Objectives: The purposes of this research were to investigate the hazardous effects of heat-not-burn tobacco and to clarify the health effects accompanying the transition from cigarettes to heat-not-burn tobacco. Methods: The concentrations of carbon monoxide, ammonia, formaldehyde, acetaldehyde, and dust (hazardous substances) were measured in the smoke of heat-not-burn tobacco. Twenty-nine smokers were used as the subjects. The concentrations of hazardous substances were measured in exhalation of heat-notburn tobacco. The concentration of cotinine in saliva was also measured after the transition. A questionnaire survey was performed before and after the transition to evaluate nicotine dependence, nicotine withdrawal symptoms, and smoking behaviors. Results: In the mainstream smoke, all hazardous substances investigated were detected. Carbon monoxide and dust were detected in the exhalation of heat-not-burn tobacco. The concentration of cotinine in the saliva of heat-not-burn tobacco users corresponded to that of cigarette smokers. Cigarette smoking was significantly positively related to the score of Fagerström Test for Nicotine Dependence (FTND). Heat-not-burn tobacco was significantly positively related to FTND and Minnesota Nicotine Withdrawal Scale (MNWS) scores. The group in which the number of heat-not-burn tobacco sticks consumed increased after transition showed a smaller number of cigarettes consumed and a higher MNWS score before transition than the group in which it decreased after transition. These two factors were significantly related to the difference between the numbers of cigarettes and heat-not-burn tobacco sticks in multiple linear regression analysis. Conclusions: The mainstream smoke of heat-not-burn tobacco contains harmful substances. There were the possibilities that nicotine dependence and nicotine withdrawal symptoms appear after transition and that the number of heat-not-burn tobacco sticks consumed increases.
Objective The aim of this study is to clarify the association between teaching and support skills and the subjective effectiveness of nutritional guidance of registered dietitians working at hospitals. Methods We carried out a questionnaire survey of registered dietitians at hospitals in a Japanese prefecture. The utilization of nutritional teaching skills in nutritional guidance was investigated using a self-produced 36-item questionnaire that was designed to be mainly used for diabetic patients in 4 settings: first guidance, first assessment, contemplation stage, and preparation stage. The support skills were evaluated by Kikuchi's Scale of Social Skills: 18 items. The subjective effectiveness of nutritional guidance was defined by the behavioral change of the patients after nutritional guidance as evaluated by a registered dietitian. Results There were 75 respondents (response rate 46.6 %). Among the teaching skills, basic skills in an interview were often used, but some related to coaching skills were not in common use in nutritional guidance. Based on the results of principal component analysis, we created a scale for scoring the utilization of nutritional teaching skills in each setting. Multiple linear regression analysis illustrated that high subjective effectiveness of nutritional guidance was associated with high score of teaching skills in the preparation stage setting and high score of support skills. Conclusions These results show that, in addition to frequent use of nutritional teaching skills, improvement of support skills is also necessary to enhance the effectiveness of nutritional guidance.
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