates in people who smoke.

Search methods

For this update, we searched the Cochrane Tobacco Addiction Group's Specialised Register, along with clinicaltrials.gov and the ICTRP. The date of the most recent searches was 29 October 2018.

Selection criteria

Participants were smokers of any age. Eligible interventions were those testing any type of predominantly mobile phone‐based programme (such as text messages (or smartphone app) for smoking cessation. We included randomised controlled trials with smoking cessation outcomes reported at at least six‐month follow‐up.

Data collection and analysis

We used standard methodological procedures described in the Cochrane Handbook for Systematic Reviews of Interventions. We performed both study eligibility checks and data extraction in duplicate. We performed meta‐analyses of the most stringent measures of abstinence at six months' follow‐up or longer, using a Mantel‐Haenszel random‐effects method, pooling studies with similar interventions and similar comparators to calculate risk ratios (RR) and their corresponding 95% confidence intervals (CI). We conducted analyses including all randomised (with dropouts counted as still smoking) and complete cases only.

Main results

This review includes 26 studies (33,849 participants). Overall, we judged 13 studies to be at low risk of bias, three at high risk, and the remainder at unclear risk. Settings and recruitment procedures varied across studies, but most studies were conducted in high‐income countries. There was moderate‐certainty evidence, limited by inconsistency, that automated text messaging interventions were more effective than minimal smoking cessation support (RR 1.54, 95% CI 1.19 to 2.00; I2 = 71%; 13 studies, 14,133 participants). There was also moderate‐certainty evidence, limited by imprecision, that text messaging added to other smoking cessation interventions was more effective than the other smoking cessation interventions alone (RR 1.59, 95% CI 1.09 to 2.33; I2 = 0%, 4 studies, 997 participants). Two studies comparing text messaging with other smoking cessation interventions, and three studies comparing high‐ and low‐intensity messaging, did not show significant differences between groups (RR 0.92 95% CI 0.61 to 1.40; I2 = 27%; 2 studies, 2238 participants; and RR 1.00, 95% CI 0.95 to 1.06; I2 = 0%, 3 studies, 12,985 participants, respectively) but confidence intervals were wide in the former comparison. Five studies compared a smoking cessation smartphone app with lower‐intensity smoking cessation support (either a lower‐intensity app or non‐app minimal support). We pooled the evidence and deemed it to be of very low certainty due to inconsistency and serious imprecision. It provided no evidence that smartphone apps improved the likelihood of smoking cessation (RR 1.00, 95% CI 0.66 to 1.52; I2 = 59%; 5 studies, 3079 participants). Other smartphone apps tested differed from the apps included in the analysis, as two used contingency management and one combined text messaging with an app, and so we did not pool them. Using complete case data as opposed to using data from all participants randomised did not substantially alter the findings.

Authors' conclusions

There is moderate‐certainty evidence that automated text message‐based smoking cessation interventions result in greater quit rates than minimal smoking cessation support. There is moderate‐certainty evidence of the benefit of text messaging interventions in addition to other smoking cessation support in comparison with that smoking cessation support alone. The evidence comparing smartphone apps with less intensive support was of very low certainty, and more randomised controlled trials are needed to test these interventions.

Plain Language Summary

Can programmes delivered by mobile phones help people to stop smoking?

Background

Tobacco smoking is a leading cause of preventable death. Mobile phones can be used to support people who want to quit smoking. In this review, we have focused on programmes that use text messages or smartphone apps to do so.

Search date

We searched for published and unpublished studies in October 2018.

Study characteristics

We included 26 randomised controlled studies (involving over 33,000 people) that compared smoking quit rates in people who received text messages or smartphone apps to help them quit, with people who did not receive these programmes. We were interested in studies that measured smoking for six months or longer.

Key results

We found that text messaging programmes may be effective in supporting people to quit, increasing quit rates by 50% to 60%. This was the case when they were compared to minimal support or were tested as an addition to other forms of stop‐smoking support. There was not enough evidence to determine the effect of smartphone apps.

Quality and completeness of the evidence

Most of the studies were of high quality, although three studies had high drop out rates. We are moderately confident in the results of the text messaging interventions, but there were some issues with unexplained differences between study findings and for some comparisons there was not much data. We have low confidence in the results concerning smartphone apps, and more studies are needed in this field.

Author/s:

Whittaker, R, McRobbie, H, Bullen, C, Rodgers, A, Gu, Y, Dobson, R

Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial

Brian Desmarais — Thu, 24 Oct 2019 17:04:27 +0000

Date Added:

April 3, 2020

Journal/Publication:

European Heart Journal

Publication Date:

October 22, 2019

URL:

Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1093/eurheartj/ehz754

Keywords

Perhaps once a day antihypertensives should be taken at night rather than in the AM. James W. Mold, MD, MPH

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AIMS:

The Hygia Chronotherapy Trial, conducted within the clinical primary care setting, was designed to test whether bedtime in comparison to usual upon awakening hypertension therapy exerts better cardiovascular disease (CVD) risk reduction.

METHODS AND RESULTS:

In this multicentre, controlled, prospective endpoint trial, 19 084 hypertensive patients (10 614 men/8470 women, 60.5 ± 13.7 years of age) were assigned (1:1) to ingest the entire daily dose of ≥1 hypertension medications at bedtime (n = 9552) or all of them upon awakening (n = 9532). At inclusion and at every scheduled clinic visit (at least annually) throughout follow-up, ambulatory blood pressure (ABP) monitoring was performed for 48 h. During the 6.3-year median patient follow-up, 1752 participants experienced the primary CVD outcome (CVD death, myocardial infarction, coronary revascularization, heart failure, or stroke). Patients of the bedtime, compared with the upon-waking, treatment-time regimen showed significantly lower hazard ratio-adjusted for significant influential characteristics of age, sex, type 2 diabetes, chronic kidney disease, smoking, HDL cholesterol, asleep systolic blood pressure (BP) mean, sleep-time relative systolic BP decline, and previous CVD event-of the primary CVD outcome [0.55 (95% CI 0.50-0.61), P < 0.001] and each of its single components (P < 0.001 in all cases), i.e. CVD death [0.44 (0.34-0.56)], myocardial infarction [0.66 (0.52-0.84)], coronary revascularization [0.60 (0.47-0.75)], heart failure [0.58 (0.49-0.70)], and stroke [0.51 (0.41-0.63)].

CONCLUSION:

Routine ingestion by hypertensive patients of ≥1 prescribed BP-lowering medications at bedtime, as opposed to upon waking, results in improved ABP control (significantly enhanced decrease in asleep BP and increased sleep-time relative BP decline, i.e. BP dipping) and, most importantly, markedly diminished occurrence of major CVD events.

TRIAL REGISTRATION:

ClinicalTrials.gov, number NCT00741585.

Author/s:

Hermida, R.C., Crespo, J.J., Domínguez-Sardiña, M, Otero, A., Moyá, A., Ríos, M.T., Sineiro, E., Castiñeira, M.C., Callejas, P.A., Pousa, L., Salgado, J.L., Durán, C., Sánchez, J.J., Fernández, J.R., Mojón, A., Ayala, D.E., Hygia Project Investigators

Health Benefits of Smoking Cessation

Jeffrey Wilson — Sat, 16 Feb 2019 22:50:25 +0000

Date Added:

February 16, 2019

Journal/Publication:

Tobacco Free Initiative

Publisher:

World Health Organization

URL:

Fact sheet about health benefits of smoking cessation

Type:

Patient Education Materials

Format:

Article

Keywords

MeSH

A nice fact sheet from the WHO to encourage your patients to quit smoking.

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There are immediate and long-term health benefits of quitting for all smokers.

Beneficial health changes that take place:

Within 20 minutes, your heart rate and blood pressure drop.
12 hours, the carbon monoxide level in your blood drops to normal.
2-12 weeks, your circulation improves and your lung function increases.
1-9 months, coughing and shortness of breath decrease.
1 year, your risk of coronary heart disease is about half that of a smoker's.
5 years, your stroke risk is reduced to that of a nonsmoker 5 to 15 years after quitting.
10 years, your risk of lung cancer falls to about half that of a smoker and your risk of cancer of the mouth, throat, esophagus, bladder, cervix, and pancreas decreases.
15 years, the risk of coronary heart disease is that of a nonsmoker's.

Author/s:

World Health Organization

A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy

Tracy Ashby — Fri, 15 Feb 2019 06:00:00 +0000

Date Added:

February 15, 2019

Journal/Publication:

New England Journal of Medicine

Publisher:

Massachusetts Medical Society

Publication Date:

February 14, 2019

Issue:

Volume:

380

URL:

A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1056/NEJMoa1808779

Keywords

e-cigarettes

smoking

nicotine

PMID (1):

30699054

MeSH

electronic nicotine delivery systems

smoking

smoking cessation

nicotine

In this RCT conducted in England, e-cigarettes were twice as likely as nicotine replacement products to result in abstinence from regular cigarettes at 1 year.

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BACKGROUND

E-cigarettes are commonly used in attempts to stop smoking, but evidence is limited regarding their effectiveness as compared with that of nicotine products approved as smoking-cessation treatments.

METHODS

We randomly assigned adults attending U.K. National Health Service stop-smoking services to either nicotine-replacement products of their choice, including product combinations, provided for up to 3 months, or an e-cigarette starter pack (a second-generation refillable e-cigarette with one bottle of nicotine e-liquid [18 mg per milliliter]), with a recommendation to purchase further e-liquids of the flavor and strength of their choice. Treatment included weekly behavioral support for at least 4 weeks. The primary outcome was sustained abstinence for 1 year, which was validated biochemically at the final visit. Participants who were lost to follow-up or did not provide biochemical validation were considered to not be abstinent. Secondary outcomes included participant-reported treatment usage and respiratory symptoms.

RESULTS

A total of 886 participants underwent randomization. The 1-year abstinence rate was 18.0% in the e-cigarette group, as compared with 9.9% in the nicotine-replacement group (relative risk, 1.83; 95% confidence interval [CI], 1.30 to 2.58; P<0.001). Among participants with 1-year abstinence, those in the e-cigarette group were more likely than those in the nicotine-replacement group to use their assigned product at 52 weeks (80% [63 of 79 participants] vs. 9% [4 of 44 participants]). Overall, throat or mouth irritation was reported more frequently in the e-cigarette group (65.3%, vs. 51.2% in the nicotine-replacement group) and nausea more frequently in the nicotine-replacement group (37.9%, vs. 31.3% in the e-cigarette group). The e-cigarette group reported greater declines in the incidence of cough and phlegm production from baseline to 52 weeks than did the nicotine-replacement group (relative risk for cough, 0.8; 95% CI, 0.6 to 0.9; relative risk for phlegm, 0.7; 95% CI, 0.6 to 0.9). There were no significant between-group differences in the incidence of wheezing or shortness of breath.

CONCLUSIONS

E-cigarettes were more effective for smoking cessation than nicotine-replacement therapy, when both products were accompanied by behavioral support. (Funded by the National Institute for Health Research and Cancer Research UK; Current Controlled Trials number, ISRCTN60477608.)

Author/s:

Hajek, Peter, Phillips-Waller, Anna, Przulj, Dunja, Pesola, Francesca, Smith, Katie Myers, Bisal, Natalie, Li, Jinshuo, Parrott, Steve, Sasieni, Peter, Dawkins, Lynne, Ross, Louise, Goniewicz, Maciej, Wu, Qi, McRobbie, Hayden J.

Smoking Cessation in Primary Care

Jeffrey Wilson — Wed, 05 Sep 2018 15:07:18 +0000

Date Added:

September 5, 2018

Journal/Publication:

Healthy Hearts for Oklahoma

Publisher:

Agency for Healthcare Quality and Research

Type:

Clinical Decision Aids

Format:

Slides

Keywords

smoking cessation

clinical decision aid

MeSH

smoking

smoking cessation

This is the smoking cessation decision aid developed for the Healthy Hearts for OK Project.

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Choose a treatment plan that fits the patient.

A comprehensive approach to cessation is more successful than any one mode of therapy. For patients ready to commit to quitting, use both behavioral interventions and pharmacologic therapy. Good evidence suggests that each of the following pharmacotherapies can effectively support smoking cessation, unless contraindications are present:

• Nicotine replacement therapy (gum, lozenges, patches, inhalers, and nasal spray)

• Bupropion (a norepinephrine/dopamine reuptake inhibitor and nicotinic acetylcholine receptor antagonist)

• Varenicline (a partial agonist of the alpha-4/beta-2 nicotinic acetylcholine receptor)

Author/s:

Braun, Stephen, Block, Jason, Fischer, MIchael, Mather, Arielle