Group Of Current Smokers Research Articles

Does Smoking Affect Short-Term Patient-Reported Outcomes After Lumbar Decompression?

Study Design:Retrospective cohort study.Objective:The goal of this study was to determine how smoking status influences patient-reported outcome measurements (PROMs) in patients undergoing lumbar decompression surgery.Methods:Patients undergoing lumbar decompression between 1 to 3 levels at a single-center, academic hospital were retrospectively identified. Patients <18 years old, and those undergoing surgery for infection, trauma, tumor, or revision, with less than 12 months of follow-up were excluded. Patients were divided into 3 groups: (1) never smokers (NSs); (2) current smokers (CSs); and (3) former smokers (FSs). PROMs analyzed included the Physical Component Score and Mental Component Score of the Short Form-12 Health Survey, the Oswestry Disability Index, and Visual Analogue Scale Back and Leg pain scores. One-way ANOVA was used to compare preoperative and postoperative scores between smoking groups, and multiple linear regression analysis was performed to determine whether smoking status predicted change in each outcome score, controlling for factors such as age, sex, body mass index, and other clinical variables. A P value <.05 was considered to be significant.Results:A total of 195 patients were included in the final cohort, with 121 (62.1%) patients in the NS group, 22 (11.3%) in the CS group, and 52 (26.6%) in the FS group. There were no significant differences between groups at baseline or postoperatively. Smoking status was also not a significant predictor of change in any outcome scores over time on multivariate analysis.Conclusion:These results suggest that smoking status does not significantly affect short-term complications or outcomes in patients undergoing lumbar decompression surgery.

How Does Smoking Influence Patient-reported Outcomes in Patients After Lumbar Fusion?

A retrospective cohort study. The goal of this study was to determine the effect of smoking on patient-reported outcome measurements (PROMs) after lumbar fusion surgery. Although smoking is known to decrease fusion rates after lumbar fusion, there is less evidence regarding the influence of smoking on PROMs after surgery. Patients undergoing between 1 and 3 levels of lumbar fusion were divided into 3 groups on the basis of preoperative smoking status: never smokers (NS); current smokers (CS); and former smokers (FS). PROMs collected for analysis include the Physical Component Score (PCS-12), Mental Component Score (MCS-12), Oswestry Disability Index (ODI), and Visual Analogue Scale back (VAS back) and leg (VAS leg) pain scores. Preoperative and postoperative PROMs were compared between groups. A multiple linear regression analysis was performed to determine whether preoperative smoking status was a predictor of change in PROM scores. A total of 220 (60.1%) NS, 52 (14.2%) CS, and 94 (25.7%) FS patients were included. Patients in most groups improved within each of the PROMs analyzed (P<0.05). VAS leg pain (P=0.001) was found to significantly differ between groups, with NS and FS having less disability than CS (3.6 vs. 2.0, P=0.010; and 3.6 vs. 2.4, P=0.022; respectively). Being a CS significantly predicted less improvement in ODI (P=0.035), VAS back (P=0.034), and VAS leg (P<0.001) compared with NS. In addition, NS had a significantly lower 30-day readmission rate than CS or FS (3.2% vs. 5.8% and 10.6%, respectively, P=0.029). CS exhibited worse postoperative VAS leg pain and a lower recovery ratio than never smokers. In addition, being in the CS group was a significant predictor of decreased improvement in ODI, VAS back, and VAS leg scores. Level III.

Smoking Behavior and Survival Outcomes in Bladder Cancer Patients

Purpose: The purpose of this study was to compare the survival outcomes of bladder cancer patients with different smoking behaviors. Materials and Methods: Between January 2011 and December 2014, a total of 565 bladder cancer patients were included from one institute retrospectively. Regarding smoking behavior, among these patients, 337 were nonsmokers, 52 were “quitters” (patients who had quit smoking ≥10 years ago), 54 were ex-smokers (patients who had quit smoking &lt;10 years ago), and 117 were current smokers. We compared the clinicopathological characteristics and survival outcomes among these four groups. Results: In this cohort, the 3-year overall survival (OS) (95% confidence interval [CI]) of the nonsmoker, quitter, ex-smoker, and current smoker groups were 75.6% (95% CI: 72.9%–78.3%), 67.4% (95% CI: 59.8%–75%), 84.1% (95% CI: 78.9%–89.3%), and 83.2% (95% CI: 79.3%–87.1%), respectively. Nonsmoker patients included a higher number of females, and quitters were older than the patients in the other groups. Larger tumors in quitters and higher clinical stages in ex-smokers were observed more frequently than in the patients of the other groups. Compared with nonsmokers, quitters, and ex-smokers, current smokers had no impact on OS (P = 0.541, 0.406, and 0.175, respectively) nor on cancer-specific survival (CSS) (P = 0.631, 0.388, and 0.193, respectively). Higher diagnostic age, being underweight, larger tumor sizes, and higher clinical stages were independent factors predicting OS. Conclusion: Smoking behavior seemed to not directly contribute to the deterioration of overall or CSS duration in patients with bladder cancer.

414 The Association Between Cigarette Smoking and Gastroesophageal Reflux Disease in Japan: Analysis of Symptoms and Endoscopic Findings

INTRODUCTION: Cigarette smoking is regarded as a weak or moderate risk factor of gastroesophageal reflux disease (GERD), and smoking cessation may reduce GERD symptoms. However, the evidence for these associations is limited. This study aimed to investigate the effects of cigarette smoking or smoking cessation on the development of GERD by using endoscopic findings and the Gastrointestinal Symptom Rating Scale (GSRS). METHODS: The subjects were 848 patients who received upper endoscopy and answered the GSRS questionnaire as health checkup at our hospital in Japan. The patients were divided into three groups; non-smoking, smoking-cessation, and current-smoking group (322, 371 and 155 patients, respectively). Endoscopic findings of GERD were graded by the Los Angeles classification, and grade B or more were defined as severe GERD. The GSRS questionnaire is an interview-based seven-graded rating scale including the questions on heart burn and acid regurgitation. The prevalence of patients with positive GSRS scores (i.e. 2 or more) was compared between three groups. Data were analyzed statistically using the Kruskal-Wallis, Mann-Whitney U, or chi-square test. RESULTS: The overall prevalence of endoscopic GERD and positive GSRS scores on heart burn and acid regurgitation was 19.2, 14.5, and 19.7%, respectively. The prevalence of patients with severe endoscopic GERD in smoking group was significantly higher than that in non-smoking group (OR: 4.64; 95% CI: 1.47-14.67; P = 0.007). In contrast, the prevalence of patients with positive GSRS scores on heart burn in smoking group was significantly lower than that in non-smoking group (OR: 0.46; 95% CI: 0.26-0.80; P = 0.006). As for smoking cessation, there was no significant difference in the prevalence of patients with severe endoscopic GERD between smoking-cessation and current-smoking group (OR: 0.37; 95% CI: 0.11-1.18; P = 0.149). Also, there was no significant difference in positive GSRS scores between smoking-cessation and current-smoking group (heart burn; P = 0.077, and acid regurgitation; P = 0.871). CONCLUSION: Cigarette smoking increases risk of developing endoscopic GERD severity, while not developing GERD symptoms. Upper endoscopy may be useful for Japanese using cigarette even if they have no GERD symptoms. Although smoking cessation is not associated with improvement of endoscopic GERD severity in this study, prospective studies should be performed to evaluate the effects of smoking cessation on GERD.

SF-6D utility scores of smokers and ex-smokers with or without respiratory symptoms attending primary care clinics

IntroductionThe aim of this paper is to find out generic preference-based Short-Form 6 Dimensions (SF-6D) utility scores of smokers and ex-smokers with varying cigarette exposure, with and without respiratory symptoms.MethodsSeven hundred thirty one people aged ≥30 with a history of smoking who attended 5 public primary care clinics completed a cross-sectional survey using SF-6D utility score, Breathlessness, Cough, and Sputum Scale (BCSS©) and office spirometry.ResultsMost of the subjects were men (92.5%) in an older age group (mean age 62.2 ± 11.7 years). About half of them (48.3%) were current smokers while the other half (51.7%) were ex-smokers. More than half of them (54.2%) reported mild respiratory symptoms (mean BCSS score 0.95 ± 1.12). The most common symptoms were sputum (45.1%), followed by cough (34.2%) and breathlessness (6.0%). The SF-6D overall utility score was 0.850 ± 0.106. The subjects reported significantly lower SF-6D scores when they had breathlessness (0.752 ± 0.138; p = < 0.001), cough (0.836 ± 0.107; p = 0.007), sputum (0.838 ± 0.115; p = 0.004) or any of the above symptom (0.837 ± 0.113; p < 0.001). In both groups of current smokers and ex-smokers, there was no statistically significant difference in the scores among light, moderate or heavy smokers. In the Tobit regression model of factors affecting SF-6D utility score, subjects who reported more respiratory symptoms (i.e. higher BCSS©) had lower SF-6D scores (B = − 0.018 ± 0.007, p < 0.001), while men had higher SF-6D scores than women (B = 0.037 ± 0.031, p = 0.019). Subjects who attended middle or high school had higher SF-6D score than those attended the University or above. The presence of airflow obstruction was not associated with the score.ConclusionsThe study yielded SF-6D utility scores of smokers and ex-smokers with different reported cigarette exposure, which could be useful in future clinical studies and cost-effectiveness analysis.

Crosstalk between tumor necrosis factor-alpha signaling and aryl hydrocarbon receptor signaling in nuclear factor –kappa B activation: A possible molecular mechanism underlying the reduced efficacy of TNF-inhibitors in rheumatoid arthritis by smoking

ObjectivesTo examine the influence of smoking on biologics treatment against different therapeutic targets, such as TNFα, IL-6, and T cell, in rheumatoid arthritis (RA) and elucidate the underlying molecular mechanism. MethodsThe association between drug-discontinuation due to poor therapeutic response and smoking status was analyzed individually in biologics against different therapeutic targets by a multivariable logistic regression analysis using the “NinJa” Registry, one of the largest cohorts of Japanese RA patients. In vitro enhancement of TNFα-induced NF-κB activation and subsequent proinflammatory cytokine production by cigarette chemical components was examined by RT-PCR, qPCR, ELISA, and western blotting using an immortalized rheumatoid synovial cell line, MH7A. ResultsThe rate of drug-discontinuation due to poor therapeutic response was higher in the current smoking group than in the never- or ever-smoking groups (the odds ratio of current/never smoking: 2.189, 95%CI; 1.305–3.672,P = 0.003; current/ever: 1.580, 95%CI; 0.879–2.839,P = 0.126) in the TNF inhibitor (TNFi) treatment group. However, this tendency was not observed in either the IL-6 or T cell inhibitor treatment groups. Cigarette smoke chemical components, such as benzo[α]pyrene, known as aryl hydrocarbon receptor (AhR) ligands, themselves activated NF-κB and induced proinflammatory cytokines, IL-1β and IL-6. Furthermore, they also significantly enhanced TNFα-induced NF-κB activation and proinflammatory cytokine production. This enhancement was dominantly inhibited by Bay 11-7082, an NF-κB inhibitor. ConclusionsThese results suggest a crosstalk between TNFα signaling and AhR signaling in NF-κB activation which may constitute one of the molecular mechanisms underlying the higher incidence of drug-discontinuation in RA patients undergoing TNFi treatment with smoking habits.

Kronik obstrüktif akciğer hastalığında pulmoner fonksiyonel parametreler ve kan kotinin düzeyi

Smoking is the leading cause of chronic obstructive pulmonary disease (COPD) and cotinine is reliable marker of tobacco exposure. We aimed to investigate the relationship between pulmonary function tests (FVC%, FEV1, FEV1/FVC and FEF25-75%), smoking history and blood cotinine levels in healthy volunteers as a control and patients who have COPD in our study. One hundred and two COPD patients and 106 healthy volunteers who admitted to our institution were included. Spirometric investigations of the patients and volunteers were performed. A simple, rapid and reliable gas chromatography-mass spectrometry (GC-MS) method was used for determination of cotinine levels in blood samples. The cut-off value of cotinine was determined as 41.12 ng/mL (97.2% sensitivity and 100% specificity). A significant relationship was observed between average pack-year and cotinine level in current smoker group (p< 0.05). The mean cotinine levels were 6.1, 8.8, and 467.0 ng mL-1 in never smokers, ex-smokers and current smokers, respectively. No relationship was observed between cotinine level and FVC%, FEV1% and FEV1/FVC (p> 0.05). In patient group, there was also no relationship between FEF25-75% and cotinine level however, in control group-smokers a negative correlation was found (p< 0.05; r= -0.372). We observed once again with our study that cotinine is a reliable marker of tobacco exposure. The most obvious result is the negative correlation between FEF25-75% value and cotinine level and this result may be caused by the effect of smoking in the peripheral airways at early stages of COPD.

Successful Smoking Cessation Associated with Walking Behavior in Patients with Claudication

Behavioral economics theories suggest that a preference for delayed benefits promotes positive behavioral change, a concept relevant to both smoking cessation and community-based exercise regimens for claudication. Given the high rate of smoking among older veterans, we were interested in examining the association between smoking cessation, exercise regimen adherence, and preferences for delayed versus immediate benefits. Between April 2017 and March 2018, patients with claudication at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas, received questionnaires collecting information on social, behavioral, and psychological characteristics. A dual validation system, via the electronic medical record and survey data, measured the primary outcome-smoking cessation versus current smoking. Self-reported physical activity was measured through the validated Ainsworth's compendium of Physical Activities and binary survey questions. The Walking Impairment and Barratt's Impulsivity Questionnaires measured subjective symptom severity and behavioral economics factors, respectively. Multivariable, logistic regression models identified significant associations. The survey was mailed to 500 patients who met the eligibility criteria. We received responses from 148 individuals (30%), and 67 of 141 (48%) indicated that they had successfully quit smoking. In unadjusted comparisons, the median cognitive complexity score in the smoking cessation group was higher than that in the current smoking group. A greater proportion of patients who reported walking for exercise (n=46) also reported successful smoking cessation (28/46, 61%). Among those who were not walking for exercise (n=88), more individuals reported current smoking (49/88, 56%). In the multivariable model, individuals who had successfully stopped smoking were older (odds ratio [OR]: 7.59, P<0.001), more likely to walk for exercise (OR: 3.94, P=0.009), more interested in the future than in the present (OR: 1.73, P=0.030), and more likely to regularly save money (OR: 3.49, P=0.046). We found that participants who reported successful smoking cessation were more likely to report walking for exercise. Our findings suggest that adherence to walking may be less challenging for patients who have already successfully implemented and continue to implement another beneficial health behavior (smoking cessation). Patients with claudication who are current smokers may be less likely to adopt exercise recommendations.

Abstract 16781: The Association Between Electronic Cigarette Use and Cardiovascular Disease According to Smoking Status: Brfss 2016

Background: E-cigarettes are a consumer product designed to deliver nicotine by heating a liquid produced from tobacco. Usage in the US is growing rapidly and is common among combustible cigarette users (dual use). The impact of E-cigarettes on cardiovascular disease is unknown. Aim: A cross-sectional examination of e-cigarette use with self-reported cardiovascular disease, according to smoking status, using the nationally representative health survey - the Behavioral Risk Factor Surveillance System (BRFSS) 2016 Methods: We included 404,332 BRFSS 2016 participants with information on the history of CVD and e-cigarette use. E-cigarette use was categorized as never (reference), occasional, and daily with daily +occasional e-cigarette users considered current e-cigarette users. The association of e-cigarette use and CVD (defined as self-reported coronary heart disease, myocardial infarction, or stroke) was assessed using multivariable logistic regression models stratified by smoking status (never, former, current [occasional or daily]), adjusted for age, sex and race. Results: Of the total population, there were 15,240 e-cigarette users and 85,402 with CVD. Compared to those who never used e-cigarettes, current e-cigarette users had significantly higher odds of having CVD among current smoker groups (occasional smoker: Odds Ratio (OR)= 1.36 (95% CI= 1.06 - 1.76); daily smoker: OR=1.34 (1.12 - 1.62)). Daily use of e-cigarettes among occasional smokers was significantly associated with higher odds of having CVD (OR=1.64 (1.05 - 2.57)). (Table) There was no association between e-cigarette use and CVD among never and former smokers. Strengths and Limitations: Because of large sample size, we were powered to stratify e-cigarette use by smoking status. However, BRFSSS does contain directly measured risk factors or pack-years of smoking. Conclusions: Dual use of e-cigarette and combustible cigarettes is a new pattern of tobacco product use that may be associated with more CVD.

Typing of chronic obstructive pulmonary disease using high-resolution computed tomography and the association with smoking, airway inflammation, and common comorbidities

Background/aim: This study performed typing of chronic obstructive pulmonary disease (COPD) using high-resolution computed tomography (HRCT) to determine the association with smoking, matrix metalloproteinases, and common comorbidities. Materials and methods: The study enrolled 94 hospitalized patients. Participants were divided into a group of 69 current and former smokers (group A) and a group of 25 that had never smoked (group B). Patients were also divided into 3 categories according to the degree of emphysema and bronchial wall thickness using HRCT to determine the association with levels of matrix metalloproteinase 9 (MMP-9) and TIMP-1, as well as associated comorbidities. These three categories were: type A - no or mild emphysema, with or without bronchial wall thickening; type E - emphysema without bronchial wall thickening; and type M - both emphysema and bronchial wall thickening. Results: The low attenuation area (LAA) scores in group A patients were higher than those in group B (t = 2.86, P < 0.01); correlation analysis showed that smoking was associated with a decline of the forced expiratory volume in 1 s and forced vital capacity ratio (FEV1/ FVC%) and higher LAA scores in patients with COPD (F = 4.46, F = 8.20, P < 0.05). The levels of MMP-9 in group A were higher than those in group B (t = 3.65, P < 0.01). Among COPD patients with more than 3 comorbidities, there were statistically significant differences in both the smoking group and the nonsmoking group (chi-square = 12.08, P < 0.01). When compared to type A patients, who had coincident cardiovascular diseases in the smoking group, patients of type M and E showed statistically significant differences (F = 2.42 and 2.12, P < 0.05). Conclusion: Emphysema was more severe in smokers. Metalloproteinase levels in smokers were higher than those in nonsmokers. Moreover, comorbidities were more severe in smokers.

The association between cigarette smoking and diabetic nephropathy in Chinese male patients.

To investigate the association between cigarette smoking and the clinicopathological features and renal prognosis of type 2 diabetic mellitus (T2DM) patients with diabetic nephropathy (DN). A total of 223 T2DM male patients with biopsy-proven DN who received follow-up for at least 1year were recruited. The patients were divided into two groups based on smoking status: smoking group and non-smoking group. Clinicopathologic differences were analyzed between the two groups. In addition, smokers were divided into two groups of binary analysis based on smoking amounts and two groups of former smokers and current smokers, and subgroups analysis based on age and DR, respectively. The influence of smoking on estimated glomerular filtration rate (eGFR) was estimated using logistic regression analysis and Cox regression on renal outcomes. Renal outcomes were defined by progression to end-stage renal disease (ESRD) or doubling of serum creatinine (D-SCr) level. Compared with nonsmokers, smoking patients had more moderate decline eGFR (p = 0.032) and tubular atrophy and interstitial fibrosis (p = 0.033). The adjusted logistic regression analysis suggested cigarette smoking was negatively associated with more severe decline eGFR (p = 0.015), especially for patients with DR (p = 0.010) and patients of age ≤ 50years (p = 0.012) in the subgroup analysis. In the prognosis analysis, no obvious significant risk factor was shown about smoking. Interestingly, it was observed that former smokers had lower levels of plasma glucose and triglycerides than current smokers (both p < 0.05), while smokers with small smoking amounts had lower levels of triglycerides than those with large smoking amounts (p < 0.05). Cigarette smoking patients with T2DM and DN had more moderate decline eGFR, especially for DN patients with DR, and milder IFTA lesions, although an obviously significant risk factor was not shown about smoking for DN.

Randomized trial of a patient-centered decision aid for promoting informed decisions about lung cancer screening: Implementation of a PCORI study protocol and lessons learned

PurposeWe describe the methods, stakeholder engagement, and lessons learned from a study comparing a video decision aid to standard educational materials on lung cancer screening decisions. MethodsThe study followed rigorous methodology standards from the Patient-Centered Outcomes Research Institute. The importance of patient-centeredness and patient/stakeholder engagement are reflected across the study's conceptualization, execution, interpretation, and dissemination efforts. Advisory groups of current and former smokers, quitline service providers, clinicians, and patient advocates were formed for the project. The study used both retrospective and prospective recruitment strategies. Randomization of patients occurred within state-based quitlines, with aggressive tracking of participants. We collected data at baseline and 1-week, 3-month and 6-months after receiving the intervention. The patient-centered outcomes included whether patients' receiving the decision aid a) felt better prepared to make a decision, b) felt more informed about the screening decision, c) had more clarity on their values regarding the benefits and harms of lung cancer screening, and d) were more knowledgeable about lung cancer screening than patients receiving the standard education materials. Exploratory outcomes included making an appointment with a health care provider to discuss screening, scheduling and completing lung cancer screening. ResultsWe have enrolled and randomized 516 quitline patients and learned many lessons about executing the trial based on significant patient and stakeholder engagement. ConclusionsConducting patient-centered outcomes research requires new ways of thinking and continuously checking-in with patients/stakeholders. The engagement of quitline service providers and patient advisors has been key to successful recruitment and dissemination planning.PCORI- CER-1306-03385ClinicalTrials.gov NCT ID: NCT02286713

The pulmonary damage caused by smoking: A longitudinal study.

BACKGROUND:Smoking for a long period is known to cause several harms to the human body, chiefly associated with serious pulmonary damage.OBJECTIVE: The purpose of this study was to evaluate the difference in the pulmonary damage between current smokers and ex-smokers, through measuring the bronchial parameters and the extent of emphysema, in order to further illustrate the harm of smoking and the need to stop smoking.METHODS:Using the FACT-Digital lung TM software quantitatively analysis of CT images, including the WT, WA%, LD, LV, PD, and %LAA-950 was performed. The percentage of low attenuation areas less than -950 Hounsfield units (%LAA-950) was defined as the extent of emphysema. The longitudinal data in the two consecutive years of these current smoker group and ex-smoker group were compared by paired t-test.RESULTS:The LV, %LAA-950, WT and WA% of current smokers increased more rapidly each year than that of ex-smokers. The PD and LD of current smokers declined more rapidly each year than that of ex-smokers.CONCLUSIONS:This study shows that pulmonary damage caused by smoking related to the smoking status, can be measured. Smoking cessation has a positive role in alleviating the progress of pulmonary damage.

HO-1 protects smokers exposed to artificial stone dust for pulmonary function tests deterioration.

Background: The Heme Oxygenase system, along with its catabolism products, is involved in a variety of crucial physiological functions, including cytoprotection, inflammation, anti-oxidative effects, apoptosis, angiogenesis, and vascular regulation. Objectives: To analyze the Heme Oxygenase -1 (HO-1) mediated effect of mild deterioration of pulmonary function testing (PFT) in exposed artificial stone smoking workers. Methods: One hundred stone workers divided into current smokers, ex-smokers and never smokers underwent Low Resolution Computed Tomography, PFT, induced sputum (IS) Particle Size Distribution (PSD) and Real Time PCR in IS samples. Results: Smoking status had no significant effect on PFT results but it altered the IS differential cell counts. There was significantly less decline in PFT over time for the smokers group. There was a significantly lower fraction of small particles (<2 μm) in the IS of the current smokers group compared to the never- and ex-smokers groups. HO-1 gene expression was higher among smokers compared to never- and ex-smokers groups. A low percentage of small particles (<5 μm) correlated negatively to the percentage of neutrophils and positively to the percentage of macrophages in the sputum of the smokers group. Conclusions: We found significantly lower risk for decreased PFT deterioration among smokers workers exposed to artificial stone dust with higher HO-1 gene expression suggesting a possible protective effect of smoking by the involvement of HO-1 mechanism. (Sarcoidosis Vasc Diffuse Lung Dis 2018; 35: 276-284).

Smoking and Risk of Ischemic Stroke in Young Men.

There is a strong dose-response relationship between smoking and risk of ischemic stroke in young women, but there are few data examining this association in young men. We examined the dose-response relationship between the quantity of cigarettes smoked and the odds of developing an ischemic stroke in men under age 50 years. The Stroke Prevention in Young Men Study is a population-based case-control study of risk factors for ischemic stroke in men ages 15 to 49 years. The χ2 test was used to test categorical comparisons. Logistic regression models were used to calculate the odds ratio for ischemic stroke occurrence comparing current and former smokers to never smokers. In the first model, we adjusted solely for age. In the second model, we adjusted for potential confounding factors, including age, race, education, hypertension, myocardial infarction, angina, diabetes mellitus, and body mass index. The study population consisted of 615 cases and 530 controls. The odds ratio for the current smoking group compared with never smokers was 1.88. Furthermore, when the current smoking group was stratified by number of cigarettes smoked, there was a dose-response relationship for the odds ratio, ranging from 1.46 for those smoking <11 cigarettes per day to 5.66 for those smoking 40+ cigarettes per day. We found a strong dose-response relationship between the number of cigarettes smoked daily and ischemic stroke among young men. Although complete smoking cessation is the goal, even smoking fewer cigarettes may reduce the risk of ischemic stroke in young men.

Effects of Black and Green Tea Consumption on Blood Pressure and Liver Enzymes: A Randomized Controlled Trial

Background: The effect on tea consumption on blood pressure and liver enzymes are controversial. The beneficial effects of long-term ingestion of black and green tea on systolic and diastolic blood pressure have been suggested by several studies.Objectives: The overall goal of this study was to determine the effects of high tea consumption on blood pressure and liver enzymes.Design: We completed a 6-month randomized, controlled, double-blinded trial in a group of former and current smokers who were randomized to receive black or green tea preparations or a matching placebo.Results: A total of 146 participants (80 females and 66 males) were enrolled in the study. At the end of the 6-month intervention, women in the black tea group showed a 4 mmHg decrease (p = 0.01) in systolic blood pressure while female in the green tea group showed a 30.1% decrease (p = 0.035) in Alanine transaminase (ALT). No significant changes were observed in men.Conclusion: Our data confirm previous findings related to the beneficial effect of black tea on blood pressure and of green tea on serum liver enzymes especially among females. In addition, our study showed that long-term regular consumption of black tea and green is safe.

Effect of alcohol dehydrogenase-1B and -7 polymorphisms on blood ethanol and acetaldehyde concentrations in healthy subjects with a history of moderate alcohol consumption.

This study aims to evaluate the effect of ADH1B and ADH7 genotypes on blood acetaldehyde and ethanol levels after alcohol ingestion, and to measure the genotoxic effect of smoking and ethanol on the buccal cells, also controlling for ADH variants. We recruited healthy Italian subjects with at least a moderate history of alcohol consumption. All subjects were given an alcoholic drink of 0.4 g ethanol /kg of body weight. Blood venous samples were collected at baseline, and 30, 60, 90, and 120 minutes after ingestion. Buccal cells were collected before ethanol ingestion. Sixty subjects were enrolled in the study. Individuals with the ADH1B GG genotype had median ethanol levels of 5.0mM (IQR 3.4-7.2), and those with the ADH1B GT/TT genotype had 4.7mM (IQR 4.2-4.8). Corresponding acetaldehyde levels were 1.5μM (IQR 0.7-2.6) for ADH1B GG genotype and 1.6μM (IQR 1.5-1.7) for ADH1B CG/GG genotype. Individuals with the ADH7 CC genotype had median ethanol levels of 5.0mM (IQR 3.3-7.2), while 5.0mM (IQR 4.7-5.6) was in those with the ADH7 CG/GG genotype. Corresponding acetaldehyde levels were 1.5 μM (IQR 0.7-2.6) for ADH7 CC genotype and 1.5 μM (IQR 1.4-1.6) for ADH7 CG/GG genotypes. A non-significant increase in the frequency of karyolitic and pyknotic cells was found in the group of heavy drinkers and current smokers, when compared to the moderate drinkers and the non-smokers. Our study does not support the hypothesis that ADH1B and ADH7 genotypes affect blood ethanol and acetaldehyde concentration.

Association of Serum Galectin-3 with the Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

BackgroundAcute exacerbation of chronic obstructive pulmonary disease (AECOPD) aggravates the overall severity in COPD patients, resulting in severe morbidity and mortality. However, there are no objective biomarkers currently available to predict the development of AECOPD. Several studies have indicated that galectin-3 (Gal-3) is involved in diseases characterized by excessive inflammatory response and fibrosis. The objective of this study was to examine the dynamic changes of Gal-3 in acute exacerbation and convalescence phases of COPD.Material/MethodsSerum levels of Gal-3, high sensitivity C-reactive protein (hsCRP), and prohormone of brain natriuretic peptide (pro-BNP) were determined using multiplex enzyme-linked immunosorbent assay kits. Serum levels of Gal-3 in 44 patients with COPD were further analyzed and correlated with the parameters of lung function and the biomarkers of systemic inflammation.ResultsThe mean level of serum Gal-3 was significantly higher in acute exacerbation of COPD compared with the level in COPD convalescence phase (32.10±9.83 versus 29.02±8.68 ng/mL, p<0.01). Serum levels of Gal-3 positively correlated with hsCRP (r=0.354, p=0.018 for total patients) and pro-BNP (r=0.319, p=0.035 for total patients) in AECOPD. In addition, the level of Gal-3 was the highest in the current smoker group, and the lowest in the never-smoker group in either the acute exacerbation phase (33.91±3.55 versus 29.12±11.73 ng/mL, p=0.036) or the convalescence phase (30.94±3.40 versus 27.76±9.68 ng/mL, p=0.045) of COPD.ConclusionsOur results indicated that serum Gal-3 is increased in AECOPD patients, which is also positively associated with systemic inflammation and smoking in patients with COPD, suggesting that Gal-3 might be a valuable biomarker for AECOPD.

Gingival Pigmentation Affected by Smoking among Different Age Groups: A Quantitative Analysis of Gingival Pigmentation Using Clinical Oral Photographs.

The presence of any age-related differences in gingival pigmentation associated with smoking, particularly in a young population, remains to be fully investigated. The purpose of this study was to determine the age-related differences in smoking gingival pigmentation. Gingival pigmentation was analyzed using the gingival melanosis record (GMR) and Hedin’s classification with frontal oral photographs taken at 16 dental offices in Japan. Participants were categorized into 10-year age groups, and their baseline photographs were compared. In addition, to evaluate the effect of smoking cessation on gingival pigmentation, subjects were divided into a former smoker group (stopped smoking) and current smoker group. A total of 259 patients 19 to 79 years of age were analyzed. People in their 30s showed the most widespread gingival pigmentation. In addition, subjects in their 20s showed a weak effect of smoking cessation on gingival pigmentation. These findings suggested that the gingival pigmentation induced by smoking was more remarkable in young people than in middle-aged people. This information may be useful for anti-smoking education, especially among young populations with a high affinity for smoking.

Influence of cigarette smoking on osteonecrosis of the femoral head (ONFH): a systematic review and meta-analysis.

Current studies demonstrate controversy regarding the relationship between cigarette smoking and osteonecrosis of the femoral head (ONFH). We conducted a meta-analysis to evaluate the association between smoking and ONFH. Relevant articles published before September 2016 were identified by a systematic search of EMBASE and MEDLINE via Ovid. Summary odds ratios (OR) were calculated using random effects models, and study quality was assessed using a modified Newcastle-Ottawa scale. 102 citations were screened and 7 case-control studies were identified and included in the review. When compared with nonsmokers, current smokers had a higher risk of developing ONFH (OR 2.53; 95% confidence interval [CI] 1.68-3.79), as did former smokers (OR 1.82; 95% CI, 1.10-3.00). Within the group of current smokers, those classified as heavy smokers (with a daily number >20 cigarettes/day) demonstrated higher risks of ONFH (OR 2.03; 95% CI, 1.29-3.19), and light smokers classified as smoking <20 cigarettes/day, also demonstrated a higher risk of ONFH when compared with nonsmokers (OR 1.73; 95% CI, 1.06-2.83). When smoking was classified by pack-years, heavy smokers (>20 pack-years) were at a higher risk of ONFH (OR 2.26; 95% CI, 1.24-4.13), but no significant difference in risk was identified in light smokers (<20 pack-years) (OR 1.81; 95% CI, 0.88-3.71) when compared with nonsmokers. Our meta-analysis showed that current smokers were at a higher risk of ONFH, this high risk can also be found in former smokers. And heavy cigarette smoking showed a higher risk of ONFH than light smoking.