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Rota M, Possenti I, Valsassina V, Santucci C, Bagnardi V, Corrao G, Bosetti C, Specchia C, Gallus S, Lugo A. Dose-response association between cigarette smoking and gastric cancer risk: a systematic review and meta-analysis. Gastric Cancer 2024; 27:197-209. [PMID: 38231449 DOI: 10.1007/s10120-023-01459-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/16/2023] [Indexed: 01/18/2024]
Abstract
This study aims at providing an accurate and up-to-date quantification of the dose-response association between cigarette smoking and gastric cancer (GC) risk, overall and by subsite. We conducted a systematic review and meta-analysis of case-control and cohort studies on the association between cigarette smoking and GC risk published up to January 2023. We estimated pooled relative risks (RR) of GC and its subsites according to smoking status, intensity, duration, and time since quitting. Among 271 eligible articles, 205 original studies were included in this meta-analysis. Compared with never smokers, the pooled RR for GC was 1.53 (95% confidence interval; CI 1.44-1.62; n = 92) for current and 1.30 (95% CI 1.23-1.37; n = 82) for former smokers. The RR for current compared with never smokers was 2.08 (95% CI 1.66-2.61; n = 21) for gastric cardia and 1.48 (95% CI 1.33-1.66; n = 8) for distal stomach cancer. GC risk nonlinearly increased with smoking intensity up to 20 cigarettes/day (RR:1.69; 95% CI 1.55-1.84) and levelled thereafter. GC risk significantly increased linearly with increasing smoking duration (RR: 1.31; 95% CI 1.25-1.37 for 20 years) and significantly decreased linearly with increasing time since quitting (RR: 0.65; 95% CI 0.44-0.95 for 30 years since cessation). The present meta-analysis confirms that cigarette smoking is an independent risk factor for GC, particularly for gastric cardia. GC risk increases with a low number of cigarettes up to 20 cigarettes/day and increases in a dose-dependent manner with smoking duration.
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Affiliation(s)
- Matteo Rota
- Department of Molecular and Translational Medicine, Università Degli Studi Di Brescia, Brescia, Italy
| | - Irene Possenti
- Department of Medical Epidemiology, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy
| | - Valeria Valsassina
- Department of Medical Epidemiology, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy
| | - Claudia Santucci
- Department of Medical Epidemiology, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, Università Degli Studi Di Milano-Bicocca, Milan, Italy
| | - Giovanni Corrao
- Laboratory of Healthcare Research and Pharmacoepidemiology, Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- National Centre of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
| | - Cristina Bosetti
- Department of Medical Epidemiology, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy
| | - Claudia Specchia
- Department of Molecular and Translational Medicine, Università Degli Studi Di Brescia, Brescia, Italy
| | - Silvano Gallus
- Department of Medical Epidemiology, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy
| | - Alessandra Lugo
- Department of Medical Epidemiology, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy.
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Scala M, Bosetti C, Bagnardi V, Possenti I, Specchia C, Gallus S, Lugo A. Dose-response Relationships Between Cigarette Smoking and Breast Cancer Risk: A Systematic Review and Meta-analysis. J Epidemiol 2023; 33:640-648. [PMID: 36967121 PMCID: PMC10635814 DOI: 10.2188/jea.je20220206] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/16/2022] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The possible association between cigarette smoking and breast cancer risk has been quite controversial. METHODS We conducted a systematic review and meta-analysis of all available observational studies published on the issue up to January 2020. Random-effects models were used to compute pooled relative risks (RRs) for cigarette smoking status and dose-risk relationships were evaluated using one-stage random-effects dose-response models. RESULTS A total of 169 studies were selected, providing a pooled RR for breast cancer of 1.07 (95% confidence interval [CI], 1.05-1.10) for current, 1.08 (95% CI, 1.06-1.10) for former, and 1.09 (95% CI, 1.07-1.11) for ever smokers, compared to never smokers. Results were consistent in case-control and cohort studies. No meaningful differences were observed across strata of most covariates considered, nor according to relevant genetic mutations and polymorphisms (ie, BRCA mutation, N-acetyltransferase and glutathione S-transferase genotypes, and P53). Breast cancer risk increased linearly with intensity of smoking (RR 1.12; 95% CI, 1.08-1.16 for 20 cigarettes/day and 1.26; 95% CI, 1.17-1.36 for 40 cigarettes/day), and with increasing duration of smoking (RR 1.05; 95% CI, 1.03-1.08 for 20 years of smoking and 1.11; 95% CI, 1.06-1.16 for 40 years of smoking). CONCLUSION The present large and comprehensive meta-analysis-conducted using an innovative approach for study search-supports the evidence of a causal role of tobacco smoking on breast cancer risk.
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Affiliation(s)
- Marco Scala
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Cristina Bosetti
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, Università degli Studi di Milano-Bicocca, Milan, Italy
| | - Irene Possenti
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Claudia Specchia
- Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
| | - Silvano Gallus
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandra Lugo
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
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Lee PN, Coombs KJ, Hamling JS. Evidence relating cigarettes, cigars and pipes to cardiovascular disease and stroke: Meta-analysis of recent data from three regions. World J Meta-Anal 2023; 11:290-312. [DOI: 10.13105/wjma.v11.i6.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND More recent data are required relating to disease risk for use of various smoked products and of other products containing nicotine. Earlier we published meta-analyses of recent results for chronic obstructive pulmonary disease and lung cancer on the relative risk (RR) of current compared to never product use for cigarettes, cigars and pipes based on evidence from North America, Europe and Japan. We now report corresponding up-to-date evidence for acute myocardial infarction (AMI), ischaemic heart disease (IHD) and stroke.
AIM To estimate, using recent data, AMI, IHD and stroke RRs by region for current smoking of cigarettes, cigars and pipes.
METHODS Publications in English from 2015 to 2020 were considered that, based on epidemiological studies in the three regions, estimated the current smoking RR of AMI, IHD or stroke for one or more of the three products. The studies should involve at least 100 cases of stroke or cardiovascular disease (CVD), not be restricted to populations with specific medical conditions, and should be of cohort or nested case-control study design or randomized controlled trials. A literature search was conducted on MEDLINE, examining titles and abstracts initially, and then full texts. Additional papers were sought from reference lists of selected papers, reviews and meta-analyses. For each study identified, we entered the most recent available data on current smoking of each product, as well as the characteristics of the study and the RR estimates. Combined RR estimates were derived using random-effects meta-analysis for stroke and, in the case of CVD, separately for IHD and AMI. For cigarette smoking, where far more data were available, heterogeneity was studied by a wide range of factors. For cigar and pipe smoking, a more limited heterogeneity analysis was carried out. A more limited assessment of variation in risk by daily number of cigarettes smoked was also conducted. Results were compared with those from previous meta-analyses published since 2000.
RESULTS Current cigarette smoking: Ten studies gave a random-effects RR for AMI of 2.72 [95% confidence interval (CI): 2.40-3.08], derived from 13 estimates between 1.47 and 4.72. Twenty-three studies gave an IHD RR of 2.01 (95%CI: 1.84-2.21), using 28 estimates between 0.81 and 4.30. Thirty-one studies gave a stroke RR of 1.62 (95%CI: 1.48-1.77), using 37 estimates from 0.66 to 2.91. Though heterogeneous, only two of the overall 78 RRs were below 1.0, 71 significantly (P < 0.05) exceeding 1.0. The heterogeneity was only partly explicable by the factors studied. Estimates were generally higher for females and for later-starting studies. They were significantly higher for North America than Europe for AMI, but not the other diseases. For stroke, the only endpoint with multiple Japanese studies, RRs were lower there than for Western studies. Adjustment for multiple factors tended to increase RRs. Our RR estimates and the variations by sex and region are consistent with earlier meta-analyses. RRs generally increased with amount smoked. Current cigar and pipe smoking: No AMI data were available. One North American study reported reduced IHD risk for non-exclusive cigar or pipe smoking, but considered few cases. Two North American studies found no increased stroke risk with exclusive cigar smoking, one reporting reduced risk for exclusive pipe smoking (RR 0.24, 95%CI: 0.06-0.91). The cigar results agree with an earlier review showing no clear risk increase for IHD or stroke.
CONCLUSION Current cigarette smoking increases risk of AMI, IHD and stroke, RRs being 2.72, 2.01 and 1.62. The stroke risk is lower in Japan, no increase was seen for cigars/pipes.
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Affiliation(s)
- Peter Nicholas Lee
- Medical Statistics and Epidemiology, P.N.Lee Statistics and Computing Ltd., Sutton SM2 5DA, Surrey, United Kingdom
| | - Katharine J Coombs
- Medical Statistics and Epidemiology, P.N.Lee Statistics and Computing Ltd., Sutton SM2 5DA, Surrey, United Kingdom
| | - Jan S Hamling
- Medical Statistics and Epidemiology, P.N.Lee Statistics and Computing Ltd., Sutton SM2 5DA, Surrey, United Kingdom
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Yeob KE, Kim SY, Kim YY, Park JH. Nationwide prevalence and trends in cigarette smoking among adult men with and without disabilities in South Korea between 2009 and 2017. Public Health 2023; 222:92-99. [PMID: 37536197 DOI: 10.1016/j.puhe.2023.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/19/2023] [Accepted: 06/19/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVES Current smoking rates for people with and without disabilities vary among countries. This study analyzed smoking behavior over 9 years in adult South Korean men with disabilities, according to disability severity and type, and in those without disabilities. STUDY DESIGN This was a cross-sectional study. METHODS This analysis was conducted using national disability registration data and national general health checkup data for 2009-2017. Age-standardized smoking behaviors were analyzed for each year according to the presence, severity, and type of disability. The odds of current smoking were determined by multivariate logistic regression after adjusting for sociodemographic and clinical variables. RESULTS The age-standardized smoking rate and average number of cigarettes for men with mild disabilities in the younger age group were 1.16 (43.0 vs 36.8%) and 1.05 (16.1 vs 15.3 cigarettes) times higher than in non-disabled men as of 2017. The highest smoking rate was observed in men with physical disabilities in the younger age. In the older age group, the highest smoking rate was that of men with intellectual or psychological disabilities. CONCLUSION Smoking behaviors remained poorest in men with disabilities, especially those with mild, physical, and intellectual/psychological disabilities. Public health policies should focus on people with disabilities to promote health, prevent secondary conditions, and reduce health disparities by implementing antismoking health policies.
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Affiliation(s)
- K E Yeob
- College of Medicine/Institute of Health & Science Convergence, Chungbuk National University, Cheongju, South Korea; Chungbuk Tobacco Control Center, Cheongju, South Korea
| | - S Y Kim
- College of Medicine/Institute of Health & Science Convergence, Chungbuk National University, Cheongju, South Korea; Chungbuk Tobacco Control Center, Cheongju, South Korea; Department of Public Health and Preventive Medicine, Chungbuk National University Hospital, Cheongju, South Korea
| | - Y Y Kim
- Big Data Steering Department, National Health Insurance Service, Wonju, Republic of Korea; Drug Evaluation Department, National Institute of Food and Drug Safety Evaluation, Cheongju, Republic of Korea
| | - J H Park
- College of Medicine/Institute of Health & Science Convergence, Chungbuk National University, Cheongju, South Korea; Chungbuk Tobacco Control Center, Cheongju, South Korea.
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Lee PN, Coombs KJ, Hamling JS. Evidence relating cigarette, cigar and pipe smoking to lung cancer and chronic obstructive pulmonary disease: Meta-analysis of recent data from three regions. World J Meta-Anal 2023; 11:228-252. [DOI: 10.13105/wjma.v11.i5.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/10/2023] [Accepted: 05/30/2023] [Indexed: 06/16/2023] Open
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Malevolti MC, Lugo A, Scala M, Gallus S, Gorini G, Lachi A, Carreras G. Dose-risk relationships between cigarette smoking and cervical cancer: a systematic review and meta-analysis. Eur J Cancer Prev 2023; 32:171-183. [PMID: 36440802 DOI: 10.1097/cej.0000000000000773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Cervical cancer (CC) is the fourth most frequent cancer worldwide. Cigarette smoking has been shown to influence CC risk in conjunction with human papillomavirus (HPV) infection. The aim of this study is to provide the most accurate and updated estimate of this association and its dose-response relationship. METHODS Using an innovative approach for the identification of original publications, we conducted a systematic review and meta-analysis of studies published up to January 2021. Random effects models were used to provide pooled relative risks (RRs) of CC for smoking status. Dose-response relationships were evaluated using one-stage random effects models with linear or restricted cubic splines models. RESULTS We included 109 studies providing a pooled RR of invasive CC and preinvasive lesions, respectively, of 1.70 [95% confidence interval (CI), 1.53-1.88] and 2.11 (95% CI, 1.85-2.39) for current versus never smokers, and, respectively, 1.13 (95% CI, 1.02-1.24) and 1.29 (95% CI, 1.15-1.46) for former versus never smokers. Considering HPV does not alter the positive association or its magnitude. Risks of CC sharply increased with few cigarettes (for 10 cigarettes/day, RR = 1.72; 95% CI, 1.34-2.20 for invasive CC and RR = 2.13; 95% CI, 1.86-2.44 for precancerous lesions). The risk of CC increased with pack-years and smoking duration and decreased linearly with time since quitting, reaching that of never smokers about 15 years after quitting. CONCLUSION This comprehensive review and meta-analysis confirmed the association of smoking with CC, independently from HPV infection. Such association rose sharply with smoking intensity and decreased after smoking cessation.
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Affiliation(s)
| | - Alessandra Lugo
- Department of Environmental Health Science, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan
| | - Marco Scala
- Department of Environmental Health Science, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan
| | - Silvano Gallus
- Department of Environmental Health Science, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan
| | - Giuseppe Gorini
- Oncologic Network, Prevention and Research Institute (ISPRO), Florence
| | - Alessio Lachi
- Department of Statistics, Informatics and Applications "Giuseppe Parenti", University of Florence, Florence, Italy
| | - Giulia Carreras
- Oncologic Network, Prevention and Research Institute (ISPRO), Florence
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Luo J, Tang X, Li F, Wen H, Wang L, Ge S, Tang C, Xu N, Lu L. Cigarette Smoking and Risk of Different Pathologic Types of Stroke: A Systematic Review and Dose-Response Meta-Analysis. Front Neurol 2022; 12:772373. [PMID: 35145466 PMCID: PMC8821532 DOI: 10.3389/fneur.2021.772373] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/06/2021] [Indexed: 12/05/2022] Open
Abstract
Objectives To quantify the association of cigarette smoking, including cigarettes per day and quitting duration, with the risk of different types of stroke morbidity and mortality in the general population, and to clarify the shape of the dose-response relations. Study Selection Prospective cohort studies and reported on the association between smoking, quitting and the incidence or mortality of stroke were included. Data Extraction and Synthesis All available data were converted uniformly to odds ratios (ORs) and were pooled using random-effects meta-analysis with inverse variance weighting. A dose-response meta-analysis was performed to explore the quantitative relationship between different smoking characteristics and the risk of different pathologic types of stroke incidence. Results Twenty-five studies with 3,734,216 individuals were included. Compared to never smokers, the pooled ORs of stroke morbidity and mortality were 1.45 (1.24–1.70) and 1.44 (1.23–1.67) among ever smokers and 1.90 (1.55–2.34) and 1.70 (1.45–1.98) among current smokers. The risk of different pathologic types of stroke was also increased among ever and current smokers. There was a significant non-linear dose-response association between the number of cigarette smoking and the risk of stroke incidence. Comparing no smoking, the ORs for smoking five and 35 cigarettes per day were 1.44 (1.35–1.53) and 1.86 (1.71–2.02). Other pathologic types of stroke have a similar dose-response relationship. There was also non-linear dose-response association between the length of time since quitting and risk of stroke. The risk of stroke decreased significantly after quitting for 3 years [OR = 0.56 (0.42–0.74)]. Conclusion The risk of different types of stroke among smokers is remarkably high. Our findings revealed a more detailed dose-response relationship and have important implications for developing smoking control strategies for stroke prevention. Systematic Review Registration https://inplasy.com/inplasy-2020-6-0062/, identifier: INPLASY202060062.
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Affiliation(s)
- Jianyu Luo
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaorong Tang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fan Li
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, United States
- Center for Methods in Implementation and Prevention Science, Yale School of Public Health, New Haven, CT, United States
| | - Hao Wen
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lin Wang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shuqi Ge
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunzhi Tang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
- Chunzhi Tang
| | - Nenggui Xu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
- Nenggui Xu
| | - Liming Lu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
- *Correspondence: Liming Lu
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Chen S, Kawasaki Y, Hu H, Kuwahara K, Yamamoto M, Uehara A, Honda T, Yamamoto S, Nakagawa T, Miyamoto T, Okazaki H, Hori A, Shimizu M, Murakami T, Kochi T, Eguchi M, Imai T, Nishihara A, Tomita K, Akter S, Kabe I, Mizoue T, Dohi S. Smoking Cessation, Weight Gain, and the Trajectory of Estimated Risk of Coronary Heart Disease: 8-Year Follow-up From a Prospective Cohort Study. Nicotine Tob Res 2021; 23:85-91. [PMID: 31504860 PMCID: PMC7789946 DOI: 10.1093/ntr/ntz165] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 08/28/2019] [Indexed: 12/25/2022]
Abstract
Introduction The effect of weight gain following smoking cessation on cardiovascular risks is unclear. We aimed to prospectively investigate the association of weight gain following smoking cessation with the trajectory of estimated risks of coronary heart disease (CHD). Methods In a cohort of 18 562 Japanese male employees aged 30–64 years and initially free of cardiovascular diseases, participants were exclusively grouped into sustained smokers, quitters with weight gain (body weight increase ≥5%), quitters without weight gain (body weight increase <5% or weight loss), and never smokers. Global 10-year CHD risk was annually estimated by using a well-validated prediction model for the Japanese population. Linear mixed models and piecewise linear mixed models were used to compare changes in the estimated 10-year CHD risk by smoking status and weight change following smoking cessation. Results During a maximum of 8-year follow-up, both quitters with and without weight gain had a substantially decreased level of estimated 10-year CHD risk after quitting smoking, compared with sustained smokers (all ps for mean differences < .001). The estimated 10-year CHD risk within the first year after cessation decreased more rapidly in quitters without weight gain than in quitters with weight gain (change rate [95% confidence interval, CI] −0.90 [−1.04 to −0.75] vs. −0.40 [−0.60 to −0.19] % per year, p < .0001). Thereafter, the estimated 10-year CHD risk in both groups increased at similar rates (change rate [95% CI] −0.07 [−0.21 to 0.07] vs. 0.11 [−0.09 to 0.30] % per year, p = .16, from year 1 to year 2; and 0.10 [0.05 to 0.15] vs. 0.11 [0.04 to 0.18] % per year, p = .80, from year 2 to year 8). Conclusions In this population of middle-aged, Japanese male workers, smoking cessation greatly reduces the estimated 10-year risk of CHD. However, weight gain weakens the beneficial effect of quitting smoking in a temporary and limited fashion. Implications To the best of our knowledge, this study is the first to examine the effect of weight gain following smoking cessation on the trajectory of the absolute risk of CHD. Our data imply that the benefits of cessation for reducing the absolute risk of CHD outweigh the potential risk increase due to weight gain, and suggest that in order to maximize the beneficial effects of quitting smoking, interventions to control post-cessation weight gain might be warranted.
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Affiliation(s)
- Sanmei Chen
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Huanhuan Hu
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keisuke Kuwahara
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan.,Teikyo University Graduate School of Public Health, Tokyo, Japan
| | | | | | | | | | | | | | | | - Ai Hori
- Department of Global Public Health, University of Tsukuba, Ibaraki, Japan
| | - Makiko Shimizu
- Mizue Medical Clinic, Keihin Occupational Health Center, Kanagawa, Japan
| | - Taizo Murakami
- Mizue Medical Clinic, Keihin Occupational Health Center, Kanagawa, Japan
| | | | | | | | | | | | - Shamima Akter
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Isamu Kabe
- Tsukuba Plant, Kubota Co, Ibaraki, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
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Kasturiratne A, Ediriweera DS, De Silva ST, Niriella MA, Thulani UB, Pathmeswaran A, Dassanayake AS, De Silva AP, Chackrewarthy S, Ranawaka U, Kato N, Wickremasinghe AR, de Silva HJ. Patterns and predictors of mortality in a semi-urban population-based cohort in Sri Lanka: findings from the Ragama Health Study. BMJ Open 2020; 10:e038772. [PMID: 32994253 PMCID: PMC7526314 DOI: 10.1136/bmjopen-2020-038772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To describe patterns and predictors of mortality in a semi-urban population in Sri Lanka. DESIGN A prospective population-based cohort study. SETTING Ragama Medical Officer of Health area in the Gampaha district, Sri Lanka. PARTICIPANTS Adults between 35 and 64 years of age were recruited using an age stratified random sampling technique in 2007. MEASURES At baseline, we recorded socio-demographic, lifestyle, anthropometric, biochemical and clinical data of the participants. Over 10 years, we obtained the cause and date of death from the death registration documents of deceased participants. We determined the survival probability of the cohort over 10 years and estimated Hazard ratios (HRs) for all-cause mortality (ACM), cardiovascular mortality (CVM) and cancer-related mortality (CRM) using Cox's proportional hazards model. We also estimated the survival probabilities for men and women in each 10-year age group and standardised mortality ratio relative to the source population. RESULTS There were 169 deaths over 10 years with standardised mortality rates of 5.3 and 2.4 per 1000 years of follow-up for men and women, respectively. Independent predictors of: ACM were older age, lower income, smoking and diabetes mellitus while gender, education, occupation, harmful alcohol use, waist circumference and hypertension were not; CVM were older age, lower income, smoking, diabetes and hypertension while gender and harmful alcohol use were not; CRM was older age while gender, smoking and diabetes were not. Those engaged in clerical and technical occupations or unemployed had a lower risk of CRM as compared with those engaged in elementary occupations. CONCLUSIONS Older age, lower income, smoking, diabetes and hypertension strongly predict mortality in this cohort. Addressing the identified modifiable predictors through behavioural modification will improve longevity in similar populations.
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Affiliation(s)
| | - Dileepa Senajith Ediriweera
- Centre for Health Informatics, Biostatistics and Epidemiology, University of Kelaniya Faculty of Medicine, Ragama, Sri Lanka
| | | | - Madunil Anuk Niriella
- Department of Medicine, University of Kelaniya Faculty of Medicine, Ragama, Sri Lanka
| | - Uthuru Beddage Thulani
- Department of Public Health, University of Kelaniya Faculty of Medicine, Ragama, Sri Lanka
| | | | | | | | - Sureka Chackrewarthy
- Department of Biochemistry and Clinical Chemistry, University of Kelaniya Faculty of Medicine, Ragama, Sri Lanka
| | - Udaya Ranawaka
- Department of Medicine, University of Kelaniya Faculty of Medicine, Ragama, Sri Lanka
| | - Norihiro Kato
- Department of Gene Diagnostics and Therapeutics, National Center for Global Health and Medicine Research Institute, Shinjuku-ku, Tokyo, Japan
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Lugo A, Peveri G, Gallus S. Should we consider gallbladder cancer a new smoking‐related cancer? A comprehensive meta‐analysis focused on dose–response relationships. Int J Cancer 2019; 146:3304-3311. [DOI: 10.1002/ijc.32681] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/29/2019] [Accepted: 09/06/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Alessandra Lugo
- Department of Environmental Health Sciences Istituto di Ricerche Farmacologiche Mario Negri IRCCS Milan Italy
| | - Giulia Peveri
- Department of Molecular and Translational Medicine Università degli Studi di Brescia Brescia Italy
| | - Silvano Gallus
- Department of Environmental Health Sciences Istituto di Ricerche Farmacologiche Mario Negri IRCCS Milan Italy
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11
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Liu X, Peveri G, Bosetti C, Bagnardi V, Specchia C, Gallus S, Lugo A. Dose-response relationships between cigarette smoking and kidney cancer: A systematic review and meta-analysis. Crit Rev Oncol Hematol 2019; 142:86-93. [DOI: 10.1016/j.critrevonc.2019.07.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/19/2019] [Accepted: 07/24/2019] [Indexed: 01/22/2023] Open
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12
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Santucci C, Bosetti C, Peveri G, Liu X, Bagnardi V, Specchia C, Gallus S, Lugo A. Dose-risk relationships between cigarette smoking and ovarian cancer histotypes: a comprehensive meta-analysis. Cancer Causes Control 2019; 30:1023-1032. [PMID: 31236793 DOI: 10.1007/s10552-019-01198-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 06/17/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE Although smoking has not been associated with overall ovarian cancer risk, a different impact on various histotypes has been reported. Our aim is to provide an accurate, up-to-date estimate of the dose-risk relationships between cigarette smoking and epithelial ovarian cancer, overall and by histotypes. METHODS Using an innovative approach for the identification of original study publications, we conducted a systematic review and meta-analysis of epidemiological studies published on the topic until September 2018. Summary relative risks (RR) for cigarette smoking were estimated using random-effects models; dose-risk relationships were evaluated using one-stage random-effects models with restricted cubic splines. RESULTS Thirty-seven studies were considered in the meta-analysis. The summary RRs for current versus never smokers were 1.05 (95% confidence interval CI 0.95-1.16) for overall ovarian cancer, 1.78 (95% CI 1.52-2.07) for mucinous, 0.77 (95% CI 0.65-0.93) for clear cell, 0.81 (95% CI 0.73-0.91) for endometrioid, and 1.05 (95% CI 0.94; 1.17) for serous cancer. The risk of borderline mucinous (RR 2.09) and serous (RR 1.16) tumors was higher than for invasive cancers (RR 1.44 and 0.95, respectively). For mucinous cancer, risk was noticeably higher with smoking intensity and duration (RR 2.35 for 20 cigarettes/day, and 2.11 for 20 years of smoking). A non-significant linear relation was found with smoking intensity, duration, and time since quitting for overall ovarian cancer and other histotypes. CONCLUSIONS This uniquely large and comprehensive meta-analysis confirms that although cigarette smoking does not appear to be a risk factor for ovarian cancer, and it is even slightly protective for some rare histotypes, there is a strong dose-risk relationship with mucinous ovarian cancer.
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Affiliation(s)
- Claudia Santucci
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Giulia Peveri
- Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
| | - Xiaoqiu Liu
- Laboratory of Lifestyle Epidemiology, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, Università degli Studi di Milano-Bicocca, Milan, Italy
| | - Claudia Specchia
- Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
| | - Silvano Gallus
- Laboratory of Lifestyle Epidemiology, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy.
| | - Alessandra Lugo
- Laboratory of Lifestyle Epidemiology, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy
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Gunter R, Szeto E, Jeong SH, Suh S, Waters AJ. Cigarette Smoking in South Korea: A Narrative Review. Korean J Fam Med 2019; 41:3-13. [PMID: 31189304 PMCID: PMC6987030 DOI: 10.4082/kjfm.18.0015] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 09/10/2018] [Indexed: 12/17/2022] Open
Abstract
Although the prevalence of cigarette smoking has declined in Western countries over the past few decades, a comparable decline among males has not been observed in Asian countries, especially in South Korea, where approximately 40%–50% of men and 4%–8% of women have been identified as smokers, and there is a pressing need to understand the background of cigarette smoking in these populations. The present study is a narrative review of the research literature on cigarette smoking in South Korea. First, we describe the social, economic, and cultural factors that impact cigarette smoking in South Korea. The paper also reviews the available peer-reviewed literature comprising observational studies and interventional studies, including randomized controlled trials. The extant literature on smoking in Korean Americans is also reviewed. Cigarette smoking in South Korea has been relatively understudied, and this review identifies priority areas for future research, including the use of mobile interventions.
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Affiliation(s)
- Rebekah Gunter
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Edwin Szeto
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Se-Hoon Jeong
- School of Media & Communication, Korea University, Seoul, Korea
| | - Sooyeon Suh
- Department of Psychology, Sungshin Women's University, Seoul, Korea
| | - Andrew J Waters
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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14
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Lugo A, Peveri G, Bosetti C, Bagnardi V, Crippa A, Orsini N, Rota M, Gallus S. Strong excess risk of pancreatic cancer for low frequency and duration of cigarette smoking: A comprehensive review and meta-analysis. Eur J Cancer 2018; 104:117-126. [PMID: 30347287 DOI: 10.1016/j.ejca.2018.09.007] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 12/13/2022]
Abstract
AIM Cigarette smoking is an established risk factor for pancreatic cancer but an updated quantification of the association is lacking. Our aim is to provide the most accurate and updated estimate of the dose-response relationships between cigarette smoking and pancreatic cancer risk. METHODS Using an innovative approach for the identification of original publications, we conducted a systematic review and meta-analysis of epidemiological studies published on the issue up to April 2017. Random effects models were used to provide pooled estimates for the cigarette smoking status; dose-risk relationships were evaluated using one-stage random effects models with restricted cubic splines. RESULTS Seventy-eight studies were included, providing a pooled relative risk (RR) of pancreatic cancer of 1.8 (95% confidence interval, CI: 1.7-1.9) for the current and 1.2 (95% CI: 1.1-1.2) for the former vs. never smokers. A sharp increase in pancreatic cancer risk was found already with a low number of cigarettes and up to 30 cigarettes/day (RR 2.2, 95% CI: 1.9-2.4). Similarly, the risk of pancreatic cancer steady increased after a few years of smoking up to 30 years (RR 1.8, 95% CI: 1.6-2.0). The risk rapidly decreased with increasing time since quitting and was 0.6 (95% CI: 0.5-0.7, for the former vs. current smokers) after 20 years of quitting. CONCLUSIONS The present meta-analysis indicates that pancreatic cancer risk sharply increases with a low number of cigarettes or after a few years of smoking and that it rapidly decreases a few years after cessation, although it takes almost 20 years to reach that of never smokers.
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Affiliation(s)
- Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Giulia Peveri
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy; Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
| | - Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, Università Degli Studi di Milano-Bicocca, Milan, Italy
| | - Alessio Crippa
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Nicola Orsini
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Matteo Rota
- Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Milan, Italy
| | - Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
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Nakamura K, Watanabe M, Okuda N, Yoshita K, Kabayama M, Torii S, Kuribayashi T, Itai K, Kamide K, Miura K, Okayama A. The Influence of the Japanese Nationwide Cardiovascular Prevention System Health Guidance on Smoking Cessation Among Smokers: A Propensity Score Matching Analysis. J Atheroscler Thromb 2018; 25:323-334. [PMID: 29199202 PMCID: PMC5906185 DOI: 10.5551/jat.42051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Aim: We investigated whether 2 types of personalized health guidance (repeated and single counseling) in the Japanese nationwide cardiovascular prevention system promoted smoking cessation among smokers. Methods: The study included 47,745 Japanese smokers aged 40 to 74 years classified into 2 personalized health guidance schemes. After a 1-year follow-up, we compared the rates of smoking cessation between individuals who had received counseling (“supported”) and those who had not received counseling (“unsupported”). Using propensity score matching analysis, we estimated the average treatment effect (ATE) of each approach on smoking cessation after balancing out the characteristics between the supported and unsupported groups. The propensity score regression model included age, medical insurance type, weight gain since the age of 20 years, exercise, eating habits, alcohol intake, quality of sleep, readiness to modify lifestyle, willingness to receive support, and body mass index. Results: In the repeated counseling scheme, the age-adjusted rates of smoking cessation in the supported and unsupported groups were 8.8% and 6.3% for males, and 9.8% and 9.1% for females respectively. In the single counseling scheme, the corresponding rates were 8.4% and 7.3% for supported and unsupported males, and 11.0% and 11.7% for supported and unsupported females respectively. The ATE of repeated counseling was + 2.64% (95% confidence interval: + 1.51% to + 3.77%) for males and + 3.11% (−1.85% to +8.07%) for females. The ATE of single counseling was +0.61% (−1.17% to +2.38%) for males and −1.06% (−5.96% to +3.85%) for females. Conclusions: In the Japanese cardiovascular prevention system, repeated counseling may promote smoking cessation among male smokers.
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Affiliation(s)
- Koshi Nakamura
- Department of Public Health, Hokkaido University Faculty of Medicine
| | - Makoto Watanabe
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Art and Science
| | - Katsushi Yoshita
- Department of Food Science and Nutrition, Graduate School of Human Life Science, Osaka City University
| | - Mai Kabayama
- Division of Health Science, Osaka University Graduate School of Medicine
| | - Sayuki Torii
- Department of Public Health, Shiga University of Medical Science
| | | | | | - Kei Kamide
- Division of Health Science, Osaka University Graduate School of Medicine
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science
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Lee PN, Forey BA, Thornton AJ, Coombs KJ. The relationship of cigarette smoking in Japan to lung cancer, COPD, ischemic heart disease and stroke: A systematic review. F1000Res 2018; 7:204. [PMID: 30800285 PMCID: PMC6367657 DOI: 10.12688/f1000research.14002.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/14/2018] [Indexed: 02/06/2023] Open
Abstract
Background: To present up-to-date meta-analyses of evidence from Japan relating smoking to major smoking-related diseases. Methods: We restricted attention to lung cancer, chronic obstructive pulmonary disease (COPD), ischemic heart disease (IHD) and stroke, considering relative risks (RRs) for current and ex-smokers relative to never smokers. Evidence by amount smoked and time quit was also considered. For IHD and stroke only, studies had to provide age-adjusted RRs, with age-specific results considered. For each disease we extended earlier published databases to include more recent studies. Meta-analyses were conducted, with random-effects RRs and tests of heterogeneity presented. Results: Of 40 studies, 26 reported results for lung cancer and 7 to 9 for each other disease. For current smoking, RRs (95%CIs) were lung cancer 3.59 (3.25-3.96), COPD 3.57 (2.72-4.70), IHD 2.21 (1.96-2.50) and stroke 1.40 (1.25-1.57). Ex-smoking RRs were lower. Data for lung cancer and IHD showed a clear tendency for RRs to rise with increasing amount smoked and decrease with increasing time quit. Dose-response data were unavailable for COPD and unclear for stroke, where the association was weaker. Conclusions: Compared to studies in other Asian and Western countries, current smoking RRs were quite similar for IHD and stroke. The comparison is not clear for COPD, where the Japanese data, mainly from cross-sectional studies, is limited. For lung cancer, the RRs are similar to those in other Asian countries, but substantially lower than in Western countries. Explanations for this are unclear, but less accurate reporting of smoking by Japanese may contribute to the difference.
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Affiliation(s)
- Peter N. Lee
- P.N. Lee Statistics and Computing Ltd., Sutton, SM2 5DA, UK
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17
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Chhoun P, Ngin C, Tuot S, Pal K, Steel M, Dionisio J, Pearson H, Mburu G, Brody C, Yi S. Non-communicable diseases and related risk behaviors among men and women living with HIV in Cambodia: findings from a cross-sectional study. Int J Equity Health 2017; 16:125. [PMID: 28705242 PMCID: PMC5513209 DOI: 10.1186/s12939-017-0622-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 07/04/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND There is a growing concern for an increasing burden of non-communicable diseases (NCDs) in people living with HIV. This concern is evident especially in developing countries where dietary and lifestyle risk factors associated with NCDs are becoming more prominent. This study explored the prevalence of diabetes mellitus, hypertension, and hyperlipidemia and related risk factors in men and women living with HIV in Cambodia. METHODS This cross-sectional study was conducted among 510 adult people living with HIV randomly selected from one city and four provinces in Cambodia. A structured questionnaire was used to collect data on socio-demographic characteristics, health behaviors, medical history, and antiretroviral therapy (ART). Anthropometric and biological measurements were performed. Descriptive statistics were used to calculate proportions and means of the measured variables. An independent Student's t-test was used for continuous variables. Chi square test or Fisher's exact test was used for categorical variables to explore gender differences. RESULTS Prevalence of diabetes mellitus, hypertension, and hyperlipidemia was 9.4, 15.1, and 33.7%, respectively. The prevalence of hyperlipidemia was significantly higher among men compared to women. Mean systolic and diastolic blood pressures were also significantly higher among men. Regarding risk factors, 17.3% of participants were overweight, and 4.1% were obese. Tobacco and alcohol use was common, particularly among men. Fruit and vegetable consumption was considerably low among both men and women. Physical activity levels were also low. About 40% of participants reported having a job that involved mostly sitting or standing; 46.3% reported engaging in moderate activities; and 11.8% reported engaging in vigorous activities during leisure time. A significantly higher proportion of men compared to women engaged in vigorous activities both at work and during leisure time. CONCLUSIONS The prevalence of diabetes mellitus, hypertension, and hyperlipidemia among men and women living with HIV in Cambodia is considerably high. Related risk factors were also common. Given the comorbidity of NCDs and HIV, policy and programmatic interventions are required, including integration of NCD screening into HIV programs. Distinctions in the levels of diseases and in health behaviors between men and women suggest that interventions need to be tailor-made and gender-specific, targeting their respective diseases and behaviors.
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Affiliation(s)
- Pheak Chhoun
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | - Chanrith Ngin
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | - Sovannary Tuot
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | - Khuondyla Pal
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | - Martin Steel
- Public Health Program, Touro University California, Vallejo, USA
| | | | - Hattie Pearson
- Public Health Program, Touro University California, Vallejo, USA
| | - Gitau Mburu
- Divison of Health Research, Lancaster University, Lancaster, UK
- International HIV/AIDS Alliance, Brighton, UK
| | - Carinne Brody
- Public Health Program, Touro University California, Vallejo, USA
| | - Siyan Yi
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
- Public Health Program, Touro University California, Vallejo, USA
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18
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Voxelwise meta-analysis of gray matter anomalies in chronic cigarette smokers. Behav Brain Res 2016; 311:39-45. [PMID: 27173432 DOI: 10.1016/j.bbr.2016.05.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 05/02/2016] [Accepted: 05/06/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Evidence from previous voxel-based morphometry (VBM) studies revealed that widespread brain regions are involved in chronic smoking. However, the spatial localization reported for gray matter (GM) abnormalities is heterogeneous. The aim of the present study was quantitatively to integrate studies on GM abnormalities observed in chronic smokers. METHODS A systematic search of the PubMed, Web of Knowledge and Science Direct databases from January 1, 2000 to July 31, 2015 was performed to identify eligible whole-brain VBM studies. Comprehensive meta-analyses to investigate regional GM abnormalities in chronic smokers were conducted with the Seed-based d Mapping software package. RESULTS Eleven studies comprising 686 chronic cigarette smokers and 1024 nonsmokers were included in the meta-analyses. Consistently across studies, the chronic smokers showed a robust GM decrease in the bilateral prefrontal cortex and a GM increase in the right lingual cortex. Moreover, meta-regression demonstrated that smoking years and cigarettes per day were partly correlated with GM anomalies in chronic cigarette smokers. CONCLUSIONS The convergent findings of this quantitative meta-analysis reveal a characteristic neuroanatomical pattern in chronic smokers. Future longitudinal studies should investigate whether this brain morphometric pattern can serve as a useful target and a prognostic marker for smoking intervention.
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19
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Smoking increases the risk of all-cause and cardiovascular mortality in patients with chronic kidney disease. Kidney Int 2015. [DOI: 10.1038/ki.2015.212] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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20
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Kurmi OP, Li L, Wang J, Millwood IY, Chen J, Collins R, Guo Y, Bian Z, Li J, Chen B, Xie K, Jia W, Gao Y, Peto R, Chen Z. COPD and its association with smoking in the Mainland China: a cross-sectional analysis of 0.5 million men and women from ten diverse areas. Int J Chron Obstruct Pulmon Dis 2015; 10:655-65. [PMID: 25848242 PMCID: PMC4374651 DOI: 10.2147/copd.s75454] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
PURPOSE In adult Chinese men, smoking prevalence is high, but little is known about its association with chronic respiratory disease, which is still poorly diagnosed and managed. METHODS A nationwide study recruited 0.5 million men and women aged 30-79 years during 2004-2008 from ten geographically diverse areas across the Mainland China. Information was collected from each participant regarding smoking and self-reported physician diagnosis of chronic bronchitis/emphysema (CB/E), along with measurement of lung function indices. Logistic regression was used to yield sex-specific odds ratios (ORs) relating smoking to airflow obstruction (AFO), defined as forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) <0.7 and CB/E, adjusting for age, areas, education, and income. RESULTS Overall 74% of men were ever regular smokers; among them, 7.2% had AFO compared with 5.4% in never-smokers, yielding an OR of 1.42 (95% confidence interval [CI]: 1.34-1.50). The risk was strongly associated with amount smoked and starting to smoke at a younger age. Among ex-smokers, the OR was more extreme for those who had quit due to illness (OR: 1.86, 95% CI: 1.77-1.96) than those who had quit by choice (OR:1.08, 95% CI: 1.01-1.16). CB/E prevalence was also significantly elevated in ex-smokers who had quit because of ill health (OR:2.79, 95% CI: 2.64-2.95), but not in regular smokers (OR:1.04, 95% CI: 0.96-1.11). Female smokers was rare (3%), but carried an excess risk for AFO (OR:1.53, 95% CI: 1.43-1.65) and, to a lesser extent, for CB/E (OR:1.28, 95% CI: 1.15-1.42). CONCLUSION In Mainland China, adult smokers, particularly ex-smokers who had quit because of illness, had significantly higher prevalence of chronic respiratory disease. AFO appeared to be more strongly associated with smoking than self-reported chronic respiratory disease.
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Affiliation(s)
- Om P Kurmi
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, Mainland China ; Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, Mainland China
| | - Jenny Wang
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Iona Y Millwood
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, Mainland China
| | - Rory Collins
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Yu Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, Mainland China
| | - Zheng Bian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, Mainland China
| | - Jiangtao Li
- NCDs Prevention and Control Department, Huixian CDC, Huixian, Henan, Mainland China
| | - Biyun Chen
- NCDs Prevention and Control Department, Hunan CDC, Changsha, Mainland China
| | - Kaixu Xie
- NCDs Prevention and Control Department, Tongxiang CDC, Zhejiang, Mainland China
| | - Weifan Jia
- NCDs Prevention and Control Department, Liuyang CDC, Baiyikengdao, Liuyang, Changsha, Hunan, Mainland China
| | - Yali Gao
- NCDs Prevention and Control Department, Sichuan CDC, Sichuan, Mainland China
| | - Richard Peto
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Zhengming Chen
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
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21
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Clinical benefits of smoking cessation in reducing all-cause and disease-specific mortality among older people in Taiwan: A 10-year nationwide retrospective cohort study. Eur Geriatr Med 2014. [DOI: 10.1016/j.eurger.2014.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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22
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Fujisawa D, Umezawa S, Basaki-Tange A, Fujimori M, Miyashita M. Smoking status, service use and associated factors among Japanese cancer survivors--a web-based survey. Support Care Cancer 2014; 22:3125-34. [PMID: 24848577 DOI: 10.1007/s00520-014-2284-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 05/06/2014] [Indexed: 01/22/2023]
Abstract
PURPOSE This study aims to investigate smoking status and its associated factors among Japanese cancer survivors. We stretched our focus on association with health-related behaviors other than smoking (alcohol intake, physical exercise, and social activity) and the smoking cessation strategies used by cancer survivors. METHODS An anonymous cross-sectional web-based survey was conducted, enrolling survivors of various types of cancer up to 10 years after diagnosis. Smoking status, socioeconomic status, health-related behaviors other than smoking, and smoking cessation resource that the participants used were evaluated. Factors associated with continuous smoking after cancer diagnosis were explored using multivariate analysis. RESULTS Among 168 participants who were smoking at the time of cancer diagnosis, 96 participants (57.1 %) continued smoking. Sixty-seven survivors (69.8 %) were willing to reduce or quit smoking, however, only 39 survivors (40.6 %) were provided with counseling or intervention on smoking cessation. Male gender, shorter time after cancer diagnosis, and lack of regular physical exercise associated with continuous smoking. Higher level of fear of cancer recurrence had trend-level significance of association with smoking cessation. CONCLUSIONS Substantial proportions of Japanese cancer survivors continue smoking after diagnosis of cancer. The majority of them are not provided with relevant information or support, despite their willingness of reducing or quitting smoking. Smoking cessation is associated with other health behaviors (i.e., physical exercise). This suggests considerable missed opportunities for health-care providers to provide cancer survivors with counseling and evidence-based interventions. Promotion of professional support on smoking cessation and education to encourage healthy behaviors are needed.
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Affiliation(s)
- Daisuke Fujisawa
- Psycho-Oncology Division, National Cancer Center East, Kashiwa, Japan,
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23
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He Y, Jiang B, Li LS, Li LS, Sun DL, Wu L, Liu M, He SF, Liang BQ, Hu FB, Lam TH. Changes in smoking behavior and subsequent mortality risk during a 35-year follow-up of a cohort in Xi'an, China. Am J Epidemiol 2014; 179:1060-1070. [PMID: 24674900 DOI: 10.1093/aje/kwu011] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Prospective evidence of the associations of smoking cessation with chronic obstructive pulmonary disease (COPD) and other causes of death in Asia is scarce. Previous studies, which were mostly based on baseline smoking behavior only, were subject to sick-quitter bias and misclassification resulting from changes in smoking behavior during follow-up. We followed up a cohort for 18 years (1976-1994) to assess changes in smoking behavior and then for an additional 17 years (1994-2011) to examine the relationships of continuing to smoke and new quitting with mortality risk in 1,494 Chinese people (961 men, 533 women). Of the baseline current smokers, 38.7% quit between 1976 and 1994. From 1994 to 2011, a total of 488 persons (359 men, 129 women) died. Ever smokers had increased risks of lung cancer, coronary heart disease, thrombotic stroke, and COPD, with dose-response relationships. For all tobacco-related mortality, the relative risk for new quitters compared with continuing smokers was 0.68 (95% confidence interval: 0.46, 0.99) for those who had quit 2-7 years previously and 0.56 (95% confidence interval: 0.37, 0.85) for those who had quit 8 years or more previously. The corresponding relative risks were 0.69 and 0.45 for lung cancer, 0.78 and 0.51 for coronary heart disease, 0.76 and 0.84 for thrombotic stroke, and 0.89 and 0.61 for COPD, respectively. Smoking increased tobacco-related deaths, and particularly deaths from COPD, in China, whereas quitting at middle age (at approximately 50 years of age) substantially reduced the risks of death from these causes. The benefits of smoking cessation were underestimated in previous studies that did not use repeated measures.
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Babizhayev MA. The detox strategy in smoking comprising nutraceutical formulas of non-hydrolyzed carnosine or carcinine used to protect human health. Hum Exp Toxicol 2014; 33:284-316. [PMID: 24220875 DOI: 10.1177/0960327113493306] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The increased oxidative stress in patients with smoking-associated disease, such as chronic obstructive pulmonary disease, is the result of an increased burden of inhaled oxidants as well as increased amounts of reactive oxygen species generated by various inflammatory, immune and epithelial cells of the airways. Nicotine sustains tobacco addiction, a major cause of disability and premature death. In addition to the neurochemical effects of nicotine, behavioural factors also affect the severity of nicotine withdrawal symptoms. For some people, the feel, smell and sight of a cigarette and the ritual of obtaining, handling, lighting and smoking a cigarette are all associated with the pleasurable effects of smoking. For individuals who are motivated to quit smoking, a combination of pharmacotherapy and behavioural therapy has been shown to be most effective in controlling the symptoms of nicotine withdrawal. In the previous studies, we proposed the viability and versatility of the imidazole-containing dipeptide-based compounds in the nutritional compositions as the telomere protection targeted therapeutic system for smokers in combination with in vitro cellular culture techniques being an investigative tool to study telomere attrition in cells induced by cigarette smoke (CS) and smoke constituents. Our working therapeutic concept is that imidazole-containing dipeptide-based compounds (non-hydrolyzed carnosine and carcinine) can modulate the telomerase activity in the normal cells and can provide the redox regulation of the cellular function under the terms of environmental and oxidative stress and in this way protect the length and the structure of telomeres from attrition. The detoxifying system of non-hydrolyzed carnosine or carcinine can be applied in the therapeutic nutrition formulations or installed in the cigarette filter. Patented specific oral formulations of non-hydrolyzed carnosine and carcinine provide a powerful manipulation tool for targeted therapeutic inhibition of cumulative oxidative stress and inflammation and protection from telomere attrition associated with smoking. It is demonstrated in this work that both non-hydrolyzed carnosine and carcinine are characterized by greater bioavailability than pure l-carnosine subjected to enzymatic hydrolysis with carnosinase, and perform the detoxification of the α,β-unsaturated carbonyl compounds present in tobacco smoke. We argue that while an array of factors has shaped the history of the 'safer' cigarette, it is the current understanding of the industry's past deceptions and continuing avoidance of the moral implications of the sale of products that cause the enormous suffering and death of millions that makes reconsideration of 'safer' cigarettes challenging. In contrast to this, the data presented in the article show that recommended oral forms of non-hydrolyzed carnosine and carcinine protect against CS-induced disease and inflammation, and synergistic agents with the actions of imidazole-containing dipeptide compounds in developed formulations may have therapeutic utility in inflammatory lung diseases where CS plays a role.
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Affiliation(s)
- Mark A Babizhayev
- 1Innovative Vision Products, Inc., County of New Castle, Delaware, USA
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Kamsa-Ard S, Promthet S, Lewington S, Burrett JA, Sherliker P, Kamsa-Ard S, Wiangnon S, Parkin DM. Association between smoking and mortality: Khon Kaen cohort study, Thailand. Asian Pac J Cancer Prev 2013; 14:2643-7. [PMID: 23725189 DOI: 10.7314/apjcp.2013.14.4.2643] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite anti-smoking campaigns, smoking prevalence among Thai males aged 30 or older is high, at around 50%. The purpose of this study was to determine the relationship between smoking and mortality in a rural Thai community. MATERIALS AND METHODS Subjects enrolled into the Khon Kaen cohort study between 1990 and 2001 were followed up for their vital status until 16th March 2012. The death resource was from the Bureau of Policy and Strategy, Ministry of Interior, Thailand. A Cox proportional hazards model was used to analyse the association between smoking and death, controlling for age, education level and alcohol drinking, and confidence intervals were calculated using the floating risk method. RESULTS The study recruited 5,962 male subjects, of whom 1,396 died during a median 13.5 years of follow-up. Current smokers were more likely to die than never smokers after controlling for age, education level and alcohol drinking (HR, 95%CI: 1.41, 1.32- 1.51), and the excess mortality was greatest for lung cancer (HR, 95%CI: 3.51, 2.65-4.66). However, there was no increased risk with increasing dose of tobacco, and no difference in risk between smokers of yamuan (hand- rolled cigarettes) and manufactured tobacco. CONCLUSION Mortality from cancer, particularly lung cancer, and from all causes combined is dependent on smoking status among men in rural Thailand, but the relative risks are lower than have been reported from studies in high income countries, where the tobacco epidemic is more established.
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Affiliation(s)
- Siriporn Kamsa-Ard
- Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
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Lee JE, McLerran DF, Rolland B, Chen Y, Grant EJ, Vedanthan R, Inoue M, Tsugane S, Gao YT, Tsuji I, Kakizaki M, Ahsan H, Ahn YO, Pan WH, Ozasa K, Yoo KY, Sasazuki S, Yang G, Watanabe T, Sugawara Y, Parvez F, Kim DH, Chuang SY, Ohishi W, Park SK, Feng Z, Thornquist M, Boffetta P, Zheng W, Kang D, Potter J, Sinha R. Meat intake and cause-specific mortality: a pooled analysis of Asian prospective cohort studies. Am J Clin Nutr 2013; 98:1032-41. [PMID: 23902788 PMCID: PMC3778858 DOI: 10.3945/ajcn.113.062638] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Total or red meat intake has been shown to be associated with a higher risk of mortality in Western populations, but little is known of the risks in Asian populations. OBJECTIVE We examined temporal trends in meat consumption and associations between meat intake and all-cause and cause-specific mortality in Asia. DESIGN We used ecological data from the United Nations to compare country-specific meat consumption. Separately, 8 Asian prospective cohort studies in Bangladesh, China, Japan, Korea, and Taiwan consisting of 112,310 men and 184,411 women were followed for 6.6 to 15.6 y with 24,283 all-cause, 9558 cancer, and 6373 cardiovascular disease (CVD) deaths. We estimated the study-specific HRs and 95% CIs by using a Cox regression model and pooled them by using a random-effects model. RESULTS Red meat consumption was substantially lower in the Asian countries than in the United States. Fish and seafood consumption was higher in Japan and Korea than in the United States. Our pooled analysis found no association between intake of total meat (red meat, poultry, and fish/seafood) and risks of all-cause, CVD, or cancer mortality among men and women; HRs (95% CIs) for all-cause mortality from a comparison of the highest with the lowest quartile were 1.02 (0.91, 1.15) in men and 0.93 (0.86, 1.01) in women. CONCLUSIONS Ecological data indicate an increase in meat intake in Asian countries; however, our pooled analysis did not provide evidence of a higher risk of mortality for total meat intake and provided evidence of an inverse association with red meat, poultry, and fish/seafood. Red meat intake was inversely associated with CVD mortality in men and with cancer mortality in women in Asian countries.
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Affiliation(s)
- Jung Eun Lee
- Department of Food and Nutrition, Sookmyung Women's University, Seoul, South Korea
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Affiliation(s)
- Majid Ezzati
- School of Public Health, Imperial College London, London, United Kingdom.
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Holmén A, Strömberg U, Magnusson K, Twetman S. Tobacco use and caries risk among adolescents--a longitudinal study in Sweden. BMC Oral Health 2013; 13:31. [PMID: 23855639 PMCID: PMC3723799 DOI: 10.1186/1472-6831-13-31] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 07/08/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoking and the use of smokeless tobacco have a detrimental impact on general and oral health. The relationship to dental caries is however still unclear. As caries is a multi-factorial disease with clear life-style, socio-economic and socio-demographic gradients, the tobacco use may be a co-variable in this complex rather than a direct etiological factor. Our aim was to analyze the impact of tobacco use on caries incidence among adolescents, with consideration to socio-economic variables by residency, using epidemiological data from a longitudinal study in the region of Halland, Sweden. METHODS The study population consisted of 10,068 adolescents between 16-19 years of age from whom yearly data on caries and tobacco use (cigarette smoking and use of smokeless tobacco) were obtained during the period 2006-2012. Reported DMFS increment between 16 and 19 years of age (∆DMFS) for an individual was considered as the primary caries outcome. The outcome data were compared for self-reported never vs. ever users of tobacco, with consideration to neighborhood-level socio-economy (4 strata), baseline (i.e., 16 years of age) DMFS and sex. The region consists of 65 parishes with various socio-economic conditions and each study individual was geo-coded with respect to his/her residence parish. Neighborhood (parish-level) socio-economy was assessed by proportion of residing families with low household purchasing power. RESULTS ∆DMFS differed evidently between ever and never users of tobacco (mean values: 1.8 vs. 1.2; proportion with ∆DMFS > 0: 54.2% vs. 40.5%; p < 0.0001). Significant differences were observed in each neighborhood-level socio-economic stratum. Even after controlling for baseline DMFS and sex, ∆DMFS differed highly significantly between the ever and never users of tobacco (overall p < 0.0001). CONCLUSION Tobacco use was clearly associated with increased caries increment during adolescence. Hence, this factor is relevant to consider in the clinical caries risk assessment of the individual patient as well as for community health plans dealing with oral health.
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Affiliation(s)
- Anders Holmén
- Department of Research and Development, Halland Hospital, SE-301 85 Halmstad, Sweden
| | - Ulf Strömberg
- Department of Research and Development, Halland Hospital, SE-301 85 Halmstad, Sweden
- Department of Occupational and Environmental Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Kerstin Magnusson
- Section of Community and Preventive Dentistry, Maxillofacial Unit,Halland Hospital, SE-301 85 Halmstad, Sweden
| | - Svante Twetman
- Section of Community and Preventive Dentistry, Maxillofacial Unit,Halland Hospital, SE-301 85 Halmstad, Sweden
- Department of Cariology, Endodontics, Pediatric Dentistry and Clinical Genetics, Institute of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Allé 20, 2200 Copenhagen N, Denmark
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Alexandrino-Silva C, Wang YP, Carmen Viana M, Bulhões RS, Martins SS, Andrade LH. Gender differences in symptomatic profiles of depression: results from the São Paulo Megacity Mental Health Survey. J Affect Disord 2013; 147:355-364. [PMID: 23246363 DOI: 10.1016/j.jad.2012.11.041] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 11/20/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND Few studies have investigated symptomatic subtypes of depression and their correlates by gender. METHODS Data are from the São Paulo Megacity Mental Health Survey. Symptom profiles of 1207 subjects (864 women; 343 men) based upon symptoms of the worst depressive episode in lifetime were examined through latent class analysis. Correlates of gender-specific latent classes were analyzed by logistic regression. RESULTS For both men and women, a 3-class model was the best solution. A mild class was found in both genders (41.1% in women; 40.1% in men). Gender differences appeared in the most symptomatic classes. In women, they were labeled melancholic (39.3%) and atypical (19.5%), differing among each other in somatic/vegetative symptoms. The melancholic class presented inhibition and eating/sleeping symptoms in the direction of decreasing, whereas the atypical class had increased appetite/weight, and hypersomnia. For men, symptoms that differentiate the two most symptomatic classes were related to psychomotor activity: a melancholic/psychomotor retarded (40.4%) and agitated depression (19.6%). The highest between-class proportion of agitation and racing thoughts was found among men in the agitated class, with similarity to bipolar mixed state. LIMITATIONS Analyses were restricted to those who endorsed questions about their worst lifetime depressive episode; the standardized assessment by lay interviewers; the small male sample size. CONCLUSIONS The construct of depression of current classifications is heterogeneous at the symptom level, where gender different subtypes can be identified. These symptom profiles have potential implications for the nosology and the therapeutics of depression.
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Affiliation(s)
- Clóvis Alexandrino-Silva
- Section of Psychiatric Epidemiology-LIM 23, Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
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Sansone N, Fong GT, Lee WB, Laux FL, Sirirassamee B, Seo HG, Omar M, Jiang Y. Comparing the experience of regret and its predictors among smokers in four Asian countries: findings from the ITC surveys in Thailand, South Korea, Malaysia, and China. Nicotine Tob Res 2013; 15:1663-72. [PMID: 23509091 PMCID: PMC3768330 DOI: 10.1093/ntr/ntt032] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: Nearly all smokers in high-income Western countries report that they regret smoking (Fong, G. T., Hammond, D., Laux, F. L., Zanna, M. P., Cummings, M. K., Borland, R., & Ross, H. [2004]. The near-universal experience of regret among smokers in four countries: Findings from the International Tobacco Control Policy Evaluation Survey. Nicotine and Tobacco Research, 6, S341–S351. doi:10.1080/14622200412331320743), but no research to date has examined the prevalence of regret among smokers in non-Western, low- and middle-income countries. Methods: Data were from the International Tobacco Control (ITC) Surveys of smokers in 4 Asian countries (China, Malaysia, South Korea, and Thailand); N = 9,738. Regret was measured with the statement: “If you had to do it over again, you would not have started smoking.” Results: Prevalence of regret in 3 countries (South Korea = 87%, Malaysia = 77%, and China = 74%) was lower than that found by Fong et al. in the United States, Australia, Canada, and the United Kingdom (89%–90%); but was higher in Thailand (93%). These significant country differences in regret corresponded with differences in tobacco control and norms regarding smoking. The predictors of regret in the Asian countries were very similar to those in the 4 Western countries: Regret was more likely to be experienced by smokers who smoked fewer cigarettes per day, perceived greater benefits of quitting and higher financial costs of smoking, had more prior quit attempts, worried that smoking would damage their health, and felt that their loved ones and society disapproved of smoking. Regret was also positively associated with intentions to quit (r = 0.23, p < .001). Conclusions: Across the Asian countries and high-income Western countries, the prevalence of regret varies, but the factors predicting regret are quite consistent. Regret may be an important indicator of tobacco control and is related to factors associated with future quitting.
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Affiliation(s)
- Natalie Sansone
- Department of Psychology, University of Waterloo, Ontario, Canada
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Nakamura K, Sakurai M, Miura K, Morikawa Y, Nagasawa SY, Ishizaki M, Kido T, Naruse Y, Suwazono Y, Nakagawa H. Nicotine dependence and cost-effectiveness of individualized support for smoking cessation: evidence from practice at a worksite in Japan. PLoS One 2013; 8:e55836. [PMID: 23383289 PMCID: PMC3559493 DOI: 10.1371/journal.pone.0055836] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 01/02/2013] [Indexed: 11/19/2022] Open
Abstract
Given the lack of economic studies evaluating the outcomes of smoking cessation programs from the viewpoint of program sponsors, we conducted a case study to provide relevant information for worksites. The present study was carried out between 2006 and 2008 at a manufacturing factory in the Toyama Prefecture of Japan and included subjects who voluntarily entered a smoking cessation program. The program included face-to-face counselling followed by weekly contact to provide encouragement over six months using e-mail or inter-office mail. Nicotine patches were available if required. All 151 participants stopped smoking immediately. Over the 24-month study period, self-report showed 49.7% abstained continuously from smoking. The rate of 24-month consecutive abstinence was higher in participants with lower Fagerström Test scores for Nicotine Dependence at baseline than in those with higher scores (63.6% for 0–2 points vs. 46.5% for 3–6 points vs. 43.8% for 7–10 points; chi-square test p = 0.19). A logistic regression model showed a significant linear trend for the association between the score and abstinence status after adjustment for possible confounding factors (p = 0.03). The crude incremental cost for one individual to successfully quit smoking due to the support program was ¥46,379 (i.e., ¥100 = $1.28, £0.83, or €1.03 at foreign exchange rates). The corresponding costs for the three categories of the Fagerström Test score for Nicotine Dependence were ¥31,953, ¥47,450 and ¥64,956, respectively. When a sensitivity analysis was conducted based on the 95% confidence interval of the success rate, the variance in the corresponding costs was ¥25,514–45,034 for 0–2 points, ¥38,344–61,824 for 3–6 points, and ¥45,698–108,260 for 7–10 points. The degree of nicotine dependence may therefore be an important determinant of the cost-effectiveness of smoking cessation programs.
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Affiliation(s)
- Koshi Nakamura
- Department of Epidemiology and Public Health, Kanazawa Medical University, Uchinada, Japan.
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Picco L, Subramaniam M, Abdin E, Vaingankar JA, Chong SA. Smoking and Nicotine Dependence in Singapore: Findings from a Cross-Sectional Epidemiological Study. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2012. [DOI: 10.47102/annals-acadmedsg.v41n8p325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: Smoking is one of the leading preventable causes of death throughout the world and can lead to nicotine dependence, particularly when initiated at a young age. This paper describes the prevalence of smoking and nicotine dependence in the adult Singapore resident population, whilst also exploring rates among the major ethnic groups (Chinese, Malay and Indian), different education levels and those with chronic psychiatric and physical comorbidities. Material and Methods: The Singapore Mental Health Study (SMHS) is a cross-sectional epidemiological study that was conducted between December 2009 and December 2010. Information on smoking status was assessed using the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and the Fagerstrom Test for Nicotine Dependence measured nicotine dependence. Socio-demographic information was also collected. Results: In total, 6616 respondents participated in the SMHS giving a response rate of 75.9%. We found that 16% of the population were current smokers and 4.5% had nicotine dependence. Current smokers were more likely to be younger (18 to 34 years old), males, Malay and have lower education, whilst males had a 4.6 times higher risk of nicotine dependence to that of females. The prevalence of nicotine dependence was also higher in those with alcohol abuse and those experiencing chronic pain. Conclusion: The results from this study highlight the important differences in the prevalence of smoking and nicotine dependence among different age groups, gender and ethnicity in Singapore and are important for developing future health policies and targeted preventive strategies.
Key words: Ethnicity, Gender, Population, Prevalence
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Tonstad S, Job JS, Batech M, Yel D, Kheam T, Singh PN. Adult tobacco cessation in Cambodia: I. Determinants of quitting tobacco use. Asia Pac J Public Health 2012; 25:10S-9S. [PMID: 22815309 DOI: 10.1177/1010539512451853] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study determined factors associated with quitting tobacco in Cambodia, a country with a high prevalence of men who smoke and women who use smokeless tobacco. As part of a nationwide survey, face-to-face interviews were conducted with 5145 current and 447 former tobacco users who had quit for ≥ 2 years. Determinants of quitting in multivariate analyses were age >48 years, age at initiation >25 years, ≥ 7 years of education, income ≥ 1 US dollar per day, professional (odds ratio [OR] = 2.52; 95% confidence interval [CI] = 1.27-5.01) or labor (OR = 1.98, 95% CI = 1.10-3.56) occupations, and heart disease (OR = 1.94; 95% CI = 1.10, 3.42). Smokeless tobacco users were 10-fold less likely to quit (OR = 0.10; 95% = CI 0.05-0.20) than smokers. In conclusion, tobacco cessation among Cambodians was lower than in nations with decades of comprehensive tobacco control policies. Tobacco cessation programs and policies should include all forms of tobacco and target young to middle-aged users before onset of disease and premature death.
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Nakamura K, Nakagawa H, Sakurai M, Murakami Y, Irie F, Fujiyoshi A, Okamura T, Miura K, Ueshima H. Influence of smoking combined with another risk factor on the risk of mortality from coronary heart disease and stroke: pooled analysis of 10 Japanese cohort studies. Cerebrovasc Dis 2012; 33:480-91. [PMID: 22517421 DOI: 10.1159/000336764] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 01/18/2012] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND In spite of the importance of a multifactorial approach to preventing cardiovascular disease in smokers, most information on the combined adverse effects of smoking and hypertension or high serum cholesterol on cardiovascular disease has been derived from Western populations, and coronary heart disease was often used as the only endpoint. Therefore, the present large-scale pooled analysis attempted to provide reliable information on the adverse effects of the coexistence of smoking and hypertension or high serum cholesterol on the risk of mortality from coronary heart disease and stroke in both, individuals and the entire population in Japan. METHODS A total of 27,385 male and 39,207 female participants aged 40-89 years were enrolled from 10 well-qualified Japanese cohort studies with a mean follow-up of 10.1 years. Hazard ratios and their corresponding 95% confidence intervals in smokers who had hypertension or high serum cholesterol were estimated for men and women separately using a Cox proportional hazards regression model that included age, body mass index, cohort and either serum total cholesterol or systolic blood pressure as covariates. Fractions of deaths attributable to the coexistence of these risk factors were also calculated. RESULTS The multivariate-adjusted hazard ratios in male and female current smokers with hypertension, compared with those with neither factor were 2.57 (95% confidence intervals, 1.51-4.38) and 6.14 (3.49-10.79) for coronary heart disease, and 3.28 (1.89-5.71) and 1.61 (0.81-3.18) for cerebral infarction, respectively. The fractions of deaths attributable to the coexistence of current smoking and hypertension in men and women were 24.6 and 9.6% for coronary heart disease and 28.1 and 2.0% for cerebral infarction, respectively. Smokers with high serum cholesterol were broadly comparable to hypertensive smokers only with respect to coronary mortality risk; the hazard ratios, compared with those with neither factor were 4.19 (2.33-7.53) for men and 3.90 (1.57-9.67) for women. The fraction of coronary deaths attributable to the coexistence of current smoking and high serum cholesterol was 6.3% in men and 2.2% in women. There was no interaction between smoking habit and blood pressure or serum total cholesterol for these two subtypes in both men and women. CONCLUSIONS Particular attention should be given to smokers who have concomitant hypertension or high serum cholesterol for preventing deaths due to cardiovascular disease. From a public health perspective in Japan, priority should be given to hypertensive smokers, since this group makes a large contribution to the burden of both coronary and cerebral infarction deaths.
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Affiliation(s)
- Koshi Nakamura
- Department of Epidemiology and Public Health, Kanazawa Medical University, Uchinada, Japan.
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Birmpili E, Katsiki N, Malhotra A, Dimopoulou E, Mikhailidis DP, Tsiligiroglou-Fachantidou A. Gender and Socio-economic Differences in Daily Smoking and Smoking Cessation Among Adult Residents in a Greek Rural Area. Open Cardiovasc Med J 2012; 6:15-21. [PMID: 22435078 PMCID: PMC3308319 DOI: 10.2174/1874192401206010015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 12/20/2011] [Indexed: 11/22/2022] Open
Abstract
Despite the well-known health risks, smoking is still highly prevalent worldwide. Greece has the highest level of adult smoking rate (40%) across the European Union. We investigated gender and socio-economic differences in daily smoking and smoking cessation among Greek adults. We conducted a cross-sectional survey between October and November 2009 in 434 adults residing in a Greek rural area. Data were collected with the use of the World Health Organization Global Adult Tobacco Survey (WHO GATS) Core Questionnaire. Respondents were classified into smokers (if they had smoked at least 100 cigarettes in their lifetime and continued to smoke) or non-smokers. Overall, 58.1% (n=252) were smokers (58.5% male, n=127 and 57.8% female, n=125); 51.2% (n=222) were younger than 18 years-old when they started smoking. Men tended to start smoking at a younger age, to smoke more cigarettes/day and to have smoked a greater average of cigarettes during the last 5 days. Overall, 82.5% of smokers attempted to stop smoking a year prior to the study, with women having a greater difficulty in quitting smoking. The main source of information on smoking was the mass media (73.5%) and books (53.7%), whereas doctors and other health professionals were the least listed source of relative information (27.7 and 8.1%, respectively). Smoking rates among Greek adults were high, but a considerable number of individuals who smoked, wished to quit and had attempted to do so. Smoking cessation clinics are not perceived as a valuable support in quitting effort.
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Affiliation(s)
- Evangelia Birmpili
- Department of Physical Education and Sport sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Chen B, Cao H, Wang D, Liu D, Zeng J, Wang Y, Zhang S, Gao J, Yu J, Li W. Design and application of a self-evaluation questionnaire for individuals at a high-risk of lung cancer. Thorac Cancer 2012; 3:60-67. [PMID: 28920269 DOI: 10.1111/j.1759-7714.2011.00088.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE The purpose of this study was to establish a comprehensive evaluation system to assess the risk factors of lung cancer for the general population. METHODS With the method of evidence-based medicine, risk factors of lung cancer were identified and their risk assignments were calculated to design the Self-evaluation Scoring Questionnaire for High-risk Individuals of Lung Cancer. Studies including more than 10 000 subjects were carried the out to confirm the questionnaire's value. RESULTS The questionnaire consisted of 15 risk factors and their risk assignments, such as sex, age, smoking, female passive smoking, previous illness histories, exposure to harmful gases, mental depression and genetic susceptibility. In the population application, data from 30 lung cancer patients revealed its desired reliability and validity. The next pre-investigation, including 94 patients and 252 controls, confirmed its differentiating power, and encouraged a much larger-scale survey with 2161 subjects to determine the threshold (T) to identify high-risk individuals, the threshold was 116 points. According to this criterion, 1537 high-risk volunteers and 6556 controls were recruited to participate in a 3-year follow-up study from 2007 to 2009. There were 31 cases of lung cancer detected in the high-risk group, with a detection rate of 2.02%, significantly higher than that of the controls (5/6556, 0.08%), indicating an excellent predictive value of the questionnaire. CONCLUSIONS The Self-evaluation Scoring Questionnaire for High-risk Individuals of Lung Cancer was a good means for evaluating the risks of lung cancer.
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Affiliation(s)
- Bojiang Chen
- Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China Physiology and Experimental Medicine Program, University of Toronto, Toronto, Canada Department of Physical Examination Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Huibi Cao
- Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China Physiology and Experimental Medicine Program, University of Toronto, Toronto, Canada Department of Physical Examination Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Dongmei Wang
- Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China Physiology and Experimental Medicine Program, University of Toronto, Toronto, Canada Department of Physical Examination Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Dan Liu
- Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China Physiology and Experimental Medicine Program, University of Toronto, Toronto, Canada Department of Physical Examination Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jing Zeng
- Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China Physiology and Experimental Medicine Program, University of Toronto, Toronto, Canada Department of Physical Examination Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Youjuan Wang
- Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China Physiology and Experimental Medicine Program, University of Toronto, Toronto, Canada Department of Physical Examination Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Shangfu Zhang
- Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China Physiology and Experimental Medicine Program, University of Toronto, Toronto, Canada Department of Physical Examination Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jun Gao
- Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China Physiology and Experimental Medicine Program, University of Toronto, Toronto, Canada Department of Physical Examination Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jianqun Yu
- Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China Physiology and Experimental Medicine Program, University of Toronto, Toronto, Canada Department of Physical Examination Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Weimin Li
- Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China Physiology and Experimental Medicine Program, University of Toronto, Toronto, Canada Department of Physical Examination Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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Babizhayev MA, Savel'yeva EL, Moskvina SN, Yegorov YE. Telomere length is a biomarker of cumulative oxidative stress, biologic age, and an independent predictor of survival and therapeutic treatment requirement associated with smoking behavior. Am J Ther 2011; 18:e209-26. [PMID: 20228673 DOI: 10.1097/mjt.0b013e3181cf8ebb] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Globally, tobacco use is associated with 5 million deaths per annum and is regarded as one of the leading causes of premature death. Major chronic disorders associated with smoking include cardiovascular diseases, several types of cancer, and chronic obstructive pulmonary disease (lung problems). Cigarette smoking (CS) generates a cumulative oxidative stress, which may contribute to the pathogenesis of chronic diseases. Mainstream and side stream gas-phase smoke each have about the same concentration of reactive free radical species, about 1 × 10(16) radicals per cigarette (or 5 × 10(14) per puff). This effect is critical in understanding the biologic effects of smoke. Several lines of evidence suggest that cigarette smoke constituents can directly activate vascular reactive oxygen species production. In this work we present multiple evidence that CS provide the important risk factors in many age-related diseases, and is associated with increased cumulative and systemic oxidative stress and inflammation. The cited processes are marked by increased white blood cell (leucocytes, WBCs) turnover. The data suggest an alteration of the circulating WBCs by CS, resulting in increased adherence to endothelial cells. Telomeres are complex DNA-protein structures located at the end of eukaryotic chromosomes. Telomere length shortens with biologic age in all replicating somatic cells. It has been shown that tobacco smoking enhances telomere shortening in circulating human WBCs. Telomere attrition (expressed in WBCs) can serve as a biomarker of the cumulative oxidative stress and inflammation induced by smoking and, consequently, show the pace of biologic aging. We originally propose that patented specific oral formulations of nonhydrolized carnosine and carcinine provide a powerful tool for targeted therapeutic inhibition of cumulative oxidative stress and inflammation and protection of telomere attrition associated with smoking. The longitudinal studies of the clinical population groups described in this study including elderly support the hypothesis that telomere length is a predictor of survival and therapeutic treatment requirement associated with smoking behavior.
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Kondo T, Osugi S, Shimokata K, Honjo H, Morita Y, Maeda K, Yamashita K, Muramatsu T, Shintani S, Matsushita K, Murohara T. Smoking and smoking cessation in relation to all-cause mortality and cardiovascular events in 25,464 healthy male Japanese workers. Circ J 2011; 75:2885-92. [PMID: 21979146 DOI: 10.1253/circj.cj-11-0416] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Smoking is still a major health problem among males in Japan. The effects of smoking and quitting on mortality and cardiovascular disease (CVD) need updating. METHODS AND RESULTS This was a prospective cohort study with a median follow-up of 7.5 years of a total of 25,464 healthy male Japanese workers aged 20-61 years who were not on any medication. The adjusted hazard ratios (HR; 95% confidence interval) for all-cause death were 1.51 (0.73, 2.94), 1.68 (1.07, 2.70), 1.30 (0.70, 2.34), and those for total CVD events 1.91 (0.72, 4.67), 2.94 (1.65, 5.63), and 3.25 (1.69, 6.54) for light smokers (1-10 cigarettes/day), moderate smokers (11-20/day), and heavy smokers (≥ 21/day) compared to never-smokers, respectively. Total CVD events increased dose-dependently as the number of cigarettes/day increased. Acute myocardial infarction was increased at any level of smoking. Stroke was increased at a moderate level of smoking. Quitting for ≥ 4 years, compared with continuing smokers, reduced the HR for all-cause death to 0.64 (0.38, 1.01), and total CVD events to 0.34 (0.17, 0.62). CONCLUSIONS In healthy young- and middle-aged Japanese males, a significant increase in HR for total CVD events was confirmed for a smoking level of 11-20 cigarettes/day. Quitting reduced the HR for total CVD events, with quitting for ≥ 4 years being statistically significant. A similar trend was observed for all-cause mortality.
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Affiliation(s)
- Takahisa Kondo
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Atzmon I, Linn S, Richter E, Portnov BA. Cancer risks in the Druze Isifya Village: Reasons and RF/MW antennas. ACTA ACUST UNITED AC 2011; 19:21-8. [PMID: 21873036 DOI: 10.1016/j.pathophys.2011.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Revised: 04/30/2010] [Accepted: 05/04/2010] [Indexed: 10/17/2022]
Abstract
BACKGROUND The present study was initiated to examine the claims of the residents of the Druze Isifya Village in Northern Israel that their high cancer rates were associated with the past exposures to radiation from radio and cellular transmitters. OBJECTIVE To investigate the association between past exposure to RF/MW transmitters and cancer risks, taking into account familial cancer history, occupational exposures and indicators of life-style. METHODS We carried out a population-based case-control study involving 307 residents, of whom 47 were diagnosed between 1989 and 2007 with different types of cancer and 260 controls. Cancer diagnoses were obtained from medical the records. Exposure status of individual houses were determined from a map, based on the distances between each house and RF/MW antennas, and were calculated using geographic information systems (GIS) tools. Data on additional risk factors for cancer, like smoking and occupation, were obtained from individual questionnaires. The analysis was adjusted for measures of life style and occupational exposure, and Binary multiple logistic regressions was used, for all cancer sites and for individual cancer types for those cancers with at least 5 documented cases. RESULTS Past occupational exposures to chemicals (e.g., pesticides) and electronics, were found to be strongly associated with increased cancer risks (all sites: OR=2.79; CI=1.14-6.82; P<0.05), but no discernible trend in overall cancer risk was associated with proximity to sources of past RF/MW radiation exposure (n=47 OR=1.00; CI=0.99-1.02; P>0.4). Colorectal cancer showed a negligible elevated adjusted risk associated with radiation intensity (n=11 OR=1.03; CI=1.01-1.05; P<0.01). CONCLUSION There was evidence for an increased risk of cancers which were associated with chemicals in manufacturing and agriculture and electronics, where there may have been exposures to EMF, but the study did not confirm the suspicion of increased cancer risks associated with radiation for most cancer types in this village. Misclassification of past exposures could explain the negative finding.
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Affiliation(s)
- Iris Atzmon
- School of Public Health, University of Haifa, Israel
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Abstract
BACKGROUND Smoking is a risk factor for inflammatory, fistulizing cutaneous diseases. It seems reasonable that smoking might be a risk factor for anal abscess/fistula. OBJECTIVE This study aimed to test the hypothesis that recent smoking is a risk factor for development of anal abscess/fistula. DESIGN This is a case-control study. SETTINGS This study was conducted at a Department of Veterans Affairs general surgical clinic. PATIENTS Included in the study were 931 patients visiting the general surgical clinic over a 6-month period. INTERVENTIONS A tobacco use questionnaire was administered. MAIN OUTCOME MEASURES Patients with anal abscess/fistula history were compared with controls, who had all other general surgical conditions. To investigate the temporal relation between smoking and the clinical onset of anal abscess/fistula, we compared the group consisting of current smokers and former smokers who had recently quit, against the group consisting of nonsmokers and former smokers who had quit a longer time ago (ie, not recently). We excluded patients with IBD and HIV. RESULTS Cases and controls were comparable in age (57 and 59 y) and sex (93% and 97% male). After exclusions, there were 74 anal abscess/fistula cases and 816 controls. Among the anal abscess/fistula cases, 36 patients had smoked within 1 year before the onset of anal abscess/fistula symptoms, and 38 had not smoked within the prior year; among controls, 249 had smoked within 1 year before seeking surgical treatment, and 567 had not (OR 2.15, 95% CI 1.34-3.48, 2-tail P = .0025). Using a 5-year cutoff for recent smoking, the association was less pronounced but still significant (OR 1.72, 95% CI 1.03-2.86, P = .0375), and the association was insignificant at 10 years (OR 1.34, 95% CI 0.78-2.21, P = .313). LIMITATIONS Limitations of the study included self-selection bias, recall bias, convenience sample, and noninvestigation of the dose-response relationship. CONCLUSIONS Recent smoking is a risk factor for anal abscess/fistula development. As in other smoking-related diseases, the influence of smoking as a risk factor for anal abscess/fistula diminishes to baseline after 5 to 10 years of smoking cessation. Anal abscess/fistula can be added to the list of chronic, inflammatory cutaneous conditions associated with smoking.
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陈 勃, 李 为, 贾 勇, 郭 娜, 刘 丹, 唐 娴, 王 琼, 肖 俐. [A cross-sectional investigation on risk factors of lung cancer for residents over 40 years old in Chengdu, Sichuan Province, China]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2010; 13:1021-6. [PMID: 21081041 PMCID: PMC6000492 DOI: 10.3779/j.issn.1009-3419.2010.11.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 08/18/2010] [Indexed: 11/23/2022]
Abstract
BACKGROUND In the previous studies, we have designed the Self-evaluation Scoring Questionnaire for High-risk Individuals of Lung Cancer. In order to make a better understanding of the status of risk factors of lung cancer for residents in Chengdu, we carried out the investigation from June 2009 to December 2009. METHODS With the stratified random sampling method, eligible residents were included and their risk factors of lung cancer were collected with the Self-evaluation Scoring Questionnaire for High-risk Individuals of Lung Cancer. RESULTS According to the criteria of the questionnaire, 21.34% of the population were at high risk of lung cancer. The smoking rate for male was 48.58%, higher than that of 2.65% for female. About 5.39% of male smokers began smoking before 15 years old. The average daily tobacco consumption in the most population was less than 20 pieces, with a duration between 20 to 40 years. However, there were 11.34% of all women suffered from passive smoking, and another 15.30% and 5.86% of residents were exposed to cooking fumes, minerals or asbestos. As for the previous illness history, 0.77%-18.08% of individuals have connective tissue diseases, pulmonary tuberculosis, emphysema and others. Finally, 4.91% of residents endured the long-term mental depression, and 7.24% had a positive family history of tumors. CONCLUSIONS The status of risk factors for lung cancer among residents in Chengdu was not optimistic. It should be paid more attention to tobacco control and environmental improvement to improve people's health.
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Affiliation(s)
- 勃江 陈
- 610041 成都,四川大学华西医院呼吸内科Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu 610041, China
| | - 为民 李
- 610041 成都,四川大学华西医院呼吸内科Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu 610041, China
| | - 勇 贾
- 610041 成都,四川大学华西医院呼吸内科Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu 610041, China
- 610041 成都,四川省成都市疾病预防控制中心Centre for Disease Control and Prevention of Chengdu, Chengdu 610041, China
| | - 娜 郭
- 610041 成都,四川大学华西医院呼吸内科Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu 610041, China
| | - 丹 刘
- 610041 成都,四川大学华西医院呼吸内科Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu 610041, China
| | - 娴 唐
- 610041 成都,四川省成都市武侯区疾病预防控制中心Centre for Disease Control and Prevention of Wuhou District, Chengdu 610041, China
| | - 琼 王
- 610300 成都,四川省成都市青白江区疾病预防控制中心Centre for Disease Control and Prevention of Qingbaijiang District, Chengdu 610300, China
| | - 俐 肖
- 610045 成都,四川省成都市武侯区晋阳社区卫生服务中心Health Center of Jinyang Community in Wuhou District, Chengdu 610045, China
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Babizhayev MA, Yegorov YE. Smoking and health: association between telomere length and factors impacting on human disease, quality of life and life span in a large population-based cohort under the effect of smoking duration. Fundam Clin Pharmacol 2010; 25:425-42. [PMID: 20698892 DOI: 10.1111/j.1472-8206.2010.00866.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Reactive oxygen species (ROS) are of primary importance as they cause damage to lipids, proteins, and DNA either endogenously by cellular mechanism, or through exogenous exposure to environmental injury factors, including oxidation insult factors, such as tobacco smoke. Currently 46.3 million adults (25.7 percent of the population) are smokers. This includes 24 million men (28.1 percent of the total) and more than 22 million women (23.5 percent). The prevalence is highest among persons 25-44 years of age. Cigarette smokers have a higher risk of developing several chronic disorders. These include fatty buildups in arteries, several types of cancer and chronic obstructive pulmonary disease (lung problems). As peripheral leukocytes have been the main target of human telomere research, most of what is known about human telomere dynamics in vivo is based on these cells. Leukocyte telomere length (TL) is a complex trait that is shaped by genetic, epigenetic, and environmental determinants. In this article, we consider that smoking modifies leukocyte TL in humans and contributes to its variability among individuals, although the smoking effect on TL and its relation with other metabolic indices may accelerate biological aging and development of smoking-induced chronic diseases in a large human population-based cohorts with smoking behavior. Recent studies confirmed that individuals with shorter telomeres present a higher prevalence of arterial lesions and higher risk of cardiovascular disease mortality. This study originally suggests that efficient therapeutic protection of TL and structure in response to stresses that are known to reduce TL, such as oxidative damage or inflammation associated with tobacco smoking, would lead to better telomere maintenance. Recently, we have discovered the potential use of telomere-restorative imidazole-containing dipeptide (non-hydrolized carnosine, carcinine) based therapy for better survival of smokers. We conclude that a better therapeutic or nutritional maintenance of TL may confer healthy aging in smokers and exceptional longevity in regularly ROS-exposed human survivors.
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Nakamura K, Okamura T, Hayakawa T, Kanda H, Okayama A, Ueshima H. Medical expenditures of men with hypertension and/or a smoking habit: a 10-year follow-up study of National Health Insurance in Shiga, Japan. Hypertens Res 2010; 33:802-7. [PMID: 20505676 DOI: 10.1038/hr.2010.81] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Hypertension and smoking are major causes of disability and death, especially in the Asia-Pacific region, where there is a high prevalence of a combination of these two risk factors. We attempted to measure the medical expenditures of a Japanese male population with hypertension and/or a smoking habit over a 10-year period of follow-up. A cohort study was conducted that investigated the medical expenditures due to a smoking habit and/or hypertension during the decade of the 1990s using existing data on physical status and medical expenditures. The participants included 1708 community-dwelling Japanese men, aged 40-69 years, who were classified into the following four categories: 'neither smoking habit nor hypertension', 'smoking habit alone', 'hypertension alone' or 'both smoking habit and hypertension.' Hypertension was defined as a systolic blood pressure of > or =140 mm Hg, a diastolic blood pressure of > or =90 mm Hg or taking antihypertensive medications. In the study cohort, 24.9% had both a smoking habit and hypertension. During the 10-year follow-up period, participants with a smoking habit alone (18,444 Japanese yen per month), those with hypertension alone (21,252 yen per month) and those with both a smoking habit and hypertension (31,037 yen per month) had increased personal medical expenditures compared with those without a smoking habit and hypertension (17,418 yen per month). Similar differences were observed even after adjustment for other confounding factors (P<0.01). Japanese men with both a smoking habit and hypertension incurred higher medical expenditures compared with those without a smoking habit, hypertension or their combination.
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Affiliation(s)
- Koshi Nakamura
- Department of Epidemiology and Public Health, Kanazawa Medical University, Uchinada, Japan.
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