Risk of Vitamin D Deficiency in Smokers: Mix-Method
Abstract
Cigarettes are one of the leading causes of death in the world and Indonesia. Cigarettes emit cigarette smoke, which contains toxins and has pro-inflammatory properties that interfere the metabolism of vitamin D in the lungs. The study aimed to determine the risk of vitamin D deficiency in active smokers in Rungkut Village, Surabaya City. This research method is a mix-method with a Convergent Parallel Design type strategy, which is a way of collecting quantitative (cross-sectional) and qualitative data (interpretative phenomenological analysis) simultaneously, with purposive sampling technique. The variable was the risk of vitamin D deficiency and vitamin D level. Subjects were active smokers aged ≥19 years in the Rungkut Subdistrict. The number of samples involved in this research was 125 samples in the quantitative phase, and 15 people in the qualitative phase. The highest level of smoking severity was light smokers (45.60%). Most of respondents had normal vitamin D levels (≥20 mg/mL) of 73.33%, averaging of 37.66 ± 5.89 mg/mL. Most active smokers are at risk of vitamin D deficiency. Risk factors for deficiency in heavy smokers are not consuming foods containing vitamin D (such as fish, eggs, and milk), not consuming fish oil supplements and vitamins, and not sunbathing. However, the level of physical activity tended to be moderate-heavy. The conclusion is that smokers must pay attention to their intake of foods containing vitamin D and exposure to sunlight to achieve sufficient vitamin D levels.
References
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21. Moghadasi N, Alimohammadi I, Safari Variani A, et al. The Effect of Mobile Radiation on the Oxidative Stress Biomarkers in Pregnant Mice. Journal of Family and Reproductive Health. 2021 Sep;15(3):172-178. https://doi.org/10.18502/jfrh.v15i3.7134
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26. Islam MS, Rashid M, Sizear MI, et al. Cigarette Smoking and Associated Factors Among Men in Five South Asian Countries: A Pooled Analysis of Nationally Representative Surveys. PLoS One. 2022;17(11):e0277758. https://doi.org/10.1371/journal.pone.0277758
27. Foulds J, Veldheer S, Pachas G, et al. The Effects of Reduced Nicotine Content Cigarettes on Biomarkers of Nicotine and Toxicant Exposure, Smoking Behavior and Psychiatric Symptoms in Smokers with Mood or Anxiety Disorders: A Double-Blind Randomized Trial. PLoS One. 2022;17(11):e0275522. https://doi.org/10.1371/journal.pone.0275522
28. Omare MO, Kibet JK, Cherutoi JK, et al. A Review of Tobacco Abuse And Its Epidemiological Consequences. Zeitschrift Fur Gesundheitswissenschaften = Journal of Public Health. 2022;30(6):1485-500. https://doi.org/10.1007/s10389-020-01443-4
29. Golestan YP, Kalan ME, Taleb ZB, et al. The Effect of Price on Cigarette Consumption, Distribution, and Sale In Tehran: A Qualitative Study. BMC Public Health. 2021;21(1):1720. https://doi.org/10.1186/s12889-021-11733-5
30. Lorensia A, Suryadinata RV, Arganitya GN. Relationship of Food Vitamin D Intake with Obesity in Adolescent in Surabaya. Global Medical & Health Communication. 2022;10(2):104–110. https://ejournal.unisba.ac.id/index.php/gmhc/article/view/9024
31. AlFaris NA, Alshammari GM, AlTamimi JZ, et al. Evaluating The Effects of Different Processing Methods on The Nutritional Composition of Shrimp and The Antioxidant Activity of Shrimp Powder. Saudi Journal of Biological Sciences 2022;29(1):640-9. https://doi.org/10.1016/j.sjbs.2021.09.029
32. Sridonpai P, Judprasong K, Tirakomonpong N, et al. Effects of Different Cooking Methods on the Vitamin D Content of Commonly Consumed Fish in Thailand. Foods. 2022;11(6):819. https://doi.org/10.3390/foods11060819
33. Andrade JM, Grandoff PG, Schneider ST. Vitamin D Intake and Factors Associated With Self-Reported Vitamin D Deficiency Among US Adults: A 2021 Cross-Sectional Study. Frontiers in Nutrition. 2022;9:899300. https://doi.org/10.3389/fnut.2022.899300
34. Vičič V, Mikuš RP, Kugler S, et al. Vitamin D Fortification of Eggs Alone and in Combination with Milk in Women Aged 44-65 Years: Fortification Model and Economic Evaluation. Slovenian Journal of Public Health. 2022;62(1):30-33. https://doi.org/10.2478/sjph-2023-0005
35. Daly RM, De Ross B, Gianoudis J, et al. Dose-Response Effect of Consuming Commercially Available Eggs on Wintertime Serum 25-Hydroxyvitamin D Concentrations in Young Australian Adults: a 12-Week Randomized Controlled Trial. The Journal of Nutrition. 2022;152(7):1702-1710. https://doi.org/10.1093/jn/nxac044
36. Pellegrino L, Marangoni F, Muscogiuri G, et al. Vitamin D Fortification of Consumption Cow's Milk: Health, Nutritional and Technological Aspects. A Multidisciplinary Lecture of the Recent Scientific Evidence. Molecules. 2021;26(17):5289.
https://doi.org/10.3390/molecules26175289
37. Weir RR, Johnston M, Lowis C, et al. Vitamin D3 Content of Cows' Milk Produced in Northern Ireland and Its Efficacy As A Vehicle For Vitamin D Fortification: A UK Model. International Journal of Food Sciences and Nutrition. 2021;72(4):447-455. https://doi.org/10.1080/09637486.2020.1837743
38. Zhang Y, Lin S, Li J, et al. Interaction of Passive Smoking and Diet Habits on Vitamin D Deficiency among Women of Reproductive Age in Rural Central China. Nutrients. 2022;15(1):126. https://doi.org/10.3390/nu15010126
39. Tiwari RK, Sharma V, Pandey RK, et al. Nicotine Addiction: Neurobiology and Mechanism. Journal of Pharmacopuncture. 2020;23(1):1–7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7163392/
40. Lorensia A, Suryadinata RV. Profil of Omega-3 Food Intake and Its Association with Socioeconomic Status on Online Motorcycle Driver Smokers. Healthcare in Low-resource Settings. 2023;11(s1):11164. https://www.pagepressjournals.org/index.php/hls/article/view/11164
41. Carlberg C. Vitamin D and Pigmented Skin. Nutrients. 2022;14(2):325. https://doi.org/10.3390/nu14020325
42. Raymond-Lezman JR, Riskin SI. Benefits and Risks of Sun Exposure to Maintain Adequate Vitamin D Levels. Cureus. 2023;15(5):e38578. https://doi.org/10.7759/cureus.38578
43. Sultana N. Sun Awareness and Sun Protection Practices. Clinical, Cosmetic and Investigational Dermatology. 2020;13:717–730. https://doi.org/10.2147/CCID.S265477
44. Shan L, Dong H, Wang T, et al. Screen Time, Age and Sunshine Duration Rather Than Outdoor Activity Time Are Related to Nutritional Vitamin D Status in Children With ASD. Frontiers in Pediatrics. 2022;9:806981. https://doi.org/10.3389/fped.2021.806981
45. Rocka A, Jasielska F, Madras D, et al. The Impact of Digital Screen Time on Dietary Habits and Physical Activity in Children and Adolescents. Nutrients. 2022;14(14):2985. https://doi.org/10.3390/nu14142985
46. Zhang J, Cao ZB. Exercise: A Possibly Effective Way to Improve Vitamin D Nutritional Status. Nutrients. 2022;14(13):2652. https://doi.org/10.3390/nu14132652
47. Lorensia A, Suryadinata RV, Chandra NLMR. Profile of Vitamin D Status, Physical Activity, and Lung Health in Construction Workers. Community Medicine and Public Health of Indonesia Journal. 2020;1(2):117–24. http://comphi.sinergis.org/index.php/comphi/article/view/19
48. Lorensia A, Muntu CM, Suryadinata RV, et al. Effect of lung function disorders and physical activity on smoking and non-smoking students. Journal of Preventive Medicine and Hygiene. 2021; 62(1):89–96. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8283647
2. West R. Tobacco Smoking: Health Impact, Prevalence, Correlates and Interventions. Psychology & Health. 2017;32(8):1018–1036. https://doi.org/10.1080/08870446.2017.1325890
3. Varghese J, Gharde PM. A Comprehensive Review on the Impacts of Smoking on the Health of an Individual. Cureus. 2023;15(10):e46532. https://doi.org/10.7759/cureus.46532
4. Yang L, Zhao H, Liu K, et al. Smoking Behavior and Circulating Vitamin D Levels in Adults: A Meta-Analysis. Food Science & Nutrition. 2021;9(10):5820–5832. https://doi.org/10.1002/fsn3.2488
5. Dahdah A, Jaggers RM, Sreejit G, et al. Immunological Insights into Cigarette Smoking-Induced Cardiovascular Disease Risk. Cells. 2022;11(20):3190. https://doi.org/10.3390/cells11203190
6. Nikniaz L, Ghojazadeh M, Nateghian H, et al. The Interaction Effect of Aerobic Exercise and Vitamin D Supplementation on Inflammatory Factors, Anti-Inflammatory Proteins, and Lung Function in Male Smokers: A Randomized Controlled Trial. BMC Sports Science, Medicine Rehabilitation. 2021;13(1):102. https://doi.org/10.1186/s13102-021-00333-w
7. Chen YC, Sung HC, Chuang TY, et al. Vitamin D3 Decreases TNF-α-Induced Inflammation in Lung Epithelial Cells Through a Reduction in Mitochondrial Fission and Mitophagy. Cell Biology and Toxicology. 2022;38(3):427–450. https://doi.org/10.1007/s10565-021-09629-6
8. Tian T, Jiang X, Qin R, et al. Effect of Smoking on Lung Function Decline in a Retrospective Study of a Health Examination Population in Chinese Males. Front Med (Lausanne). 2023;9:843162. https://doi.org/10.3389/fmed.2022.843162
9. Augustine LF, Nair KM, Kulkarni B. Sun Exposure as a Strategy for Acquiring Vitamin D in Developing Countries of Tropical Region: Challenges & Way Forward. Indian J Med Res. 2021;154(3):423–432. https://doi.org/10.4103/ijmr.IJMR_1244_18
10. Lorensia A, Suryadinata RV, Inu IA. Comparison of Vitamin D Status And Physical Activity Related With Obesity in Student. Journal of Applied Pharmaceutical Science. 2022;12(4):108–118. https://doi.org/10.7324/JAPS.2022.120412
11. Lorensia A, Suryadinata RV. Smoking Cessation Experience and Socioeconomic Status of Online Motorcycle Taxi Drivers in Surabaya. Media Kesehatan Masyarakat Indonesia. 2021;17(3):80–87. https://doi.org/10.30597/mkmi.v17i3.14059
12. Octavius GS, Shakila A, Meliani M, et al. Vitamin D Deficiency is a Public Health Emergency among Indonesian Children and Adolescents: A Systematic Review and Meta-Analysis of Prevalence. Annals of Pediatric Endocrinology & Metabolism: apem. 2023;28(1):10-19. https://doi.org/10.6065/apem.2244170.085
13. Suryadinata RV, Lorensia A. Frekuensi Asupan Makanan, Pengetahuan Vitamin D dan Obesitas Pada Kelompok Usia Lanjut Food Frequency, Knowledge about Vitamin D and Obesity among Elderly. Amerta Nutrition. 2020;4(1):43–48.
https://doi.org/10.2473/amnt.v4i1.2020
14. Widyastuty AASA, Jihan JC. Tingkat Kekumuhan dan Analisis Spasial Permukiman Kumuh Perkotaan (Studi Kasus: Surabaya Timur). Jurnal Teknik Waktu. 2018;16(2);47–55. https://doi.org/10.36456/waktu.v16i02.1667
15. Holipah H, Sulistomo HW, Maharani A. Tobacco Smoking and Risk of All-Cause Mortality in Indonesia. PLoS One. 2020;15(12):e0242558. https://doi.org/10.1371/journal.pone.0242558
16. Herath P, Wimalasekera S, Amarasekara T, et al. Effect of Cigarette Smoking on Smoking Biomarkers, Blood Pressure and Blood Lipid Levels Among Sri Lankan Male Smokers. Postgraduate Medical Journal. 2022;98(1165):848–854. https://doi.org/10.1136/postgradmedj-2021-141016
17. Sugiura T, Dohi Y, Takagi Y, et al. Close Association between Subclinical Atherosclerosis and Pulmonary Function in Middle-Aged Male Smokers. Journal of Atherosclerosis and Thrombosis. 2020;27(11):1230–1242. https://doi.org/10.5551/jat.55996
18. Sutherland JP, Zhou A, Hyppönen E. Vitamin D Deficiency Increases Mortality Risk in the UK Biobank: A Nonlinear Mendelian Randomization Study. Annals of Internal Medicine. 2022;175(11):1552–1559. https://doi.org/10.7326/M21-3324
19. AlSubai A, Baqai MH, Agha H, et al. Vitamin D and Preeclampsia: A Systematic Review And Meta-Analysis. SAGE Open Medicine. 2023;11:20503121231212093. https://doi.org/10.1177/20503121231212093
20. Sherief LM, Ali A, Gaballa A, et al. Vitamin D Status and Healthy Egyptian Adolescents: Where Do We Stand?. Medicine (Baltimore). 2021;100(29):e26661. https://doi.org/10.1097/MD.0000000000026661
21. Moghadasi N, Alimohammadi I, Safari Variani A, et al. The Effect of Mobile Radiation on the Oxidative Stress Biomarkers in Pregnant Mice. Journal of Family and Reproductive Health. 2021 Sep;15(3):172-178. https://doi.org/10.18502/jfrh.v15i3.7134
22. Nguyen CV, Le TT, Nguyen NH. The Impact of Cigarette Prices on Smoking Participation and Tobacco Expenditure in Vietnam. PLoS One. 2021;16(12):e0260415. https://doi.org/10.1371/journal.pone.0260415
23. Septiani R. Hubungan Lama Merokok dan Frekuensi Merokok dengan Kadar Hemoglobin (HB) Pada Perokok Aktif. Babul Ilmi: Jurnal Ilmiah Multi Science Kesehatan. 2022;14(1):30–40. https://jurnal.stikes-aisyiyah-palembang.ac.id/index.php/Kep/article/view/809
24. Weir CB, Jan A. BMI Classification Percentile And Cut Off Points. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
25. Salsabila NN, Indraswari N, Sujatmiko B. Gambaran Kebiasaan Merokok Di Indonesia Berdasarkan Indonesia Family Life Survey 5 (IFLS 5). Jurnal Ekonomi Kesehatan Indonesia. 2022;7(1):13-22. https://journal.fkm.ui.ac.id/jurnal-eki/article/view/5394
26. Islam MS, Rashid M, Sizear MI, et al. Cigarette Smoking and Associated Factors Among Men in Five South Asian Countries: A Pooled Analysis of Nationally Representative Surveys. PLoS One. 2022;17(11):e0277758. https://doi.org/10.1371/journal.pone.0277758
27. Foulds J, Veldheer S, Pachas G, et al. The Effects of Reduced Nicotine Content Cigarettes on Biomarkers of Nicotine and Toxicant Exposure, Smoking Behavior and Psychiatric Symptoms in Smokers with Mood or Anxiety Disorders: A Double-Blind Randomized Trial. PLoS One. 2022;17(11):e0275522. https://doi.org/10.1371/journal.pone.0275522
28. Omare MO, Kibet JK, Cherutoi JK, et al. A Review of Tobacco Abuse And Its Epidemiological Consequences. Zeitschrift Fur Gesundheitswissenschaften = Journal of Public Health. 2022;30(6):1485-500. https://doi.org/10.1007/s10389-020-01443-4
29. Golestan YP, Kalan ME, Taleb ZB, et al. The Effect of Price on Cigarette Consumption, Distribution, and Sale In Tehran: A Qualitative Study. BMC Public Health. 2021;21(1):1720. https://doi.org/10.1186/s12889-021-11733-5
30. Lorensia A, Suryadinata RV, Arganitya GN. Relationship of Food Vitamin D Intake with Obesity in Adolescent in Surabaya. Global Medical & Health Communication. 2022;10(2):104–110. https://ejournal.unisba.ac.id/index.php/gmhc/article/view/9024
31. AlFaris NA, Alshammari GM, AlTamimi JZ, et al. Evaluating The Effects of Different Processing Methods on The Nutritional Composition of Shrimp and The Antioxidant Activity of Shrimp Powder. Saudi Journal of Biological Sciences 2022;29(1):640-9. https://doi.org/10.1016/j.sjbs.2021.09.029
32. Sridonpai P, Judprasong K, Tirakomonpong N, et al. Effects of Different Cooking Methods on the Vitamin D Content of Commonly Consumed Fish in Thailand. Foods. 2022;11(6):819. https://doi.org/10.3390/foods11060819
33. Andrade JM, Grandoff PG, Schneider ST. Vitamin D Intake and Factors Associated With Self-Reported Vitamin D Deficiency Among US Adults: A 2021 Cross-Sectional Study. Frontiers in Nutrition. 2022;9:899300. https://doi.org/10.3389/fnut.2022.899300
34. Vičič V, Mikuš RP, Kugler S, et al. Vitamin D Fortification of Eggs Alone and in Combination with Milk in Women Aged 44-65 Years: Fortification Model and Economic Evaluation. Slovenian Journal of Public Health. 2022;62(1):30-33. https://doi.org/10.2478/sjph-2023-0005
35. Daly RM, De Ross B, Gianoudis J, et al. Dose-Response Effect of Consuming Commercially Available Eggs on Wintertime Serum 25-Hydroxyvitamin D Concentrations in Young Australian Adults: a 12-Week Randomized Controlled Trial. The Journal of Nutrition. 2022;152(7):1702-1710. https://doi.org/10.1093/jn/nxac044
36. Pellegrino L, Marangoni F, Muscogiuri G, et al. Vitamin D Fortification of Consumption Cow's Milk: Health, Nutritional and Technological Aspects. A Multidisciplinary Lecture of the Recent Scientific Evidence. Molecules. 2021;26(17):5289.
https://doi.org/10.3390/molecules26175289
37. Weir RR, Johnston M, Lowis C, et al. Vitamin D3 Content of Cows' Milk Produced in Northern Ireland and Its Efficacy As A Vehicle For Vitamin D Fortification: A UK Model. International Journal of Food Sciences and Nutrition. 2021;72(4):447-455. https://doi.org/10.1080/09637486.2020.1837743
38. Zhang Y, Lin S, Li J, et al. Interaction of Passive Smoking and Diet Habits on Vitamin D Deficiency among Women of Reproductive Age in Rural Central China. Nutrients. 2022;15(1):126. https://doi.org/10.3390/nu15010126
39. Tiwari RK, Sharma V, Pandey RK, et al. Nicotine Addiction: Neurobiology and Mechanism. Journal of Pharmacopuncture. 2020;23(1):1–7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7163392/
40. Lorensia A, Suryadinata RV. Profil of Omega-3 Food Intake and Its Association with Socioeconomic Status on Online Motorcycle Driver Smokers. Healthcare in Low-resource Settings. 2023;11(s1):11164. https://www.pagepressjournals.org/index.php/hls/article/view/11164
41. Carlberg C. Vitamin D and Pigmented Skin. Nutrients. 2022;14(2):325. https://doi.org/10.3390/nu14020325
42. Raymond-Lezman JR, Riskin SI. Benefits and Risks of Sun Exposure to Maintain Adequate Vitamin D Levels. Cureus. 2023;15(5):e38578. https://doi.org/10.7759/cureus.38578
43. Sultana N. Sun Awareness and Sun Protection Practices. Clinical, Cosmetic and Investigational Dermatology. 2020;13:717–730. https://doi.org/10.2147/CCID.S265477
44. Shan L, Dong H, Wang T, et al. Screen Time, Age and Sunshine Duration Rather Than Outdoor Activity Time Are Related to Nutritional Vitamin D Status in Children With ASD. Frontiers in Pediatrics. 2022;9:806981. https://doi.org/10.3389/fped.2021.806981
45. Rocka A, Jasielska F, Madras D, et al. The Impact of Digital Screen Time on Dietary Habits and Physical Activity in Children and Adolescents. Nutrients. 2022;14(14):2985. https://doi.org/10.3390/nu14142985
46. Zhang J, Cao ZB. Exercise: A Possibly Effective Way to Improve Vitamin D Nutritional Status. Nutrients. 2022;14(13):2652. https://doi.org/10.3390/nu14132652
47. Lorensia A, Suryadinata RV, Chandra NLMR. Profile of Vitamin D Status, Physical Activity, and Lung Health in Construction Workers. Community Medicine and Public Health of Indonesia Journal. 2020;1(2):117–24. http://comphi.sinergis.org/index.php/comphi/article/view/19
48. Lorensia A, Muntu CM, Suryadinata RV, et al. Effect of lung function disorders and physical activity on smoking and non-smoking students. Journal of Preventive Medicine and Hygiene. 2021; 62(1):89–96. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8283647
Authors
Lorensia, A., Jalmav, M. M. A. ., Dhiba, Z. ., & Suryadinata, R. V. . (2024). Risk of Vitamin D Deficiency in Smokers: Mix-Method . Media Kesehatan Masyarakat Indonesia, 20(2), 85-101. https://doi.org/10.30597/mkmi.v20i2.32775
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