Smoking History Function Research Articles

Prediction of lung cancer risk based on age and smoking history

Background and ObjectiveThe CISNET models provide predictions for dying of lung cancer in any year of life as a function of age and smoking history, but their predictions are quite variable and the models themselves can be complex to implement. Our goal was to develop a simple empirical model of the risk of dying of lung cancer that is mathematically constrained to produce biologically appropriate probability predictions as a function of current age, smoking start age, quit age, and smoking intensity. MethodsThe six adjustable parameters of the model were evaluated by fitting its predictions of cancer death risk versus age to the mean of published predictions made by the CISNET models for the never smoker and for six different scenarios of lifetime smoking burden. ResultsThe mean RMS fitting error of the model was 6.16 × 10 -2 (% risk of dying of cancer per year of life) between 55 and 80 years of age. The model predictions increased monotonically with current age, quit age and smoking intensity, and decreased with increasing start age. ConclusionsOur simple model of the risk of dying of lung cancer in any given year of life as a function of smoking history is easily implemented and thus may serve as a useful tool in situations where the mortality risks of smoking need to be estimated.

ACTIVE CIGARRETE SMOKING MAY HAVE AN INFLUENCE ON THE NATURAL HISTORY OF SUPERFICIAL BLADDER CANCER

The CISNET models provide predictions for dying of lung cancer in any year of life as a function of age and smoking history, but their predictions are quite variable and the models themselves can be complex to implement. Our goal was to develop a simple empirical model of the risk of dying of lung cancer that is mathematically constrained to produce biologically appropriate probability predictions as a function of current age, smoking start age, quit age, and smoking intensity.The six adjustable parameters of the model were evaluated by fitting its predictions of cancer death risk versus age to the mean of published predictions made by the CISNET models for the never smoker and for six different scenarios of lifetime smoking burden.The mean RMS fitting error of the model was 6.16 × 10 -2 (% risk of dying of cancer per year of life) between 55 and 80 years of age. The model predictions increased monotonically with current age, quit age and smoking intensity, and decreased with increasing start age.Our simple model of the risk of dying of lung cancer in any given year of life as a function of smoking history is easily implemented and thus may serve as a useful tool in situations where the mortality risks of smoking need to be estimated.

Symptom severity in obese women with binge eating disorder as a function of smoking history

To compare obese female former smokers with binge eating disorder (BED) to women with BED with no smoking history in the severity of binge eating and associated symptoms. A consecutive series of 91 obese women with current diagnoses of BED were administered structured diagnostic and investigator-based interviews and self-report questionnaires to assess symptoms associated with eating disorders. Participants were classified as "never" or "former" smokers and symptom profiles were compared across smoking groups. Former and never-smoking groups did not differ in age, body mass index, or current binge frequency. Former smokers reported significantly higher levels of dietary restraint, rigid dieting strategies, and avoidance of eating. Former smokers were significantly more likely than never-smokers to endorse specific symptoms of eating pathology (i.e., rigid dieting strategies). Despite the average 15-year interval since smoking cessation, the former smokers in this patient group resembled current smokers with other eating disorders in terms of rigid and restrictive weight control methods. Obese patients with a smoking history may benefit from treatment to address rigid/pathological dieting and strategies.

Psychiatric Comorbidity in Binge-Eating Disorder as a Function of Smoking History

To examine the comorbidity of psychiatric disorders in obese women with binge-eating disorder (BED) as a function of smoking history. A consecutive series of 103 obese treatment-seeking women with current DSM-IV diagnoses of BED were administered structured diagnostic interviews to assess all DSM-IV Axis I psychiatric disorders. Participants were classified as "never" or "daily" smokers, and lifetime rates of comorbid psychopathology were compared across smoking groups using logistic regression. The study was conducted from February 2003 to March 2005. Smokers were significantly more likely to meet criteria for co-occurring diagnoses of major depressive disorder (p = .03), panic disorder (p = .01), posttraumatic stress disorder (p < .05), and substance abuse or dependence (p = .01). Even after excluding participants with substance use disorders, significant differences remained, with lifetime smokers having significantly higher rates of co-occurring anxiety disorders. It is possible that for some obese women with BED, binge eating and cigarette smoking share common functions, i.e., both behaviors may serve to modulate negative affect and/or anxiety. Although the current findings are consistent with a view of a common diathesis for the development of impulsive eating, cigarette or other substance use, and additional Axis I psychopathology, prospective longitudinal studies are needed to elucidate the nature of potential pathways.

Behavioral performance effects of nicotine in smokers and nonsmokers

Performance on finger-tapping and handsteadiness, tasks opposite in response requirements, was compared between male smokers and nonsmokers (n = 10 each) on two occasions, once following intake of nicotine (15 μg/kg) by measured-dose nasal spray and once following placebo. Compared with nonsmokers, smokers had significantly greater increase in finger-tapping speed due to nicotine. On the other hand, smokers tended to have improved performance on handsteadiness (i.e., less involuntary movement) due to nicotine, while nonsmokers had impaired performance, although this difference was not significant. Nicotine-induced changes in performance on each task were inversely related, suggesting specificity of the behavioral effects of nicotine depending on task demands, rather than a generalized effect. These effects of nicotine on behavioral performance may be important in understanding the reinforcing value of nicotine intake, and differences in effects as a function of smoking history may suggest chronic adaptation to nicotine.

Screening by chest photofluorography in Los Angeles. The minifilm circa 1970.

Two decades ago, when extensive tuberculosis case-finding was underway, a minifilm of the chest was a high yield mass screening test. Today readings of “suspect tuberculosis” comprise a minority of significant minifilm findings, based upon the experience of the Breathmobile Project. Both a positive minifilm and a positive smoking history function as risk factors for questionnaire and spirometry evidence of early chronic respiratory disease. Two decades ago the variability of mini-film readings was the subject of several classical studies of screening techniques. Based upon an analysis of 26,000 Breathmobile minifilms, positive discordance continues to be a prominent phenomenon, the chest physicians and radiologists favoring different reading categories. A validity study of 837 minifilms showed dual readings had an average sensitivity of 72% and a specificity of 96%, compared with single readings whose values were 52% and 98%, respectively.