|
Rassegna Stampa Scientifica Agosto 2024
|
"Introduced as battery-powered sticks that emit nicotine-infused vapor, vape pens have transformed into increasingly sophisticated entertainment devices. And that, researchers say, is a potentially huge problem. Disposable vapes gained small illuminated displays last year, typically to show how much battery life remained. In about six months, though, the displays grew to the size of a flip phone screen and came equipped with retro games similar to Pac-Man and Tetris — on a product that costs less than $20. The speed at which vapes advanced to include an interactive display, as well as the devices’ potential appeal to young people, is raising concerns about nicotine addiction among teenagers, say UC Riverside researchers Man Wong and Prue Talbot…
"The catalyst for this new generation of vapes, Wong said, was Geek Bar Pulse, a vape that had the first full-length screen... Researchers still aren’t sure what the health effects of vapes are. In the absence of clear guidance, users will generally assume the devices are not as bad as cigarettes “because they don’t have as many chemicals,” Talbot said. In truth, she said, vapes and e-cigarettes “have different chemicals, and some of those chemicals are toxic, and we don’t know exactly what the long-term effects are.”" [Karen Garcia. ‘Smart vapes’ featuring video games could lure youths to nicotine addiction, UC Riverside experts say, LA Times]
"Thousands of teachers from across England are warning that vaping in schools is causing widespread issues with children's behaviour and health. Teaching union NASUWT [National Association of Schoolmasters Union of Women Teachers] commissioned a survey of 4,000 teachers - and more than 85% of them warned vaping on school premises is causing problems. It comes as a Bath Professor who tested vapes in 30 schools in England found Spice and THC present in vapes in 25 of those schools. He is now fearful a child will die this summer holiday because their vape is unknowingly laced with Spice." [No author. Vapes in schools: The scale of the issue revealed with kids as young as five vaping, ITV; See also: ‘We’re going to see a death’ - stark warning as vapes spiked with Spice in England's schools, ITV]
"British American Tobacco (BAT) shares rose almost 3% in early Thursday [July 25] trade as it beat first-half profit forecasts and investors latched on to some positives at its key U.S. business. The maker of Lucky Strike and Dunhill cigarettes made over 40% of its revenues in the United States in 2023, mostly from tobacco, though it is also trying to grow income from smoking alternatives. But the company has struggled in this key market as under-pressure consumers have been swapping from its more expensive cigarette brands to cheaper alternatives or e-cigarettes. BAT's e-cigarettes have lost share to a flood of illegal disposable vapes." [Emma Rumney. BAT shares climb as first-half results fuel US optimism, Reuters ; See also: BAT Warns New Products Are Unlikely to Make £5 Billion in 2025, Bloomberg News]
"When I set out to write a medical memoir chronicling my seven-year battle with lung cancer, I wanted to provide a road map and reassurance for fellow sufferers, whether at the moment of diagnosis or while undergoing treatment… I soon realized that I would have to include the whole truth if I hoped to save anyone other than myself. My three primary cancers were very likely the result of a thirty-year history of cigarette smoking… What is the source of my reluctance to include the information? Stigma… For many people, it seems easier to empathize with someone who is ill through no apparent fault of their own. However, all afflicted individuals need our compassion and support to make the lifestyle changes or treatment choices necessary to alter their health outcomes." [Jan Pezarro. My Ten-Year-Old Daughter Tried to Warn Me, but Nothing Prepared Me for My Diagnosis, Newsweek]
"In 2017, tobacco companies spent around $1 million every hour to promote cigarettes and smokeless tobacco in the US. That same year, they were also mandated to sponsor and disseminate Federal court ordered Corrective Statements (CSs) advertisements in outlets such as newspapers and major television networks. Thus, it is crucial to monitor the marketing activities of the tobacco industry to bolster effective tobacco control efforts… Between 2009 and 2018, the total adjusted cigarette marketing expenditures exhibited no significant changes… In response to marketing regulations, tobacco companies shifted their funds to less regulated channels. In 2018, a significant portion of promotional expenditures were directed toward various price discounts, which could potentially expose vulnerable children and youths to cigarette marketing."
Comparative analysis of tobacco industry cigarette marketing expenditures in the United States, 2009–2018
Humanities and Social Sciences Communications volume 11, Article number: 957 (2024)
Published: 26 July 2024
Shaikha AlDukhail & Israel T. Agaku
https://www.nature.com/articles/s41599-024-03445-z
Note: Open Access.
"In 2022, the majority of the 28.8 million U.S. adults who smoked cigarettes wanted to quit, approximately one half tried to quit, but fewer than 10% were successful. Fewer than 40% of adults who smoked used treatment (counseling or medication) when trying to quit; one half received clinician advice or assistance to quit. Compared with adults who smoked nonmenthol cigarettes, those who smoked menthol cigarettes had similarly low quit success despite a higher quit attempt prevalence, potentially related to their lower treatment use."
Adult Smoking Cessation — United States, 2022
MMWR Weekly / July 25, 2024 / 73(29);633–641
Brenna VanFrank, Ann Malarcher, Monica E. Cornelius, Anna Schecter. Ahmed Jamal, Michael Tynan
https://www.cdc.gov/mmwr/volumes/73/wr/mm7329a1.htm
https://www.cdc.gov/mmwr/volumes/73/wr/pdfs/mm7329-H.pdf
Note: Open Access.
Related coverage:
Study finds that despite wanting to quit, only 8.8 percent quit smoking in 2022
https://medicalxpress.com/news/2024-07-percent.html#google_vignette
"We compared cigarette smoking and use of electronic cigarettes (vaping) among 4,975 cases with lung cancer to 27,294 control subjects without cancer… We found that vaping combined with cigarette smoking was eight times more common in the cases with lung cancer than the control subjects, and the risk of developing lung cancer was four times higher among those who combined vaping and cigarette smoking than those who only smoked. These findings were consistent for men and women and for all major cell types of lung cancer. Our results suggest that vaping in combination with cigarette smoking accelerates the rate of developing lung cancer compared to smoking alone."
Vaping, Smoking and Lung Cancer Risk
J Oncol Res Ther 9: 10229.
Bittoni MA, Carbone DP, Harris RE
https://www.gavinpublishers.com/article/view/vaping-smoking-and-lung-cancer-risk
https://www.gavinpublishers.com/assets/articles_pdf/Vaping-Smoking-and-Lung-Cancer-Risk.pdf
Note: Open Access.
Related coverage:
Smoking & Vaping Together Raise Lung Cancer Risks Even Higher
"This randomized crossover clinical trial that included 50 adult e-cigarette users who preferred using a salt-based, high-nicotine concentration of 5% found that partial nicotine reduction significantly increased users’ topography parameters, including puffing time, puff duration, and inhalation volume. Meaning Results of this study provide evidence of compensatory puffing behavior among current e-cigarette users in this population when partial nicotine reduction is applied, suggesting that at least for current e-cigarette users, partial nicotine reduction can lead to enhanced exposure to some toxicants in the short [term]."
Partial Nicotine Reduction and E-Cigarette Users’ Puffing Behaviors Among Adults Aged 21 to 35 Years
A Randomized Crossover Clinical Trial
JAMA Netw Open. 2024;7(7):e2422954.
July 26, 2024
Tarana Ferdous, Simanta Roy, Sreshtha Chowdhury, Rime Jebai, Leonardo Maya, Anthony P. DeCaprio, Zoran Bursac, Wasim Maziak
https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2821557
Related Invited Commentary:
Lowering Nicotine Levels to Reduce Dependence on E-Cigarettes—Promising yet Complicated
https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2821564
Note: Open Access.
Relevant NEJM Correspondence:
An Exchange about “Population-Based Disease Odds for E-Cigarettes and Dual Use versus Cigarettes”
https://evidence.nejm.org/doi/full/10.1056/EVIDe2400220
"In this cohort study of 1985 adults who smoked cigarettes and used e-cigarettes, use of e-cigarettes in 2019 to 2021 vs 2014-2015 to 2015-2016 and daily use of e-cigarettes vs nondaily use were associated with greater overall cigarette discontinuation rates. Meaning: These results suggest that public health policy decisions regarding e-cigarettes should be based on data from e-cigarettes marketed in recent years that have evolved outside the regulated market."
E-Cigarette Characteristics and Cigarette Cessation Among Adults Who Use E-Cigarettes
JAMA Netw Open. 2024;7(8):e2423960.
August 1, 2024
Karin A. Kasza, Cheryl Rivard, Maciej L. Goniewicz, Geoffrey T. Fong, David Hammond, K. Michael Cummings, Andrew Hyland
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821816
Note: Open Access.
Related PR:
Daily Use of E-Cigarettes Linked to Higher Cigarette Quit Rates, Roswell Park Research Shows
More E-Cig Use Linked to Greater Chances of Quitting Smoking
https://www.medpagetoday.com/pulmonology/smoking/111339
"Using data from the State and National Youth Risk Behavior Surveys, we find that the adoption of an ENDS [electronic nicotine delivery systems] flavor restriction reduces frequent and everyday youth ENDS use by 1.2 to 2.5 percentage points. Auxiliary analyses of the Behavioral Risk Factor Surveillance System show similar effects on ENDS use for young adults ages 18-20. However, we also detect evidence of an unintended effect of ENDS flavor restrictions that is especially clear among 18-20-year-olds: inducing substitution to combustible cigarette smoking. Finally, there is no evidence that ENDS flavor restrictions affect ENDS use among adults aged 21 and older or non-tobacco-related health behaviors such as binge drinking and illicit drug use."
The Effect of E-Cigarette Flavor Bans on Tobacco Use
NBER WORKING PAPER 32535
ISSUE DATE June 2024
Chad D. Cotti, Charles J. Courtemanche, Yang Liang, Johanna Catherine Maclean, Erik T. Nesson & Joseph J. Sabia
https://www.nber.org/papers/w32535
https://www.nber.org/system/files/working_papers/w32535/w32535.pdf
Note: Open Access.
Related coverage:
Flavored Vape Bans Led to Increase in Teen Smoking: Study
https://www.newsweek.com/flavored-vape-bans-teen-smoking-1910815
Ed. Note: The Newsweek story claims the study "was funded with a grant from Global Action to End Smoking, an independent, U.S. nonprofit organization" but, of course, the independence of GAES is questionable at best given it's the rebranded Foundation for a Smoke-Free World (FSFW), founded and funded by Philip Morris International (PMI).
"TNE [Total nicotine equivalents], NNAL [4-(methylnitrosamino)-1–3-(pyridyl)-1-butanol], and Cd [cadmium] were higher in cases than controls (adjusted for age, race, sex, body mass index, and cigarettes per day). Among cases, these levels were higher in African Americans compared with Whites. After accounting for age, sex, body mass index, and pack-years, a one-SD increase in log-TNE (OR = 1.30; 95% CI, 1.10–1.54) and log-NNAL (OR = 1.27; 95% CI, 1.03–1.58 with TNE adjustment) was associated with lung cancer risk. In this study, in which NNAL concentration is relatively high, the association for log-TNE was attenuated after adjustment for log-NNAL… Impact: Urinary NNAL, TNE, and Cd concentrations in current smokers, particularly African American smokers, may be useful for predicting lung cancer risk."
Association of Urinary Biomarkers of Tobacco Exposure with Lung Cancer Risk in African American and White Cigarette Smokers in the Southern Community Cohort Study
Cancer Epidemiol Biomarkers Prev (2024) 33 (8): 1073–1082.
Sharon E. Murphy, Cherie Guillermo, Nicole M. Thomson, Steven G. Carmella, Milo Wittmann, Melinda C. Aldrich, Qiuyin Cai, Shannon M. Sullivan, Daniel O. Stram, Loïc Le Marchand, Stephen S. Hecht, William J. Blot, S. Lani Park
"Tobacco companies have capitalized on the Olympics’ widespread cultural impact since the birth of the modern Olympic Games in 1896—until the practice was stopped in 1987. A new online exhibition by The University of Alabama Center for the Study of Tobacco and Society explores this history with archival print and film advertisements from 1910 to 1988… In a 1935 ad in the Saturday Evening Post, Olympic high-diving champion Harold “Dutch” Smith states, “Camels don’t get your wind.” And in a 1960 ad featured in Ebony magazine, Olympic 400 meter champion George Rhoden holds a cigarette against the backdrop of an Olympic track with the quote, “Kent is my favorite, too.” While this year’s Olympic Games in Paris will be completely tobacco-free—all Olympics Games have been smoke-free since 1988 and tobacco-free since 2010—these archival images provide a surreal window into a century of shared history between tobacco companies and the world’s greatest athletes."
Before the Olympics were smoke-free, tobacco brand deals ran rampant
Cancer Letter
July 26, 2024 Vol.50 No.30
https://cancerletter.com/in-the-archives/20240726_5/
See also:
Smoke rings: Tobacco and the Olympics
https://cancerhistoryproject.com/
"In response to growing concerns about the rising use of nicotine replacement therapies (NRTs) among youth, particularly nicotine pouches, Health Minister Mark Holland is putting through restrictions aimed at curbing their appeal and accessibility. These measures, which will take effect [tomorrow] Aug. 28, include strict advertising restrictions, prohibiting certain flavours and limiting sales to behind the counter at pharmacies… “As of next Wednesday, there’s a couple of things that are going to happen. The first is these products are going to be moved behind the counter, [Holland said]… “The second thing is these nonsense flavours targeting our kids are gone … so Tropical Breeze and Cool Berry Splash … whatever they have, it’s over. Those products will be recalled and unavailable.”" [Katie Dangerfield. Canada restricts sale of nicotine pouches. Here’s what’s changing, Global News]
"Cigarette smoking in the United States hit an historic low this year, according to Gallup, which has been monitoring smoking trends for eight decades. The latest survey, based on Gallup's annual Consumption Habits poll conducted in July, shows 11% of U.S. adults said they smoked cigarettes in the past week. That matches Gallup's other lowest outcome in 2022, and comes close to the 12% smoking trend in 2023. In 1944, when Gallup first questioned Americans about cigarettes, 41% of adults said they had smoked. Smoking peaked in 1954 with 45% of respondents admitting they had recently lit-up a cigarette. By the late 1980s, the smoking rate had declined but was still more than three times what it is today." [Sheri Walsh. Cigarette smoking hits 80-year low in U.S., UPI]
"Last month, Philip Morris International beat estimates, and CEO Jacek Olczak credited it to “the excellent momentum of our smoke-free business,” including its most popular U.S. smokeless product, Zyn. The company also announced that annual sales of Zyn would reach around 580 million cans, reflecting roughly 50 percent growth over last year. Meanwhile, on TikTok, creators have been showing off their “lip pillows” (i.e., pouches tucked into their gums), tossing tins to their favorite musicians onstage and leaning hard into words and phrases such as Zynfluencer, Zynful moments and Zynbabwe. The hype has led to a nationwide Zyn shortage, with some convenience stores hanging signs outside telling their customers whether they have any in stock. In response, Philip Morris announced plans to build a new $600 million factory in Colorado to help meet demand." [Shane O’Neill. How Zyn became ‘in’ amid right-wing fervor for nicotine, Washington Post]
"The percentage of smokers who are using vapes as well as smoking cigarettes has also nearly doubled in the past three years, while ex-smokers who turn to e-cigarettes to quit are using them for longer… The Smokefree GB analysis, conducted by Action on Smoking and Health (Ash) and based on data collected by YouGov for the public health charity, estimates 11% of the adult population in Britain vape, the equivalent of 5.6 million people and the highest rate ever." [Storm Newton. Proportion of British adults vaping at its highest level, analysis finds, The Independent]
"Carlsbad, a surfing hot spot near San Diego, has decided to prohibit people from lighting up inside apartments, condos and other shared buildings where multiple families live. From January residents will not be able to smoke or vape cannabis and nicotine products indoors or on balconies, porches and decks. The law does not apply to single-family homes or hotels and motels…At least 84 of California’s 483 municipalities — including Beverly Hills, Cupertino and Pasadena — have enacted similar bans in multi-family private residences, according to the American Nonsmokers’ Rights Foundation." [Keiran Southern. No smoking in your own home, California city orders residents, The Times]
"Tobacco’s stubborn resistance to public-health common sense is an all-too-predictable story. Companies that profit from harmful or unhealthy products—from ultra-processed foods to prescription opioids to social media—often follow a familiar playbook of misdirection and denial to extend their sales for as long as they can. Their strategies can be so effective that public perception takes decades to catch up, fueling public-health crises that seem almost impossible to control. Companies often manufacture doubt just as effectively as they manufacture unhealthy products." [Jonathan Quick, Gavin Yamey and Eszter Rimányi. Products Can Harm People for Decades Before Companies Change. Here’s How to Stop Them, Time. See also: PLoS Global Public Health study immediately below.]
"From the peak of consumption to the most recent data, U.S. cigarette sales fell by 82%, sugar consumption by 15%, and prescription opioid prescriptions by 62%. For each, the consumption tipping point occurred when compelling evidence of harm, professional alarm, and an authoritative public health voice and/or public mobilization overcame corporate marketing and resistance efforts. The gap between suspicion of harm and the consumption tipping point ranged from one to five decades–much of which was attributable to the time required to generate sufficient evidence of harm... To our knowledge, this is the first comparative analysis of three successful efforts to change the product consumption patterns and the associated adverse health impacts of these products. The MDE [market-driven epidemics] epidemiological approach of shortening the latent time to effective mitigation provides a new method to reduce the impacts of harmful products."
Dynamics of combatting market-driven epidemics: Insights from U.S. reduction of cigarette, sugar, and prescription opioid consumption
PLoS Global Public Health
Published: July 24, 2024
Eszter Rimányi, Jonathan D. Quick, Gavin Yamey, Mustapha Immurana, Vasanti S. Malik, Tanya Doherty, Zain Jafar
https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0003479
Note: Open Access.
Related report & PR:
Products Can Harm People for Decades Before Companies Change. Here’s How to Stop Them
https://time.com/7009472/market-driven-epidemics/
How to Spot — and Stop — a Market-Driven Epidemic
https://globalhealth.duke.edu/news/how-spot-and-stop-market-driven-epidemic
"A deceptive and deadly marketing approach that Western tobacco companies were forced to disavow is propelling cigarette sales in China to new heights... Although cigarette packages do not actually display the words ”low tar”, they prominently display their tar content, and some incorporate the tar levels in their name. Zhongnanhai, a popular China Tobacco brand developed for the chain-smoking Chairman Mao Zedong, sells lines named “Black Eight” and “Five”—a reference to their machine-measured levels of tar in milligrams. “The Chinese state tobacco monopoly started late but is following Big Tobacco's low tar marketing strategy from the 20th century”, said Mary Assunta, a senior policy adviser at the Southeast Asia Tobacco Control Alliance. “It's not surprising smokers would choose Chinese-branded low tar cigarettes. Many smokers mistakenly think they are safer.”"
World Report
Low tar cigarette marketing driving a boom in sales in China
The Lancet
Volume 404, ISSUE 10453, P642-645, August 17, 2024
Jason McLure, Jude Chan
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01686-6/fulltext
Note: Open Access.
"In this crossover randomized clinical trial of 72 participants aged 21 to 25 years [in Columbus, Ohio] who used e-cigarettes, salt-based (vs freebase) nicotine resulted in higher nicotine intake after both 5-minute standardized and 30-minute ad libitum vaping, particularly at 5% (vs 1%) nicotine. Compared with freebase nicotine, nicotine salts yielded more positive subjective effects ratings and intense puffing behaviors, and menthol (vs tobacco) flavor yielded more positive subjective effects ratings. Meaning: The findings imply that salt-based nicotine formulations prevalent in the market may increase nicotine dependence among young adults already using e-cigarettes and warrant regulation."
E-Cigarette Nicotine Delivery Among Young Adults by Nicotine Form, Concentration, and Flavor
A Crossover Randomized Clinical Trial
JAMA Netw Open. 2024;7(8):e2426702.
August 9, 2024
Yoo Jin Cho, Toral Mehta, Alice Hinton, Ruth Sloan, Jean Nshimiyimana, Alayna P. Tackett, Megan E. Roberts, Marielle C. Brinkman, Theodore L. Wagener
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822152
Note: Open Access.
Related coverage:
Study reveals how salt-based nicotine and menthol flavors influence e-cigarette use in young adults
"We analyzed the effects of the two major components, PG/VG [propylene glycol/ vegetable glycerin] and nicotine, on tumor development in preclinical models. We found that PG/VG promoted tumor cell migration in migration assays and contributed to more aggressive, metastatic, and immunosuppressive tumors in vivo, aggravated by the presence of nicotine… These findings suggest that the major components used in e-cigarette fluid can impact tumor development through induced immunosuppression."
E-cigarette exposure disrupts antitumor immunity and promotes metastasis
Front. Immunol., 15 August 2024
Marcel Arias-Badia, Chien-Chun Steven Pai, PeiXi Chen, Anthony Chang, Yee May Lwin, Aahir Srinath, Jeffrey E. Gotts, Stanton A. Glantz, Lawrence Fong
https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1444020/full
Note: Open Access.
Related J Physiol research:
Influence of gestational window on offspring vascular health in rodents with in utero exposure to electronic cigarettes
https://physoc.onlinelibrary.wiley.com/doi/10.1113/JP286493
"We report the effects of vaping versus smoking on the oral cell methylome of healthy young vapers and smokers relative to non-users. Whereas vapers and smokers differ in number of differentially methylated regions (DMRs) (831 vs 2,863), they share striking similarities in the distribution and patterns of DNA methylation, chromatin states, transcription factor binding motifs, and pathways. There is substantial overlap in DMR-associated genes between vapers and smokers, with the shared subset of genes enriched for transcriptional regulation, signaling, tobacco use disorders, and cancer-related pathways… Our data support a potential link between epigenomic dysregulation in youth vapers and disease risk. These novel findings have significant implications for public health and tobacco product regulation."
Epigenomic Dysregulation in Youth Vapers: Implications for Disease Risk Assessment
Am J Respir Cell Mol Biol. 2024 Aug 12. Online ahead of print.
Stella Tommasi, Luciano Brocchieri, Silvia Tornaletti, Ahmad Besaratinia
https://www.atsjournals.org/doi/10.1165/rcmb.2024-0207OC
Related PR:
First genome-wide comparison of vapers and smokers finds similar DNA changes linked to disease risk
"A 2-group randomized clinical trial was conducted with 1503 adolescent e-cigarette users, with 70.8% retention at 7 months. In intention-to-treat analysis, with missingness coded as vaping, abstinence rates were 37.8% among participants assigned to the text message intervention and 28.0% among participants assigned to assessment-only control, a statistically significant difference. No baseline characteristics moderated the treatment-outcome relationship, including nicotine dependence. Meaning: A tailored, interactive text message program increased self-reported vaping cessation rates among adolescents recruited via social media channels."
A Vaping Cessation Text Message Program for Adolescent E-Cigarette Users
A Randomized Clinical Trial
JAMA. Published online August 7, 2024
Amanda L. Graham, Sarah Cha, Megan A. Jacobs, Michael S. Amato, Anna L. Funsten, Giselle Edwards, George D. Papandonatos
https://jamanetwork.com/journals/jama/fullarticle/2822082
Note: Open Access. Related JAMA resources available upon request.
Related JAMA Resources & PR:
E-Cigarette Use in Adults
https://jamanetwork.com/journals/jama/article-abstract/2822085
E-Cigarette Use in Adolescents and Adults—A JAMA Collection
https://jamanetwork.com/journals/jama/article-abstract/2822167
JAMA Publishes New Study on Proven Effectiveness of Truth Initiative’s Text Message Quit Vaping Program Among Teens
"Maternal cigarette smoking either before pregnancy or during any trimester of pregnancy significantly increased the risk of infant SNM [severe neonatal morbidity], even at a very low intensity (ie, 1–2 cigarettes per day). For example, compared with women who did not smoke before pregnancy, the adjusted odds ratios and 95% confidence intervals (OR, 95% CI) of composite SNM in the newborn from women who smoked 1–2, 3–5, 6–9, 10–19, and ≥20 cigarettes per day before pregnancy were 1.16 (1.13 to 1.19), 1.22 (1.20 to 1.24), 1.26 (1.23 to 1.29), 1.27 (1.25 to 1.28), and 1.31 (1.30 to 1.33), respectively. Furthermore, smokers who stopped smoking during pregnancy still had a higher risk of composite SNM than never smokers before and throughout pregnancy."
Maternal cigarette smoking before or during pregnancy increases the risk of severe neonatal morbidity after delivery: a nationwide population-based retrospective cohort study
J Epidemiol Community Health Published Online First: 20 August 2024.
Lili Yang, Liu Yang, Huan Wang, Yajun Guo, Min Zhao, Pascal Bovet, Bo Xi
https://jech.bmj.com/content/early/2024/07/09/jech-2024-222259
Note: Open Access.
Related coverage:
No amount of smoking is safe during any stage of pregnancy, study finds
