Biomedical subjects

U John

Publications and source records attributed to U John.

At least 19 recordsLinked to original sources

PubMed2007

Alcohol screening in general practices using the AUDIT: how many response categories are necessary?

AIMS: The Alcohol Use Disorders Identification Test (AUDIT) is a common screening instrument. This study analyses if response categories of the AUDIT might be dichotomized without affecting the psychometric properties of the questionnaire. METHODS: Participants between 18 and 65 years were recruited from general practices in two northern German cities. In total, 10,803 screenings were conducted (refusal rate: 5.9%). For those who were screened positive, the Munich-Composite International Diagnostic Interview (M-CIDI) was used for identification of 12-month Alcohol Use Disorders and at-risk consumption (exceeding 20/30 g per day). Abstinent subjects and screening positives without diagnostic interview were excluded from the analysis, leaving a sample of 7,112 subjects. ROC-Curves were calculated separately for each item in order to identify an optimal cut-off value. Finally, a version of the AUDIT based on dichotomized items was compared to the original version and its short-form, the AUDIT version based on three questions dealing with consumption AUDIT-C. RESULTS: As an optimal cut-off value for items on consumption, drinking at least once a week, having more than 1-2 drinks per occasion, and drinking 6 or more drinks in one sitting at least once a month were identified. For all questions on alcohol-related problems or dependence symptoms, having 'ever occurred' differed best between subjects with and without Alcohol Use Disorders or at-risk consumption. Sensitivity and specificity of the dichotomized version of the AUDIT did not differ from the original version, and both full versions performed superior compared to the AUDIT-C. CONCLUSION: Data indicate that the AUDIT response categories may be dichotomized without affecting its validity.

Adolescent↗

PubMed2006

Smoking status, obesity and hypertension in a general population sample: a cross-sectional study.

BACKGROUND: In some studies, hypertension is more common in never and former smokers than in current smokers. AIM: To examine the associations between hypertension and smoking status, when divided into subgroups by overweight and obesity. DESIGN: Cross-sectional study. METHODS: We used data from a national health survey with a probability sample of the national population of Germany aged 18 to 79 (n = 6903 with complete data). Smoking status data were collected via questionnaire. Obesity and overweight were assessed by body mass index, hypertension by blood pressure measurement and by participants' statements about antihypertensive treatment. Analyses were adjusted for gender, age, history of coronary artery disease, serum cholesterol levels, alcohol drinking, exercise, and education. RESULTS: Obese former smokers who were abstinent for 3 or more years had an adjusted odds ratio (OR) 3.6 (95% confidence interval, CI 2.3-5.7) for mild hypertension (> or =140 mmHg systolic or > or =90 mmHg diastolic blood pressure) and an adjusted OR 6.5 (95%CI 3.6-11.8) for moderate or severe hypertension (> or =160 mmHg systolic or > or =100 mmHg diastolic). Normal weight never or former smokers did not differ from normal weight current smokers smoking > or =15 cigarettes/day with regard to likelihood of hypertension (normal weight never smokers, OR 1.1, 95%CI 0.8-1.5; normal weight former smokers, abstinent 3 or more years, OR 0.8, 95%CI 0.5-1.3). DISCUSSION: In this nationally representative sample, never or former smoking was unrelated to hypertension among normal weight individuals.

Adolescent↗

PubMed2006

Association between cardiac disorders and a decades-previous history of diphtheria.

A long, prior history of diphtheria is common among middle-aged and elder European adults. The aim of the present study was to determine whether the risk of reduced ventricular function and impaired intraventricular conduction is increased in individuals with a history of diphtheria. A study population of 2,480 subjects (1,222 women) aged 45 years or older who were recruited for the Study of Health in Pomerania were available for the present analyses. Left ventricular function was assessed by echocardiography. Intraventricular conduction blocks were diagnosed using electrocardiograms. Multivariable analyses revealed that individuals with a history of diphtheria had neither an increased odds for reduced fractional shortening (OR 1.21, 95% CI 0.69-2.11; p=0.51) nor an increased odds for intraventricular conduction blocks (OR 0.90, 95% CI 0.55-1.46; p=0.67). However, regression models revealed two-way interactions between the exposure variable and hypertension with respect to both endpoints. A history of diphtheria increased the odds for both endpoints in normotensive but not in hypertensive individuals. The findings show that a history of diphtheria several decades previously in a patient is a risk marker for reduced cardiac function and impaired intraventricular conduction in individuals at low risk for these disorders.

Adult↗

PubMed2006

Validity of overweight and obesity in a nation based on self-report versus measurement device data.

OBJECTIVE: To analyze overweight and obesity in a nation by self-report (SR) data and by data about the target person provided via other household members compared to measurement devices (MD). The magnitude of hypothesized under-reporting by the SR data should be estimated with adjustment for age, gender, and education. DESIGN: Two cross-sectional studies, nationally representative health examination surveys (response rates: 61.4 and 73.2%, respectively). SETTING: Adult general population of Germany aged 20-79 years. SUBJECTS: Sample 1 included 6806 residents. Samples 2 (n=98 673) and 3 (n=34 960) included residents in the second survey. MEASUREMENTS: In sample 1 MD data were collected, in sample 2 SR data were collected, and in sample 3 body weight and height information was provided from another household member living together with the target person. RESULTS: MD data revealed higher proportions of overweight and obesity compared to SR. Among women with body mass index (BMI) 35.00 or higher, the odds ratio (OR) was 3.9 (95% confidence interval, CI, 3.2-4.7), and among men 2.8 (CI, 2.2-3.6) for MD versus SR. Data from other household members also revealed higher proportions of overweight and obesity than SR (OR for BMI 35.00 or higher 2.1, CI, 1.7-2.5, for data from other household members versus SR in women and OR 1.3, CI, 1.1-1.5, in men). CONCLUSIONS: MD data should be used when providing proportions of overweight and obesity in a nation such as Germany.

Adult↗

PubMed2006

[Why woman postpartum resume smoking].

BACKGROUND: Following a successful period of nicotine abstinence during pregnancy approximately 50% of all women relapse to smoking during the 6 months after delivery. About 34% of all children are exposed to environmental tobacco smoke due to maternal smoking. The objectives of this study are: (a) which women postpartum intend to start smoking again, (b) how does the intention to resume smoking influence the smoking status after 6 months and (c) what are the individual reasons to start smoking again. METHOD: Four weeks after giving birth (T0) sociodemographic variables, smoking behaviour before pregnancy and the intention to resume smoking were assessed in a sample of 301 women who stopped smoking before or during pregnancy. Six months after giving birth (T1) 285 women answered questions regarding their smoking behaviour and reasons for relapse. RESULTS: After giving birth 13% of the women intended to start smoking again. There was no statistical difference between women intending to start and women not intending to start smoking again with regard to sociodemography and smoking behaviour (p > 0.05). Six months later of these significantly more women smoked compared to the women without intention to resume smoking (68% vs. 27%, chi2 = 23.6; df = 1, p < 0.05, OR = 5.5). Individual reasons to resume smoking were reported by 50 % of the women, stress being the most frequent reason. DISCUSSION: At least one of ten women who were abstinent during the course of their pregnancy intends to start smoking again. They do not differ from women not intending to resume smoking. The intention to resume smoking has a predictive value for an early relapse, but also every fourth woman without intention resumes smoking. Just half of the women report a personal reason for relapsing. The results underline the need for proactive interventions for relapse prevention.

Adult↗

PubMed2006

[Characteristics of risk groups with an insufficient demand for dental services - results of the study of health in Pomerania (SHIP)].

AIM: The purpose of this study was to identify risk groups for low dental care utilisation and to highlight adequate determinants for necessary action. METHODS: The database was the "Study of Health in Pomerania" (SHIP), a cross-sectional sample drawn from the adult population (20 - 79 years) in a northeast region of Germany. 4310 of 7008 randomly selected inhabitants participated in the examinations (response rate 68.8 %). The use of dental care in the last year was analysed using logistic regression according to the conceptual model by Andersen and Newman. RESULTS: Multivariate analysis revealed that participation in the bonus scheme system of the statutory sickness funds (OR = 8.2) and participation in the bonus system of the private health insurance companies (OR = 2.6) as "enabling resources" predicted dental care use in the last year. "Objektive need" (OR = 1.02) is weaker associated with dental care utilisation than "subjective need", for instance the attitude towards need of regular dental checkups. Presence of own teeth is a significant predictor for dental care utilization (OR = 3.3), whereas edentulous persons, those with complete denture prosthesis, don't think about possible oral problems and don't visit the dentist at least once a year. Among "predisposing factors" only gender and education were significant determinats for dental care utilization. CONCLUSIONS: The conclusions concerning the significant influence of subjective need and promotional impact of the bonus scheme are important for health care. Financial incentives and motivation for regular prevention should be continued and upgraded. Measures to improve preventive dental care utilization should focus on persons with low educational levels and on men with inadequate dental care utilisation. The mental anchorage of the term "oral health" rather than the conventional term "dental health" is important, so that edentulous persons become conscious of regular prevention pointers to maintain a high quality of life.

Adult↗

PubMed2006

[General hospital patients with alcohol problems welcome counselling].

AIMS: The aim of this study was to determine predictors for openness to alcohol-related counselling among general hospital patients with alcohol problems. We wanted to test whether those with less severe alcohol problems and those with a lack of motivation for behaviour charge or with a lack of motivation to seek help would agree to participate in alcohol-related counselling. METHOD: A total of 1150 hospital patients with alcohol dependence, alcohol abuse, at-risk drinking or excessive drinking were interviewed. They were asked about their attitude towards alcohol-related counselling, about their motivation to change their drinking and about their motivation to seek professional help. A multi-variable logistic regression analysis was calculated to determine predictors for agreement to counselling. RESULTS: A total of 66 % of all participants agreed to receive information on professional help and on how they could help themselves. Among these were 77 % of the alcohol dependent participants and 56 % of the non-dependent participants. Motivation to change and motivation to seek help were identified as the most significant predictors for agreement to counselling. However, 63 % of the participants open for counselling were not yet ready to change their habits and 62 % were not yet ready to seek profession help. CONCLUSION: The majority of hospital patients with less severe alcohol problems as well as the majority of hospital patients not ready to seek more intensive professional help were open for alcohol-related counselling. Given a systematic screening, this opens up the opportunity for addiction counsellors, hospital physicians or nurses to actively offer counselling.

Adolescent↗

PubMed2006

Inverse association between periodontitis and respiratory allergies.

BACKGROUND: Periodontitis is an infection with systemic effects and a high prevalence among adults. In the aetiology of allergic diseases the hygiene hypothesis claims that infections in early infancy may protect against allergic diseases. OBJECTIVE: The aim of the present analyses was to investigate the independent relation between periodontitis and respiratory allergies such as hayfever, house dust mite (HDM) allergy and asthma. METHODS: From the Study of Health in Pomerania (SHIP) a total number of 2837 subjects aged 20 to 59 years were included in the analysis. In our study population 326, 111 and 114 subjects were classified as suffering from hayfever, HDM allergy or asthma, respectively. The attachment loss (AL) were measured. Periodontitis was defined according to the percentage of surfaces which exceeded 3 mm AL [healthy: 0-7.7%, mild: 7.8-28.6%, moderate: 28.7-63.9%, severe: >63.9%]. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression. RESULTS: After adjustment for confounding factors these analyses revealed inverse associations between periodontitis and hayfever as well as periodontitis and HDM allergy. For increasing AL, a trend of decreasing risk could be observed for hayfever (healthy: reference; mild AL: OR 0.87 [95%-CI 0.6-1.2]; moderate AL: OR 0.80 [95% CI 0.6-1.2]; server AL: OR 0.53 [95% CI 0.3-0.9]; P(trend)=0.01) and for HDM allergy (healthy: reference; mild AL: OR 0.80 [95% CI 0.5-1.3]; moderate AL: OR 0.64 [95% CI 0.3-1.2]; server AL: OR 0.39 [95% CI 0.2-0.9]; P(trend)=0.02). Furthermore, for asthma were observed a slightly inverse association in the full-adjusted model (healthy: reference; mild AL: OR 1.10 [95% CI 0.6-2.0]; moderate AL: OR 0.96 [95% CI 0.5-1.8]; server AL: OR 0.48 [95% CI 0.2-1.0]; P(trend)=0.11). CONCLUSION: There is an inverse association between periodontitis and respiratory allergies. Our results might support the hygiene hypothesis.

Adult↗

PubMed2006

Epidemiological evaluation of the multifactorial aetiology of abfractions.

The purpose of this study was to determine risk indicators for the aetiology of abfractions (cervical wedge-shaped defects) on teeth using dental and medical variables obtained in a population-based sample of the cross-sectional epidemiological 'Study of Health in Pomerania' (SHIP). Medical history, dental, and sociodemographic parameters of 2707 representatively selected subjects 20-59 years of age with more than four natural teeth were checked for associations with the occurrence of abfractions using a two-level logistic regression model on a tooth and a subject level. The estimated prevalence of developing abfractions generally increased with age. The following independent variables were associated with the occurrence of abfractions: buccal recession of the gingiva, odds ratio (OR) = 6.7; occlusal wear facets of scores 1, 2 and 3, OR = 1.5, 1.9, 1.9; tilted teeth, OR = 1.4; inlays, OR = 1.6; toothbrushing behaviour, OR = 1.9 to 2.0 (two and three times a day versus once a day). First premolars had the highest estimated risk for developing abfractions, followed by the second premolars. Maxillary and mandibular teeth behaved similarly in terms of abfractions, with the exception of mandibular canines, which had a much lower estimated risk of incurring abfractions than did maxillary canines. The results of this analysis indicated that abfractions are associated with occlusal factors, like occlusal wear, inlay restorations, altered tooth position and tooth brushing behaviour. This study delivers further evidence for a multifactorial aetiology of abfractions.

Adult↗

PubMed2006

Susceptibility to diphtheria in adults: prevalence and relationship to gender and social variables.

Recent outbreaks of diphtheria have drawn attention to the re-emergence of this disease. This study investigated susceptibility to diphtheria in north-east Germany and its relationship to gender and social factors. A study population of 4275 individuals recruited for the population-based Study of Health in Pomerania (SHIP) was available for analysis. IgG antibodies against diphtheria toxin were determined by ELISA and were used to define susceptibility to diphtheria (i.e., IgG titres < 0.1 IU/mL). The prevalence of susceptibility to diphtheria was 32.4%. Multivariate analysis revealed 45% increased odds of women being susceptible to diphtheria. Women who had not received diphtheria toxoid vaccination during the previous 10 years had four-fold increased odds of being susceptible to diphtheria toxin compared with unvaccinated men. None of the social factors investigated was associated with susceptibility status. It was concluded that a high proportion of middle-aged adults was susceptible to diphtheria. Women lacked seroprotection more often than men, which might be explained, in part, by gender-specific immune responses following vaccination. There is a need for information campaigns to improve public awareness of these problems.

Adult↗

PubMed2006

Evaluation of single nucleotide polymorphisms in the phosphodiesterase 4D gene (PDE4D) and their association with ischaemic stroke in a large German cohort.

Genetic fine mapping of the first locus identified for genetically complex forms of stroke, STRK1 (which has been mapped to chromosome 5q12 in Icelandic families), has identified the phosphodiesterase 4D gene (PDE4D) gene as a good candidate gene. Association analysis of single nucleotide polymorphisms (SNPs) in the PDE4D gene in an Icelandic stroke cohort demonstrated genetic association between six SNPs in the 5' region of PDE4D and ischaemic stroke. The present study aimed to test whether the same six SNPs in PDE4D were also associated with stroke in a large stroke cohort from northern Germany (stroke patients with acute completed ischaemic stroke: n = 1181; population based controls: n = 1569). None of the six SNPs showed significant association with ischaemic stroke in the whole stroke sample before and after adjustment for conventional stroke risk factors (age, sex, hypertension, diabetes, and hypercholesterolaemia). Haplotype analysis did also not reveal any significant association. Marginally positive statistical measures of association in the subgroup with cardioembolic stroke did not remain significant after correction for multiple testing. In conclusion, this study was unable to demonstrate an association between the six SNPs which had showed significant single marker association with stroke in the Icelandic stroke cohort and ischaemic stroke in a large German cohort.

3',5'-Cyclic-AMP Phosphodiesterases↗

PubMed2006

Associations of perceived work strain with nicotine dependence in a community sample.

BACKGROUND: Little is known about work strain and smoking, and even less about work strain and nicotine dependence. AIM: To investigate the relations of perceived work strain with nicotine dependence among an adult general population sample. METHOD: Cross sectional survey with a probability sample of residents of a northern German area with 4075 participants, aged 18-64 years (participation rate 70.2%). The current study is based on 2549 participants who were working 15 or more hours per week. Face to face at-home computer aided interviews (World Health Organization Composite International Diagnostic Interview) were carried out. Work strain, defined as high work demand and low work control, was assessed with a questionnaire. Nicotine dependence was diagnosed according to the Diagnostic and Statistical Manual (DSM-IV) of the American Psychiatric Association. In addition, the Fagerström Test for Nicotine Dependence (FTND) was used. RESULTS: Subjects with work strain had an odds ratio of 1.6 (95% CI 1.2 to 2.3) for nicotine dependence compared to those who had no work strain. In a general linear model, higher work strain was associated with a stronger relation between work demand and work control and the FTND. The findings were adjusted for alcohol use disorders, occupational status, age, and sex. CONCLUSION: Perceived work strain is related to nicotine dependence in this general adult population.

Adolescent↗

PubMed2005

Post-partum intention to resume smoking.

Little is known about the motivational background of smoking after a period of nicotine abstinence during pregnancy. The study examines the intention to resume smoking (IRS) in the post-partum period and its predictive value for smoking within 12 months post-partum. In a sample of 301 women recruited from obstetric wards who reported having stopped smoking during pregnancy, data on IRS, sociodemographic variables, recent smoking behaviour and smoking in the social network were collected. Smoking status was assessed 6 and 12 months after pregnancy. Among all formerly smoking women, 39 (13%) intended to resume smoking and 262 (87%) intended to maintain abstinence. Women with IRS returned to smoking more often than women without IRS [77 versus 45%, odds ratio (OR) = 4.1, 95% confidence interval (CI): 1.89-9.05]. In a logistic regression model, IRS (OR = 3.7, 95% CI: 1.51-9.01) and number of months currently abstinent (OR = 0.9, 95% CI: 0.76-0.96) attained statistical significance. IRS proved to be the main predictor for relapse; yet, women with no IRS are at risk to restart smoking again, too. IRS offers a cue for tailoring interventions.

Adult↗

PubMed2005

Gynaecological health care utilization and use of sex hormones--the study of Health in Pomerania.

BACKGROUND: In Germany, there is a lack of population-based data related to the use of gynaecological health care services. The objectives of our analyses utilizing a population-based cross-sectional survey conducted in one geographically defined area [Study of Health in Pomerania (SHIP)] are to assess the prevalences of: (i) attendance of gynaecological outpatient facilities and of (cervical) cancer screening; (ii) gynaecological and breast surgery; (iii) use of oral contraceptives (OC) and menopausal hormone therapy (MHT). METHODS: We analysed socio-demographic factors, reproductive history, gynaecological service utilization, and use of sex hormones in 2186 women aged 20-79 years. We used standard statistics and sex- and age group-specific weighting factors to reflect characteristics of the population of Western Pomerania. RESULTS: Approximately 43% of women reported surgical procedures. Participation in cancer screening at least once was reported by 78% of women (lifetime prevalence). Two-thirds of women stated ever use of OC, 28% (aged >40 years) ever use of MHT. CONCLUSIONS: Women in Western Pomerania reported a high life-time use of both OC and MHT. The use of cervical cancer screening exceeded the national average. Women had an almost 50% risk of undergoing gynaecological, breast or obstetric surgery. The high use of MHT and surgical procedures calls for efforts regarding continuing medical education and health care policy actions.

Adult↗

PubMed2005

[Exposure to tobacco smoke (passive smoking) in the home and inpatient treatment of children under the age of 5 years in Germany].

BACKGROUND AND OBJECTIVE: Exposure to environmental tobacco smoke (ETS) poses an impact on the health of the newborns and infants. In Germany research about the tobacco-attributable morbidity and mortality has been conducted to a very small extent. This analysis examines all data from 16 federal states in regard to number and duration of hospitalization of children exposed to ETS up to 5 years of age. MATERIAL AND METHODS: Integration of two different data sets: (a) national data (number of households with children younger than 5 years exposed to a current smoker) with (b) hospital statistics (number and duration of hospitalisations by diagnoses) for all 16 federal states. Relative risks for tobacco-attributable diseases were taken from current research. RESULTS: In Germany the rate for tobacco-attributable hospitalisations of children between 0 and < 5 years range from 1.6 % to 3.8 % between states. Between 22.0 % and 27.1 % of all hospitalisations with the diagnosis of otitis media or respiratory diseases are attributable to passive smoking. CONCLUSION: Tobacco-attributable hospitalisations pose a serious but preventable problem for the health care system.

Asthma↗

PubMed2005

Effects of item sequence on the performance of the AUDIT in general practices.

BACKGROUND: One important task in identifying subjects with alcohol use disorders (AUDs) in the general medical practice setting is the development of effective screening instruments. Sensitivity of screening questionnaires might differ according to the introductory items. This study compares two versions of the alcohol use disorders identification test (AUDIT) with varied item sequence randomly applied to patients derived from a sample of general practitioners (GP) patients. METHODS: Participants were recruited from general practices in two northern German cities; they received two different versions of the AUDIT, one group receiving the original version starting with three items addressing frequency and quantity of alcohol use (AUDIT1), and a second group receiving a version in which these items were put at the end of the questionnaire (AUDIT2). In total, 10.803 screenings were conducted (refusal rate: 5%). Alcohol use disorders were diagnosed using the Munich-Composite International Diagnostic Interview (M-CIDI). RESULTS: Logistic regression analysis revealed that AUDIT1 subjects had higher scores in the consumption items of the AUDIT, whereas AUDIT2 subjects scored higher on items focussing on symptoms of alcohol dependence or abuse. CONCLUSION: The sequence upon which items of the AUDIT are presented influences the report of drinking patterns and symptoms of alcohol use disorders in GP patients.

Adolescent↗

PubMed2005

Two-hour postdose concentration: a reliable marker for cyclosporine exposure in adolescents with stable renal transplants.

In pediatric renal transplant recipients, most patients receive maintenance treatment with cyclosporine (CsA) and mycophenolate mofetil (MMF). Until now, the 2-hour postdose CsA target level for combined maintenance treatment with MMF has not been defined. This prospective pilot study evaluated the pharmacokinetics of CsA under the influence of MMF to determine a reliable single CsA concentration time that correlates with the area under the curve (AUC(0-6h)) estimates for adolescents who were additionally treated with MMF during the late posttransplant period. The study included 13 adolescents (mean posttransplantation time, 3.5 +/- 2.55 years) with stable renal transplant function (S-Crea 121 +/- 40 micromol/L). CsA pharmacokinetic absorption profiles over a 6-hour dose interval (n = 26) were evaluated for the optimal single peak concentration using the CsA concentrations predose (C0) and at 1, 2, 3, 4, and 6 hours postdose (C1-6). Whereas C2 (mean 743.2 +/- 221.8 ng/mL) was the single point with the closest correlation to AUC(0-6h) (r2 = 0.86; P < .001), C0 (mean 120.5 +/- 35.2 ng/mL) showed the weakest correlation (r2 = 0.61, P = .002). C2 appears to be an accurate predictor of CsA exposure in adolescent kidney transplant recipients under maintenance immunosuppression in combination with MMF. Average values achieved with current dosing practices cluster around the target C2 ranges recommended for adults. The data provide a foundation for initiation of prospective clinical trials to assess the long-term risk for chronic allograft dysfunction among pediatric stable renal transplant patients in combination protocols.

Adolescent↗

PubMed2005

Smoking status, cigarettes per day, and their relationship to overweight and obesity among former and current smokers in a national adult general population sample.

BACKGROUND: Weight gain after smoking cessation is perceived to be a barrier against quitting smoking. The goal was to analyze overweight and obesity depending on smoking status and number of cigarettes per day (cpd) among former and current smokers. METHODS: The sample included 7124 residents of Germany aged 18-79 y from a national health examination survey (participation rate: 61.4%). Body weight and height were objectively measured; smoking status and cpd were assessed by a questionnaire administered in a health examination center. RESULTS: The number of cpd was positively related to being overweight and more so to obesity among former smoking men, but not women. The results were adjusted for age, school education, exercise and alcohol consumption. Men who formerly had smoked more than 30 cpd had an adjusted odds ratio (OR) of 5.0 for obesity compared to men who had never smoked. CONCLUSION: With an increasing number of cpd more psychological and physiological processes of compensation of nicotine supply after smoking cessation may be expected. Male smokers should be provided with information on how to prevent weight gain after smoking cessation. To foster smoking cessation, female smokers should be informed that women who stop smoking manage to have no increase in the rates of overweight or obesity when considered at the general population level.

Adolescent↗