Introduction There needs to be more evidence about the tobacco products utilized by individuals who smoke and the primary determinants contributing to the development of smoking behavior. Our study aimed to assess the prevalence and factors associated with using one or more tobacco products among employees from various ministries in Kuwait. Methods A cross-sectional study was conducted among employees in different ministries in Kuwait from December 27, 2018, to January 3, 2019. A questionnaire about smoking status and socio-demographic variables was used. Results There was a total of 1057 participants in this study. Of the participants, 26% (n=275) reported using at least one tobacco product. The proportion of smoking of at least one tobacco product was higher among men (n=243, 46.5%) than women (n=32, 6%). Among smokers, 1.5%, 5.9%, and 18.6% reportedly use only three, two, and one tobacco products, respectively. Of the study participants, 26% were smokers, 20.3% were exclusively cigarette smokers, and 21.8% reportedly started cigarette smoking at the age of 15 years or less. Male compared to female workers had higher odds of being smokers of at least one tobacco product (adjusted OR= 15.3, 95% CI= 10.0-23.4). Participants were significantly ( p = 0.009) more likely to use at least one tobacco product if their monthly income in Kuwaiti Dinars ranged from 501-1000 KD (adjusted OR= 1.9, 95% CI= 1.2-3.0) or 1501-2000 KD (adjusted OR= 2.3, 95% CI= 1.2-4.5) compared to those who had monthly income range 500 KD or less. Conclusion The male gender and high income of the participants were significant predictors of the use of at least one tobacco product. Anti-smoking campaigns, mass media interventions, and increasing tobacco product taxes may minimize this population's tobacco consumption.

Background The clinical impact of histological remission on short- and long-term clinical outcomes in patients with inflammatory bowel disease (IBD) is not well established. We assessed risk of clinical relapse, hospitalization, and need for surgery in patients achieving histological remission in comparison with active histological disease. Methods A systematic review was conducted using MEDLINE, Scopus, Cochrane CENTRAL, EMBASE, and conference abstracts from inception to November 2022. Our main outcome was the rate of clinical relapse in patients with IBD who reached histological remission vs patients with active histological disease. Secondary outcomes were clinical complications of IBD such as hospitalization and need for surgery. The endpoints were investigated at 2 time points, 6 to 12 months (short term) and >12 months (long term). Results Short-term outcome analysis showed that the risk of clinical relapse was significantly higher in ulcerative colitis patients with active histological disease in comparison with patients at histological remission (risk ratio [RR], 2.41; 95% confidence interval [CI], 1.69-3.44; P < .01). The risk of hospitalization in ulcerative colitis patients was not significant among the 2 groups (RR, 4.22; 95% CI, 0.91-19.62; P = .07). Long-term outcome analysis demonstrated that the risk of clinical relapse (RR, 2.07; 95% CI, 1.55-2.76; P < .01), need for surgery (RR, 3.14; 95% CI, 1.53-6.45; P < .01), and hospitalization (RR, 2.52; 95% CI, 1.59-4.00; P < .01) was significantly higher in patients with active histological disease. Conclusions Histological remission in IBD represents an important therapeutic goal that is not yet routinely pursued in clinical practice. In our study, patients who achieved histological remission have more favorable outcomes than those with active histological disease in ulcerative colitis.