Heated tobacco products (HTP) are a form of nicotine delivery intended to be an alternative to traditional cigarettes. HTP tobacco products are sold to consumers as a less harmful alternative to traditional cigarettes, both for users and bystanders. The actual impact of HTP on the health of users and its overall impact on public health is still not fully known. A systematic search of the literature was carried out to identify relevant studies published in English from 2015 to February 2021. The following databases were used: PubMed, Scopus, Elsevier and ClinicalKey. 25 studies (independent and sponsored by the tobacco industry) were considered. The analysis of exposure biomarkers and cardiovascular and respiratory biomarkers showed differences between smokers and people using heated tobacco products. Improvements in clinically relevant risk markers, especially cholesterol, sICAM-1, 8-epi-PGF2α, 11-DTX-B2, HDL and FEV1, were observed compared to persistent cigarette smokers. On the other hand, exposure to IQOS has been reported to alter mitochondrial function, which may further exaggerate airway inflammation, airway remodeling and lung cancer. These products have the potential to increase oxidative stress and increase respiratory tract infections by increasing microbial adherence to the respiratory tract. Our review suggests that HTP products may be products with a reduced risk of chronic diseases, including respiratory and cardiovascular diseases and cancer compared to traditional smoking, although in the case of non-smokers so far, they may pose a risk of their occurrence. Research seems to be necessary to assess the frequency of HTP use and its potential negative health effects.

Background: Tobacco use among young people still remains a major public health problem. Thus, the aim of this study was to perform a cross-country comparison for the factors associated with susceptibility to tobacco use among youth from five central and eastern European countries. Methods: The data used in the current analysis, focusing on youth (aged 11–17 years), who have never tried or experimented with cigarette smoking, was available from the recent Global Youth Tobacco Survey (Czech Republic (2016), n = 1997; Slovakia (2016), n = 1998; Slovenia (2017), n = 1765; Romania (2017), n = 3718; Lithuania (2018), n = 1305). Simple, multiple logistic regression analyses and random-effect meta-analysis were conducted to identify factors associated with tobacco use susceptibility as the lack of a firm commitment not to smoke. Results: Nearly a quarter of the students were susceptible to tobacco use in 4 of 5 countries. The following factors were identified, consistently across countries, as correlates of tobacco use susceptibility: exposure to passive smoking in public places (AOR from 1.3; p = 0.05 in Slovakia to 1.6; p < 0.01 in Czech Republic and Romania), peers smoking status (AOR from 1.8 p < 0.01 in Slovakia to 2.5; p < 0.01 Lithuania), opinion that smoking helped people feel more comfortable at celebrations (AOR from 1.3; p = 0.01 in Czech Republic to 1.9; p < 0.01 in Lithuania), noticing people using tobacco in mass media (AOR 1.5; p < 0.01 in Slovenia and 1.6; p < 0.01 in Lithuania), lack of knowledge on harmful effects of passive smoking (AOR 1.8; p < 0.01 in Slovakia and 2.4; p < 0.01 in Slovenia), lack of antismoking education provided by school (AOR 1.3; p < 0.05 in Czech Republic, Slovakia and Slovenia; 1.9; p < 0.01 in Lithuania), and family (AOR 1.5; p < 0.01 in Slovenia and Romania). Moreover those who believed that smoking makes young people look less attractive (AOR from 0.5; p < 0.01 in Romania to 0.7; p = 0.05 in Lithuania) and that people who smoke have less friends (AOR 0.7; p ≤ 0.06) turned out to be less susceptible to tobacco use initiation. In Czech Republic and Slovenia significantly higher susceptibility to tobacco use was observed among females as compared to males (AOR 1.4; p < 0.01), whereas in Romania opposite pattern, although not significant, was observed (p = 0.3). Having more money available for own expenses, positively correlated with smoking suitability in all countries (AOR > 1.5; p < 0.01) except Lithuania where youth with more money available tend to be less susceptible to tobacco use (p > 0.05). Youth who share the opinion that people who smoke have more friends were more susceptible to smoking in Romania (AOR 1.4; p = 0.04) but tend to be less susceptible in other countries. Exposure to advertisements at points of sale was significant correlate of tobacco use susceptibility in Slovakia and Slovenia (AOR 1.4 and 1.5 respectively; p < 0.05), with moderate heterogeneity between the countries. Conclusions: A high proportion of youth from central and eastern European countries was susceptible to tobacco use. Social factors, and those related to educational and policy issues as well as to attitudes regarding tobacco use were strongly, and consistently across countries, correlated with tobacco use susceptibility. Slight differences in susceptibility to tobacco use between the countries were related to: sex, money available for own expenses, exposure to advertisements at points of sale and opinion that people who smoke have more friends. These factors should be considered when designing and implementing anti-tobacco activities among young people.

The aim of the study was to assess whether general practitioners (GPs) monitor and evaluate the health behavior of their patients in the field of a diet, physical activity, and weight control, and whether they provide appropriate counselling as part of this evaluation. Predictors of those activities among physicians were also determined. The cross-sectional study was conducted in the Piotrkowski district among 200 GPs. The questionnaire covered socio-demographic data and lifestyle characteristics of the physicians, their role as healthy lifestyle providers, and whether they assess lifestyle characteristics of their patients and perform healthy lifestyle counselling. More than 60% of the GPs did not evaluate lifestyle features during their patients’ examination. In total, 56% of the GPs provided healthy lifestyle recommendations among patients who have not been diagnosed with chronic lifestyle-related diseases but who do not follow healthy recommendations, and 73% of GPs provided recommendations to patients with chronic diseases related to lifestyle. The study showed that the chance to assess lifestyle characteristics of the patients was significantly higher for the GPs who believed that they were obliged to do so (OR = 6.5; p = 0.002). The chance to recommend a healthy lifestyle among patients who have not been diagnosed with chronic lifestyle-related diseases but who do not follow healthy recommendations was 5.9 times higher among the GPs working in the public sector (p < 0.001) and 16.3 times higher for these who believed that they had sufficient knowledge to provide the advice (p = 0.02). The following predictors of providing a healthy lifestyle counselling among patients with diagnosed chronic lifestyle-related diseases were identified: conviction that a GPs is obligated to provide it (OR = 4.4; p = 0.02), sufficient knowledge (OR = 8.7; p = 0.01), and following health recommendations by themselves (OR = 3.9; p = 0.04). Conclusions: The identified predictors are crucial for the development of appropriate strategies aiming at increasing GPs’ involvement in preventive measures and consequently at improving the population’s health.

Introduction: The aim of the study was to determine the influence of the personal factors, such as body mass index (BMI), of general practitioners (GPs), and their counseling on weight management, healthy lifestyle, and their perceived barriers.Materials and methods: The cross-sectional study was conducted from January 2020 to December 2021 among 161 GPs in the city of Lodz.Results: Only 3.7% of physicians always advised their patients on diet and physical activity (p < 0.05). Most of the GPs (54%) provide counseling occasionally. GPs gave general advice more often to patients with chronic diseases than to patients who did not. The study showed that the chance of providing advice on eating habits or physical activity was significantly higher for the GPs who practiced physical activity (OR = 2.64; 95%Cl: 1.01–6.91, p < 0.05) and measured patient weight, height, and BMI (OR = 4.86; 95%Cl: 1.86–12.67, p < 0.001). GPs who were overweight (OR = 3.55; 95%Cl: 1.49–8.41, p < 0.01) and measured patient weight, height, and BMI (OR = 3.61; 95%Cl: 1.58–8.25, p < 0.01) were more likely to advise on nutrition or physical activity to “healthy” patients. Doctors who measured patient weight, height, and BMI advised patients with chronic diseases (OR = 6.45; 95%Cl: 2.54–16.34, p < 0.001). Over 40% of GPs believe that they are not effective in counseling. Lack of time turned out to be the main barrier to counseling for 73.3% of GPs, which was associated with heavy workload (>100 visits per week).Conclusion: As many GPs doubt their effectiveness, it is recommended that GPs attend more training activities regarding counseling. In addition, organizational changes are needed to reduce patient numbers, and financial incentives are needed to improve counseling and patient measurement.

The aim of this study was to evaluate the dietary and physical activity counseling provided to adults by family doctors. Predictors of counseling in primary healthcare were identified. A cross-sectional study was conducted from January 2020 to December 2021 among 896 adult primary care patients in the city of Łódź [Lodz], Poland. Almost 36% of the respondents were advised to change their eating habits, and 39.6% were advised to increase their physical activity. In a multivariate logistic regression analysis, people in poor health with chronic diseases related to overweight and obesity and with two, three or more chronic diseases, respectively, received advice on eating habits from their GP twice and three times more often than people in good health with no chronic conditions (OR = 1.81; p < 0.05 and OR = 1.63; p < 0.05; OR = 3.03; p < 0.001). People in the age groups 30–39 years and 40–49 years (OR = 1.71; p < 0.05 and OR = 1.58; p < 0.05), widowed (OR = 2.94; p < 0.05), with two, three or more chronic diseases (OR = 1.92; p < 0.01 and OR = 3.89; p < 0.001), and subjectively assessing overweight and obesity (OR = 1.61; p < 0.01) had a better chance of receiving advice on physical activity. The study found a higher proportion of advice on diet and physical activity provided to overweight and obese patients by primary care physicians than in other studies; however, still not all receive the necessary counseling. GPs should advise all patients not to become overweight and obese, not only those already affected by the problem.

Teen use of tobacco-related products is a significant public health concern. This study evaluated the predictors of e-cigarette use among secondary school students who were never cigarette smokers and ever cigarette smokers in Poland. Methods: This study examined a sample of Polish youths aged 13–19 (n = 19,241) attending 200 schools, 12 on average in each county. The study was a part of the National Health Program in Poland for 2016–2020. Logistic regression and multivariable logistic regression models were used to calculate crude and adjusted odds ratios. Results: Of all participants, 32.5% were ever cigarette users. Among the never cigarette users, 13.6% were deemed susceptible to e-cigarette use. Among the ever cigarette users, 60.6% were deemed susceptible to e-cigarette use. Of those susceptible to e-cigarette use, 68.2% were among the 32.5% ever cigarette users. The profile of e-cigarette use among never e-cigarette users also included: pocket money available per month (more than 150 PLN) (OR = 1.7; p = 0.001), 16–17 years old (OR = 1.9; p = 0.001), parental tobacco smoking and e-cigarette usage (OR = 2.0; p = 0.01 and OR = 1.7; p = 0.001 respectively), maternal secondary education (OR = 1.1; p = 0.04), and living in big cities >500,000 inhabitants (OR = 1.4; p = 0.04). E-cigarette users among ever cigarette users were similar to never cigarette users in their opinion that e-cigarette use is less harmful than traditional smoking (OR = 1.6; p = 0.0012) and living with both parents smoking cigarettes (OR = 1.3; p = 0.02). Additionally, the determinants were: female gender (OR = 1.5; p = 0.009) in the age group less than 15 years of age (OR = 1.3; p = 0.007). Conclusions: The major determinant of e-cigarette use in this population was prior smoking. Additionally, the results revealed that fairly obvious predictors such as parental smoking and a belief in the less harmfulness of e-cigarette use are important determinants for smoking among never or ever e-cigarette users.