Elimination Of Smoking Research Articles

Factors Influencing Self-perception of Health Status

The aim of this study was to evaluate subjective health status of Łódź adult population and to determine the factors affecting their self-perception of health. The study population consisted of randomly selected 1,056 adults aged 20-74 years from L6di district. Logistic regression model was applied to assess the factors influencing the self-perception of health. More than 30% of study subjects described their health as poor or very poor. There were no statistically significant differences between men and women regarding self-perception of health (p>0.05). Older people more frequently reported their health as poor and very poor compared to those younger than 25 years of age. Four percent of men and 10% of women younger than 25 years of age described their health as poor or very poor whereas in age category 45-54 years that percentage increased to more than 40% (men RR=16.3; p<0.001, women RR=7.5; p<0.001), in 55-64 to 60% (men RR=18.6; p<0.001, women RR=10.0; p<0.001) and for people older than 64 years of age to 60% for men (RR=12.6; p<0.01) and 72% for women (RR=13.4; p<0.001). People with lower educational degree perceived their health as worse compared to those with university diploma (men RR=5.3; p<0.001; women 4.6; p<0.001). The risk of indicating the health as poor or very poor was 3.4 times higher for unemployed men comparing to employed (p<0.001) and 1.5 for unemployed women compared to employed (p>0.05). Men indicating no leisure-time physical activity significantly more frequently described their health as poor or very poor than men with satisfactory level of recreational physical activity (RR=2.2; p<0.01). Current and former smoker men described their health as worse compared to non-smokers (current smokers RR=1.5; p>0.05; former smokers RR=1.8; p>0.05). Preventive programs aimed at improving self-perceived health should concentrate on increasing recreational physical activity and elimination of smoking. Those actions should in particular target people in older age category.

Characteristics, access, utilization, satisfaction, and outcomes of healthy start participants in eight sites.

To describe the characteristics, access, utilization, satisfaction, and outcomes of Healthy Start participants in eight selected sites, a survey of Healthy Start participants with infants ages 6–12-months-old at time of interview was conducted between October 2006 and January 2007. The response rate was 66% (n = 646), ranging from 37% in one site to >70% in seven sites. Healthy Start participants’ outcomes were compared to two national benchmarks. Healthy Start participants reported that they were satisfied with the program (>90% on five measures). Level of unmet need was 6% or less for most services, except for dental appointments (11%), housing (13%), and child care (11%). Infants had significantly better access to medical care than did their mothers, with higher rates of insurance coverage, medical homes, and checkups, and fewer unmet needs for health care. Healthy Start participants’ rates of ever breastfeeding (72%) and putting infants to sleep on their backs (70%) were at or near the Healthy People 2010 objectives, and considerably higher than rates among low-income mothers in the ECLS. The high rate of health education (>90%) may have contributed to these outcomes. Elimination of smoking among Healthy Start participants (46%) fell short of the Healthy People 2010 objective (99%). The low-birth weight (LBW) rate among Black Healthy Start participants (14%) was three times higher than the rate for Whites and Hispanics (5% each). Overall, the LBW rate in the eight sites (7.5%) was similar to the rate for low-income mothers in the ECLS, but both rates were above the Healthy People 2010 objective (5%). Challenges remain in reducing disparities in maternal and child health outcomes. Further attention to risk factors associated with LBW (especially smoking) may help close the gaps. The life course theory suggests that improved outcomes may require longer-term investments. Healthy Start’s emerging focus on interconception care has the potential to address longer-term needs of participants.

Influence of Patricipation in Leisure Time Physical Activity on Tobacco and Alcohol Consumption among Former Athletes and Non Athletes

Influence of Patricipation in Leisure Time Physical Activity on Tobacco and Alcohol Consumption among Former Athletes and Non Athletes The purpose of the study was to recognise relationships between participation in leisure time physical activity (LTPA) and smoking and alcohol consumption among former athletes (FA) and individuals with no sports experience (NA). In Spring-Summer periods in the years 1997-2002 within the purposively sampled groups of FA (n=312) and people NA (n=417) - an anonymous survey was conducted concerning their socioeconomic status, participation in LTPA, smoking and alcohol consumption. The age of examined FA and NA ranged from 18 to 51 years. Respondents' participation in LTPA was measured as follows: frequency, time and forms of LTPA. For evaluation of respondents' smoking status in the last six months the following categories were used: I do not smoke, I smoked occasionally, I smoked 1 to 10 cigarettes/day, and I smoked more than 10 cigarettes/day. Variables describing alcohol consumption involve frequency of drinking alcohol beverages and type of consumed alcohol beverages. It has shown that among male FA was a significantly lower rate of non-smokers, as compared to male NA. No correlation was found between LTPA and smoking and alcohol consumption among women FA and NA. Negative correlation between participation in LTPA and smoking and alcohol consumption was found in both male groups. The results obtained allow us to draw a conclusion that promoting participation in competitive sports or LTPA is a valuable means to complement intervention programmes focused on the reduction and elimination of tobacco smoking and alcohol consumption addressed to men.

Business Policies Affecting Secondhand Smoke Exposure

Despite recent legislative and voluntary policy changes, a significant number of workplaces, recreational venues, and public facilities do not offer the public full protection from secondhand smoke exposure. The current study assessed smoking policies, attitudes toward smoke-free policies, and support for policy change among business owners and managers of businesses open to the public in North Carolina. Business owners and managers were interviewed over the phone. Businesses included all airports, arcades, malls, bowling alleys, and arenas (seating more than 500) in the state as well as a random sample of grocery and convenience stores. A 100% smoke-free policy was reported in 53% of businesses, ranging from 12% in bowling alleys to 97% in arenas. A large majority of business owners and managers understand the health risks of secondhand smoke exposure (82%-89%) and support restrictions on smoking in their businesses (84%-91%). Barriers to voluntary policy change included the lack of legal requirement (39%) and fear of the loss of business (53%). This study used self-report data from business owners and managers; the accuracy of the business smoking policy, customer and employee exposure time, and number of complaints may vary across respondents. It is also possible some participants were influenced by factors of social desirability of responses. Continued progress in establishing 100% smoke-free indoor environments may depend on successful advocacy in instituting legislation mandating the elimination of secondhand smoke in all public places. Advocacy efforts should include education around addressing economic concerns of businesses.

Estimating health-adjusted life expectancy conditional on risk factors: results for smoking and obesity

BackgroundSmoking and obesity are risk factors causing a large burden of disease. To help formulate and prioritize among smoking and obesity prevention activities, estimations of health-adjusted life expectancy (HALE) for cohorts that differ solely in their lifestyle (e.g. smoking vs. non smoking) can provide valuable information. Furthermore, in combination with estimates of life expectancy (LE), it can be tested whether prevention of obesity and smoking results in compression of morbidity.MethodsUsing a dynamic population model that calculates the incidence of chronic disease conditional on epidemiological risk factors, we estimated LE and HALE at age 20 for a cohort of smokers with a normal weight (BMI < 25), a cohort of non-smoking obese people (BMI>30) and a cohort of 'healthy living' people (i.e. non smoking with a BMI < 25). Health state valuations for the different cohorts were calculated using the estimated disease prevalence rates in combination with data from the Dutch Burden of Disease study. Health state valuations are multiplied with life years to estimate HALE. Absolute compression of morbidity is defined as a reduction in unhealthy life expectancy (LE-HALE) and relative compression as a reduction in the proportion of life lived in good health (LE-HALE)/LE.ResultsEstimates of HALE are highest for a 'healthy living' cohort (54.8 years for men and 55.4 years for women at age 20). Differences in HALE compared to 'healthy living' men at age 20 are 7.8 and 4.6 for respectively smoking and obese men. Differences in HALE compared to 'healthy living' women at age 20 are 6.0 and 4.5 for respectively smoking and obese women. Unhealthy life expectancy is about equal for all cohorts, meaning that successful prevention would not result in absolute compression of morbidity. Sensitivity analyses demonstrate that although estimates of LE and HALE are sensitive to changes in disease epidemiology, differences in LE and HALE between the different cohorts are fairly robust. In most cases, elimination of smoking or obesity does not result in absolute compression of morbidity but slightly increases the part of life lived in good health.ConclusionDifferences in HALE between smoking, obese and 'healthy living' cohorts are substantial and similar to differences in LE. However, our results do not indicate that substantial compression of morbidity is to be expected as a result of successful smoking or obesity prevention.

"The case for clean indoor air"

In 2004, a Tsunami in South Asia killed more than 180,000 people and the world recoiled in shock and disbelief. In 2005 an earthquake in Pakistan killed close to 100,000 and the world was devastated. These are truly terrible disasters that continue to claim lives, and we are rightly horrified by their scope and scale.

Tobacco industry consumer research on socially acceptable cigarettes

Objective: To describe tobacco industry consumer research to inform the development of more “socially acceptable” cigarette products since the 1970s. Methods: Analysis of previously secret tobacco industry documents. Results: 28...

Vascular repair and regulation in kidney disease: Overview

Vascular repair and regulation in kidney disease: Overview

Risk factors associated with sick leave due to work-related injuries in Dutch farmers: an exploratory case-control study

Using data from an insurance company, the occurrence of sick leave among Dutch farmers due to work-related injuries, and the epidemiological risk factors were investigated. In this case-control study the cases had filed a sick leave claim for work-related injury from 1998–2001 and the controls had not filed any claim in this period. Most (74%) of all injuries were work-related. The most frequent types of injury (63%) were bruises, sprains/strains and fractures. Multivariable logistic regression analysis showed that farmers working in dairy farming (OR=2.6) or pig husbandry (OR=2.7), older farmers (OR=1.48 per 10 years) and smokers (OR=1.7) were at increased risk. Within dairy farming, a significant factor was contact with cows (OR=1.7 per 500 h); within pig husbandry, working > 60 h per week was a significant factor (OR=2.2). The population attributable risk was 24% for elimination of smoking, 23% for halving the number of hours' contact with cows in dairy farming and 18% for elimination of a working duration > 60 h per week in pig husbandry. Effective measures to prevent sick leave might be raising awareness that older farmers and smokers are at increased risk, and a focus on the risks of working with animals.

Pharmacologic Treatment of Chronic Obstructive Pulmonary Disease: Past, Present, and Future

Pharmacologic treatment of chronic obstructive pulmonary disease (COPD) has evolved considerably during the past several decades. Initial treatment of the disease was accomplished primarily through antibiotics, mucolytic agents, and nonselective sympathomimetic agents. Up-to-date treatment guidelines stratified according to strength of evidence are published in the National Heart, Lung, and Blood Institute-World Health Organization workshop report on the Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. Current drug therapy for stable COPD focuses primarily on bronchodilation through inhaled beta2-agonists and anticholinergic agents, immunization, and elimination of smoking as a risk factor. Although many pharmacologic agents are available to treat COPD, no drug has demonstrated effectiveness in halting progression of the disease. Rather, the goal of drug therapy at this time is to maintain control of symptoms and prevent COPD exacerbations. Compared with asthma, research into treatment for COPD has been minimal. However, a long-acting anticholinergic agent, tiotropium, has received approval status by the United States Food and Drug Administration. The drug has been shown to improve spirometric parameters, quality of life, and utilization of health care resources. In addition, several new targets for the treatment of COPD are being studied, and a few agents, including some that theoretically may slow functional decline in patients with COPD, are in development.

Early determinants of first hospital admissions for asthma and acute bronchitis among Swedish children.

To assess the changing impact of prenatal and perinatal factors with increasing age on first admissions for asthma and acute bronchitis. The Swedish Medical Birth Registry was linked to the National Hospital Discharge Registry for 214,276 Swedish children born in 1987 and 1988. The linkage comprised first admissions for acute bronchitis or asthma from 1987 to 1995. First admissions for gastroenteritis were included to distinguish between factors specific to asthma or bronchitis and non-specific factors related to an increased risk of hospital admission. Admissions for asthma and acute bronchitis before 2 y of age had a close dose-response relationship with maternal smoking, low gestational age, low maternal age and older siblings. Very premature children exposed to more than 9 cigarettes a day in utero ran a 10 times higher risk of hospitalization than postmature children without exposure to maternal smoking. However, the proportion of admissions attributed to maternal smoking was only 4.7% after adjustments for significant covariates. The number of significant determinants declined in children with their first admission for asthma after 2 y of age but male gender and low educational level were independent determinants in all age groups. Older siblings were related to an increased risk of first asthma admission before 2 y of age but a slightly reduced risk of first admission after 2 y of age. This study illustrates the varied epidemiology of asthma in different age groups. Maternal smoking was an important determinant for admission before 2 y of age but mainly in combination with other factors. The decline in hospital admissions in early childhood would therefore be small, even after the elimination of maternal smoking, if other significant perinatal and socioeconomic factors were unchanged.

Smoking and the compression of morbidity

OBJECTIVETo examine whether eliminating smoking will lead to a reduction in the number of years lived with disability (that is, absolute compression of morbidity).DESIGNMultistate life table calculations based on the...

L'enfant né prématurément confronté aux infections communautaires. Quelle prophylaxie?

Preterm infants are at high risk of severe community acquired infections. In particular viral respiratory infections, mainly respiratory syncitial virus infections (RVS), are responsible for a high incidence of rehospitalizations of preterm infants during their 2 first years of life. Prevention relies upon 1/the application of an immunization program identical to the program applied to normal term infants, a cardiorespiratory monitoring during 48-72 hours following immunization being recommended in those infants who carry a risk of recurrent apnea; 2/general measures with a demonstrated protective effect, i.e., breast feeding, elimination of smoking at home, and when possible limitation of contacts with infant and children communities. Immunoprophylaxis against RVS infections has been shown to be effective in reducing the severity of RVS infections in preterm infants but is presently not available in European countries.

Epidemiology of laryngeal cancer.

Laryngeal cancer is the second most common respiratory cancer after lung cancer. Its incidence is increasing over time in much of the world and this increase is generally accepted to be related to changes in tobacco and alcohol consumption. It is a relatively common cancer in men, but rarer in women. Moreover, interesting new issues have been raised recently about the influence of other possible risk factors. Evidence from epidemiological studies which supports the involvement of new risk factors in the aetiology of larynx cancer, as well as new perspectives in therapy, must be taken into consideration in order to realise primary and tertiary prevention. However, it remains clear that, even as new evidence continues to amass about a wide range of risk factors, primary prevention of the great majority of laryngeal cancers could be achieved by elimination of tobacco smoking and reduction of consumption of alcoholic beverages. With an additional contribution from adoption of a diet rich in fruits and vegetables, the great majority of laryngeal cancer appears to be preventable within our current epidemiological knowledge.

Attributable risks for bladder cancer in Northern Italy

Attributable risks (ARs) for bladder cancer were computed in relationship to cigarette smoking, coffee consumption, low intake of vegetables, history of cystitis, and occupation using data from a case-control study conducted in northern Italy between 1985 and 1993. Cases were 431 patients with histologically confirmed bladder cancer, and controls were 491 patients admitted to the same network of hospitals for acute, nonneoplastic, and non-urinary-tract diseases. Overall, the AR estimates were 49% for cigarette smoking, 23% for coffee consumption, 16% for low intake of vegetables, 12% for history of cystitis, and 4% for occupation. These five factors together explained more than 70% of bladder cancer cases in this population. The AR for cigarette smoking was significantly higher among men (56%) than women (17%), whereas coffee consumption, low vegetable intake, and cystitis were more important (but not significantly so) among women. These results suggest that more than 2500 of the 5400 deaths due to bladder cancer in Italy in 1990 could have been prevented by the elimination of cigarette smoking. With some appropriate dietary modification and intervention to prevent urinary tract infections and occupational exposures, this figure could approach 4000 avoidable deaths. Thus, bladder cancer could become a rare cause of death in this population.

Cigarette smoking and pancreas cancer: a case-control study based on direct interviews.

Cigarette smoking is the most consistently reported risk factor for pancreas cancer, yet the dose-response relationship in many pancreas cancer studies is weak. Because of the poor prognosis for pancreas cancer, many case-control studies have been based largely on interviews with proxy respondents, who are known to report less reliable information on detailed smoking habits than original subjects. Our purpose was to evaluate cigarette smoking as a risk factor for pancreas cancer based on data obtained only from direct interviews and to estimate the effects of quitting smoking and of switching from nonfiltered to filtered cigarettes on risk. Our objective also was to estimate the contribution of cigarette smoking toward explaining the higher pancreas cancer incidence experienced by black Americans compared with white Americans. A population-based, case-control study of pancreas cancer was conducted during 1986-1989 in Atlanta, Ga., Detroit, Mich., and 10 counties in New Jersey. Direct interviews were successfully completed with 526 case patients and 2153 control subjects aged 30-79 years, making this the largest population-based, case-control study of pancreas cancer to date based only on direct interviews. Cigarette smokers had a significant, 70% increased risk of pancreas cancer compared with the risk in nonsmokers. A significant, positive trend in risk with increasing duration smoked was apparent (P < .0001), with long-term (> or = 40 years) smokers experiencing a modest 2.1-fold risk. We also observed a negative trend in risk with increasing years quit smoking. Smokers who quit for more than 10 years experienced about a 30% reduction in risk relative to current smokers; quitters of 10 years or less experienced no risk reduction. Switching from nonfiltered to filtered cigarettes did not appear to decrease risk. Compared with nonsmokers, subjects who smoked only filtered cigarettes had a 50% elevated risk and those who smoked only nonfiltered cigarettes had a 40% elevated risk. The proportion of pancreas cancer attributable to cigarette smoking was 29% in blacks and 26% in whites. The relationship between cigarette smoking and pancreas cancer risk is likely to be causal, despite the weakness of the dose-response data. Long-term smoking cessation clearly reduces risk, whereas switching from nonfiltered to filtered cigarettes may not be beneficial. Cigarette smoking appears to explain little of the excess pancreas cancer risk experienced by blacks. Elimination of cigarette smoking would eventually prevent approximately 27% of pancreas cancer, saving 6750 lives in the United States annually.

Preventive therapy for periodontal diseases.

Rational approaches to the prevention of destructive periodontitis should be based on a clear understanding of etiology and pathogenesis. However, we are dealing with a heterogeneous family of diseases in which different factors operate. It is an oversimplification to regard poor oral hygiene, and hence an accumulation of non-specific dental bacterial plaque, as the major risk factor. Epidemiological evidence indicates that host factors are likely to be of overriding importance for the most severe forms. The limitations of nonspecific plaque control are therefore discussed. Specific inhibitors of virulence factors provide a logical approach, but their clinical application awaits improved knowledge. Improvement of general health and resistance to disease by proper nutrition, the avoidance of intercurrent disease, and elimination of smoking and stress-induced risk are encouraged. The genetic basis of susceptibility to periodontitis is increasingly understood, and, while gene therapy is not likely to be a practicable approach to prevention, genetic markers of risk are emerging.

Smoking and bladder cancer risk in Blacks and Whites in the United States

A population-based case-control study of bladder cancer (2,982 cases and 5,782 controls) conducted in 10 areas of the United States examined the effect of smoking as a risk factor among Blacks and Whites, after adjustment for occupation and other potential confounders. Although the overall risk for smoking was slightly higher in Blacks than Whites (relative risk = 2.7 and 2.2, respectively), this difference was not statistically significant. Estimation of risk by dose and currency of exposure revealed no consistent racial disparities in smoking-related risks. Race-specific, attributable risk estimates indicated that nearly half of bladder cancers among both Blacks and Whites could have been prevented by elimination of smoking.

Prevention of atopic diseases in high risk babies (long-term follow-up).

Several studies have demonstrated that dietary and environmental manipulations in the first months of life have a protective effect on the development of allergic diseases in babies "at risk" of atopy. We have prospectively followed up 174 "high risk" infants who underwent dietary and environmental manipulations, such as exclusive breast-feeding for the first 6 months of life, supplemented if necessary with soy-protein formula (Isomil, Abbott), delayed weaning beyond the 6th month of life, and rigorous environmental manipulations for the elimination of house-dust mite and passive smoking. The low prevalence of atopic disease (10%) and the trivial course of the allergic manifestations in this "at risk" population confirm the effectiveness of this preventive program. Moreover, this study demonstrates that the incidence of atopic dermatitis peaks at 6 months, and decreases until it disappears. Food allergy appears only at 6 months and may disappear later. The incidence of asthma peaks at 6 and 36 months and decreases at low levels in the intervals. Allergic rhinitis develops not sooner than 36 months.

Childhood origins of lifestyle-related risk factors for coronary heart disease in adulthood.

Research over the past 40 years clearly points to childhood as a critical period when dietary and lifestyle patterns are initiated which have longterm implications for coronary heart disease risk in adult life. Smoking, high habitual dietary intake of total fat and saturated fat, low exercise level, and excessive alcohol consumption often occur in family aggregates. They are correlated with elevated serum cholesterol, obesity, and hypertension in children, as well as with a predisposition to premature death from coronary heart disease. Intervention studies in children and adolescents show, however, that these lifestyle-risk factors are controllable through education and dietary counselling of the affected individual and their family. Equally important are the emerging data in adults showing that vigorous longterm intervention involving reduction of dietary fat and work-related stress, increased exercise, and elimination of smoking all contribute to a significant improvement in coronary perfusion. Hence, effective dietary and lifestyle management of coronary heart disease can occur at early or later stages of the disease and needs better support from health authorities at the national and international level.