Impact Of Smoking Cessation Research Articles

Tobacco smoking and cytokine levels in human epicardial adipose tissue: Impact of smoking cessation

Background & aimsEpicardial adipose tissue (EAT) is a source of a number of cytokines which could act in the pathogenesis of coronary artery disease (CAD). The potential relationship between known cardiovascular risk factors, such as smoking, dyslipidaemia or diabetes mellitus and EAT humoral signalling, has not been fully elucidated. Therefore, we designed and conducted a cross-sectional study to determine whether selected cardiovascular risk factors are linked to levels of cytokines in epicardial and subcutaneous adipose tissue (SAT). MethodsSamples of SAT and EAT were collected from consecutive patients undergoing scheduled cardiac surgery. Tissue concentrations of tumour necrosis factor-ɑ (TNF-α), interleukin-6 (IL-6), adipocyte fatty acid-binding protein, leptin, and adiponectin were determined by ELISA. ResultsWe enrolled 140 patients. TNF-α and IL-6 concentrations in EAT and SAT were significantly higher in current smokers (CS) than in never smokers (NS) and former smokers (FS). There were no differences between FS and NS. No other clinical variables were associated with cytokine concentrations in a regression analysis. ConclusionsSmoking was independently associated with higher TNF-α and IL-6 concentrations in EAT and SAT. A novel observation that pro-inflammatory cytokines are elevated in EAT in smokers could contribute to identify potential mechanisms involved in the pathogenesis of adverse effects of tobacco smoking. There were no differences between EAT cytokine production in NS and FS, which support the importance of smoking cessation for cardiovascular risk reduction.

Association Between Tobacco Smoking and Pro-Inflammatory Humoral Profile in Human Epicardial Adipose Tissue: Impact of Smoking Cessation on Cytokine Levels

Association Between Tobacco Smoking and Pro-Inflammatory Humoral Profile in Human Epicardial Adipose Tissue: Impact of Smoking Cessation on Cytokine Levels

Response to To et al.

To the Editor: We thank you for the opportunity to respond to the comments of To et al. (1) on our paper “Impact of smoking cessation on the clinical course of Crohn's disease under current therapeutic algorithms: a multicenter prospective study” (2). The recent meta-analysis by To et al. confirms that Crohn’s disease (CD) patients who smoke have increased odds of flare of disease activity and contains indirect evidence to suggest that smoking cessation is beneficial as ex-smokers appeared to be at a reduced risk of complications (3). Two prospective intervention studies, our recent publication (2) and the seminal work performed by Cosnes et al. (4), have indeed shown that CD patients who achieve complete smoking cessation have a more benign disease course when compared with those who continue to smoke. The beneficial effect of smoking cessation has now been observed before and after the widespread use of immunosuppressants and anti-tumor necrosis factor (TNF) therapies (2, 4).

Smoking Cessation and Adolescent Treatment Response With Comorbid ADHD

Minors entering treatment for alcohol and other drug (AOD) use disorders tend to smoke at high rates, and many have comorbid attention deficit hyperactivity disorder (ADHD). Clear-air laws force patients to refrain from smoking on the premises of AOD treatment facilities, which may hinder the progress of treatment-seeking populations who smoke and struggle with ADHD comorbidity in particular. This study explores clinical characteristics associated with smoking among youths presenting for residential treatment, clinical characteristics associated with smoking cessation, and the impact of smoking cessation with ADHD comorbidity on AOD treatment response. Participants were 195 adolescents (52% female, aged 14–18 years) court-referred to residential treatment. Data were collected at intake, prospectively each week for the 10-week treatment period, and at discharge. Two-thirds (67%) of the enrollment sample entered treatment smoking half a pack a day on average, a large proportion (50%) of which did not smoke during treatment. ADHD patients were more likely to smoke before and during treatment except for those who got active in service and step-work. Quitting smoking did not adversely affect AOD outcomes and was associated with better prognosis of lowered AOD cravings for youths with and without ADHD. Smoking cessation during adolescent AOD treatment is recommended with provision of pharmaceutical and/or behavioral modalities that reduce nicotine withdrawal.

Association between Smoking Status and Obesity in a Nationwide Survey of Japanese Adults.

ObjectiveA positive association between the number of cigarettes smoked per day and obesity has been reported, whereas how other smoking-related indices, such as pack-years and duration of smoking, are related with obesity has been less investigated. We analyzed the age-adjusted cross-sectional association between smoking and obesity in a general Japanese population.MethodsWe used data from a nationwide epidemiological study of Japanese adults (N = 23,106). We compared the prevalence of obesity (defined as body mass index ≥ 25kg/m2) among groups classified by smoking behavior, pack-years, number of cigarettes per day, duration of smoking, and duration and time of smoking cessation.ResultsIn men, current smokers had a lower odds ratio (OR) for obesity of 0.80 (95% confidence interval (CI): 0.72–0.88) compared to non-smokers, whereas past smokers had a higher OR of 1.23 (95% CI: 1.09–1.37) compared to current smokers. In women, there were no differences in obesity between the three groups classified by smoking behavior. However, in both sexes, the prevalence of obesity tended to increase with pack-years and the number of cigarettes per day, but not with duration of smoking in current and past smokers. Further, in male smokers, the risks for obesity were markedly higher in short-term heavy smokers compared with long-term light smokers, even with the same number of pack-years. Regarding the impact of smoking cessation, female past smokers who quit smoking at an age > 55-years had an elevated OR of 1.60 (95% CI:1.05–2.38) for obesity.ConclusionsIn a general Japanese population, obesity is progressively associated with pack-years and number of cigarettes per day, but not with the duration of smoking. When investigating the association between obesity and cigarette smoking, the daily smoking burden and the duration of smoking require to be independently considered.

Impact of Smoking Cessation on the Clinical Course of Crohn's Disease Under Current Therapeutic Algorithms: A Multicenter Prospective Study.

Given the importance of tobacco smoking (TS) as the only environmental factor repeatedly linked to the development of the Crohn's disease (CD), it is surprising that very few prospective studies have assessed whether TS is associated with an increased frequency of clinical relapse. Our aim was to evaluate the current impact of TS on disease relapse and the clinical benefit of quitting smoking in the present era of widespread use of anti-TNF drugs and immunosuppressants. This was a multicenter prospective cohort study, which included 573 CD patients in clinical remission with various smoking habits. All smokers were advised to quit. Patients not exposed to tobacco before inclusion (non- and former smokers), continuing smokers, and quitters were compared regarding differences in disease outcomes during a follow-up of 4 years. A total of 148 continuing smokers, 190 nonsmokers, 160 former smokers, and 75 quitters were included. In comparison with nonsmokers, continuing smokers relapsed more frequently with an incidence rate ratio of 1.53 (95% confidence interval (CI): 1.10-2.17). Former smokers and quitters had similar relapse incidences compared with nonsmokers. Smoking was an independent predictor for disease relapse in the multivariate analysis (hazard ratio: 1.58 (95% CI 1.20-2.09). In the time-dependent analysis, continuing smokers had earlier relapse, regardless of anti-TNF or immunosuppressant use. Continuing smokers have more disease relapses, and patients who quit smoking have a similar relapse incidence compared with nonsmokers.

Abstract 4665: Pre-diagnostic smoking, alcohol and obesity and risk of second primary cancer in female keratinocyte carcinoma survivors

Abstract BACKGROUND: Several studies have suggested a positive association between personal history of keratinocyte carcinoma and risk of subsequent cancer at other sites. Although smoking, alcohol, and obesity are well-known risk factors for first cancers, few studies evaluate the role of these risk factors in the development of second primary cancers (SPCs) in keratinocyte carcinoma survivors. METHODS: In the Nurses’ Health Study (NHS), 20,020 female keratinocyte carcinoma survivors were identified from a cohort of 115,711 women from June 1884 to June 2010. Incident SPC (all cancer combined and major individual cancers, including lung, colorectal, breast, non-Hodgkin, melanoma, endometrial, ovary, and bladder) were assessed throughout follow-up until June 2012. Cox proportional hazards models were used to calculate the relative risks (RRs) of SPC associated with pre-diagnosis smoking history, alcohol consumption, and body mass index (BMI). We also compared these estimates to those for first cancers in the cohort. RESULTS: During 239,029 person years’ follow-up, we recorded 3,365 SPC cases. Compared with nonsmokers, smokers with at least 25 cigarettes/d before keratinocyte carcinoma diagnosis had a significantly elevated SPC risk for lung cancer (RR, 24.48; 95% CI, 15.93 to 37.62) and colorectal cancer (RR, 2.36; 95% CI, 1.33 to 4.19) in dose-dependent manner (test for trend P<0.01). We found positive linear trends for the relationship between higher BMI and risk for breast cancer, endometrial cancer and all-combined SPC (test for trend P<0.01). Keratinocyte carcinoma survivors who reported drinking at least 30 g of alcohol/d had a marginally higher risk of SPC than non-alcohol drinkers (RR, 1.17; 95% CI, 0.99 to 1.39), while there was a J-shape association between alcohol consumption and risk of second primary colorectal cancer. When we compared the magnitude of the association between heavy smoking (≥25 cigarettes/day) and any cancer risk among those with keratinocyte carcinoma vs. none, the RR for keratinocyte carcinoma survivors (2.29; 95% CI, 1.97 to 2.66) slightly exceed that for participants without keratinocyte carcinoma (RR, 1.94; 95% CI, 1.79 to 2.10). CONCLUSIONS: Our study found that prediagnostic smoking and obesity were associated with overall SPCs and for several individual sites among keratinocyte carcinoma survivors. These findings suggest that more thorough surveillance and screening for SPCs is needed for the keratinocyte carcinoma survivors with these risk factors. Further research is needed to understand the long-term impact of smoking cessation and healthy weight management among cancer survivors. Citation Format: Sang Min Park, Tricia Li, Shaowei Wu, Wen-Qing Li, Abrar A. Qureshi, Eunyoung Cho. Pre-diagnostic smoking, alcohol and obesity and risk of second primary cancer in female keratinocyte carcinoma survivors. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 4665. doi:10.1158/1538-7445.AM2015-4665

Abstract P008: Weight Gain and Cardiovascular Risk Reduction Associated With Tobacco Abstinence in Smokers With Serious Mental Illness

Background: In patients with serious mental illness, high prevalence of smoking and obesity-related risk factors contribute to high rates of cardiovascular disease (CVD) and premature mortality. The impact of smoking cessation on weight gain, obesity-related risk factors, and overall cardiovascular risk among this population is unknown. Methods: We conducted secondary analyses to assess weight gain and change in CVD risk of 87 smokers with serious mental illness (schizophrenia, schizoaffective disorder, and bipolar disorder) who participated in a randomized controlled trial to test the long-term effectiveness of varenicline on smoking cessation. Initially, 203 smokers with serious mental illness were enrolled into an open-label 12-week course of varenicline. Subjects who attained abstinence at the end of the open-label phase were eligible to participate in the randomized phase, and 87 subjects were randomized to continue either varenicline or placebo for the following 40 weeks. Smoking cessation at week 52 (end of treatment) was defined as 21-day point prevalence abstinence. We compared subjects who were abstinent at week 52 (N=33) to subjects who had relapsed to smoking (N=54) on changes in weight and Framingham 10-year CVD risk score over the 52-week trial; outcomes were modeled with repeated measures analyses of variance. Results: At baseline, subjects who achieved week 52 abstinence were older (52 vs. 46 years, p=0.01) and had higher fasting serum glucose (98 vs. 89 mg/dL, p=0.008) than subjects who relapsed, but they did not differ on sex, race, smoking characteristics, blood pressure, lipids, treatment for diabetes, or treatment with antipsychotic medications. Baseline mean body mass index did not differ between abstinent and relapsed subjects (31.4 vs. 32.4, p=0.52), but the baseline mean Framingham risk score was higher for abstinent than relapsed subjects (14.2% vs. 10.8%, p=0.02). Over the 52 week study period, abstinent subjects gained more weight than relapsed subjects (4.8 kg vs. 1.2 kg, p=0.002 for time*abstinence interaction), but the mean Framingham risk score decreased substantially for abstinent subjects and not for relapsed subjects (-7.6% vs. 0.0%, p=0.003 for abstinence effect adjusting for sex, site, varenicline or placebo, and antipsychotic medications). Conclusion: Despite the high prevalence of obesity at baseline and substantial weight gain associated with long-term abstinence, smoking cessation resulted in a large reduction in the Framingham estimated 10-year CVD risk among patients with serious mental illness.

The Effects of Smoking Cessation on Weight Gain: New Evidence Using Workplace Smoking Bans

Both tobacco use and obesity are among the most important and costly health challenges faced in developed countries. Unfortunately, they may be inversely linked. While policy interventions that have placed limits on tobacco use have increased substantially over time, one unintended consequence may be to increase obesity rates. Issues of selection and unobserved heterogeneity make it difficult to empirically assess the relationship between the two health outcomes. Additionally, there may be heterogeneous policy effects by cessation cause - smoking bans or medical treatments or tobacco prices. This paper focuses on the effects of a rapidly expanding policy by using within-individual differences in exposure to workplace smoking bans to estimate the impact of smoking cessation on weight gain using a large study of over 5000 White and Black respondents followed since 1986. Findings suggest that individuals affected by the smoking bans gained more weight in the short-term than suggested by OLS estimates.

Is the Association Between Smoking and the Retinal Venular Diameter Reversible Following Smoking Cessation?

Wider retinal venular caliber is shown to be associated with an increased risk of stroke, and smoking is associated with a wider retinal venular caliber. However, the impact of smoking cessation on the retinal vessels has not been previously reported. We examined this issue in an adult cohort of atomic bomb survivors. In the Adult Health Study of Japanese atomic bomb survivors, 1664 subjects had retinal photographs taken from 2006 to 2008. The central retinal artery and vein equivalents (CRAE and CRVE) were calculated using a semiautomated software program. Multiple surveys have assessed the effects of smoking since 1963. The associations between smoking, the time since cessation, and the retinal vessel caliber were determined using linear mixed effects models. The CRVE was associated with an increased number of cigarettes smoked per day among women after adjusting for potential confounding factors (age, sex, blood pressure, hypertensive medications, white blood cell count, diabetes, body mass index, lipids, and radiation dose). Females who smoked 10 cigarettes per day had a 6.9-μm wider mean CRVE (P = 0.001) than nonsmokers. Females who had stopped smoking for 10 or more years had a mean CRVE similar to those who had never smoked (191.8 vs. 194.4 μm; P = 0.23). These associations were not observed in males or for CRAE. Wider retinal venular caliber is associated with smoking in Japanese females; however, this association becomes nonsignificant after 10 or more years of smoking cessation, suggesting that the impact of smoking on retinal venular dilation is reversible following long-term smoking cessation.

Sa1124 Clinical Impact of Smoking Cessation by Varenicline Treatment on Improvement of Reflux and Dyspeptic Symptoms and Health-Related Quality of Life

Sa1124 Clinical Impact of Smoking Cessation by Varenicline Treatment on Improvement of Reflux and Dyspeptic Symptoms and Health-Related Quality of Life

The impact of smoking cessation on schizophrenia and major depression

This review sought to determine whether quitting smoking behaviour places people with a history of schizophrenia or major depression at risk of worsening symptoms or relapse. Literature searches of Embase, MEDLINE, the Cochrane Library and PsycINFO. Six studies involving 735 people diagnosed with schizophrenia, schizoaffective disorder or psychotic disorder did not find significant change in mental health status after quitting smoking. Five out of six studies involving 1,293 people with a history of major depression did not find an increased risk of depression with abstinence from smoking, while one study did. Two of these studies found an improvement in depressive symptoms among quitters. There is no published evidence to support the hypothesis that quitting smoking is harmful to the mental health of people with schizophrenia. Smoking cessation does not appear to place smokers with a history of major depression at increased risk of worsening symptoms nor relapse, and may even improve their mood. Psychiatrists and other mental health professionals should provide their patients with the same level of support to quit smoking that is given to the rest of the population.

Sustainment of Smoking Cessation Programs in Substance Use Disorder Treatment Organizations

The majority of individuals who enter substance use disorder (SUD) treatment also use tobacco. Integrating smoking cessation services into SUD treatment may have substantial public health benefits, but few studies have examined whether organizations offering counseling-based smoking cessation programs sustain them over time. This study examines sustainment of smoking cessation programs using 2 waves of data collected from 150 SUD treatment organizations. Data were collected in 2006-2008 and 2009-2010 using face-to-face interviews, telephone interviews, and mailed surveys. Logistic regression models of sustainment were estimated with administrators' attitudes toward smoking cessation and organizational barriers as covariates. About 60.2% of these SUD treatment organizations sustained their counseling-based smoking cessation programs at follow-up. Sustainment was significantly more likely when administrators' baseline attitudes about the impact of smoking cessation on recovery were more supportive (odds ratio, OR = 1.84; 95% confidence interval, CI = 1.13-3.01; p =.015) and when programs were accredited (OR = 3.95, 95% CI = 1.65-9.50, p =.002). Worsening over time of barriers encompassing staff interest, staff skills, and competing treatment demands were negatively associated with sustainment (OR = 0.58, 95% CI = 0.42-0.81, p =.001). These findings provided empirical support for theoretical perspectives regarding the importance of leadership and staff expertise in promoting sustainment of innovations over time. Although the majority of SUD treatment organizations sustained their smoking cessation programs, the 40% rate of discontinuation is concerning and highlights the ongoing challenges faced by tobacco control efforts in substance abuse treatment.

Impact of smoking cessation on the risk of subarachnoid haemorrhage: a nationwide multicentre case control study

Background and purposeSubarachnoid haemorrhage (SAH) is the most devastating cerebrovascular disease. Cigarette smoking is one of the established risk factors for SAH, but the risk of SAH has not been...

Impact of Smoking and Smoking Cessation on Arterial Stiffness in Healthy Participants

Smoking is associated with increased arterial stiffness. However, the impact of smoking cessation on arterial stiffness remains unknown. We investigated the effect of smoking cessation on arterial stiffness. Healthy participants (n = 209) were divided into nonsmoking (NSm, n = 96), quit smoking (QSm, n = 61), and maintained smoking groups (MSm, n = 52). Arterial stiffness indexes (ankle-brachial index [ABI] and brachial-ankle pulse wave velocity [baPWV]) were assessed at baseline, and after 6 and 12 months. Baseline, arterial stiffness was significantly higher in the MSm and QSm groups than in the NSm group (P < .001). In the QSm group, there was significant difference in ABI between baseline and 12 months (P = .03). No significant differences were shown in baPWV. Both ABI and baPWV were similar between QSm and MSm group at 12 months. However, there was significant difference between QSm and NSm groups (P < .001). This study shows that 12 months of smoking cessation is associated with improved arterial stiffness.

Abstract 2574: Impact of Smoking Cessation on the Rish of Subarachnoid Hemorrhage: A Nationwide Multicenter Case-Control Study

Background: Subarachnoid hemorrhage (SAH) is the most devastating cerebrovascular disease. Cigarette smoking is one of the established risk factor for SAH, but on the relationship between smoking cessation, the risk of SAH has not been properly elucidated. Methods: We performed a nationwide multicenter case-control study from 33 hospitals in Korea. A total of 426 SAH cases and 426 age and sex-matched controls were enrolled. The participants were asked about their smoking habits, including information about the amount and duration of smoking and the time at quitting smoking. The other data about life-style and medical history were also collected with structured questionnaires which trained interviewers administered. Results: One-hundred forty eight SAH patients (37.4%) were current smokers compared with one-hundred three (24.2%) controls, giving an adjusted odds ratio of 2.84 (95% confidence interval, 1.63 to 4.97) after controlling possible confounders. According to cumulative dose of smoking (pack-years), the risk of SAH increases dose-dependently. Compared with current smokers, past smokers whose quitting duration was 5 or more years had a significant 59% reduced risk of SAH. However, previously heavy smokers (≥ 20 cigarettes per day) had a 2.3-times increased risk of SAH compared with never smokers. Conclusion: The authors report that the cigarette smoking increases the risk of SAH dose-dependently. According to smoking cessation, stopping smoking may decrease the risk time-dependently, and this beneficial effect of smoking cessation could be decreased in previously heavy smokers. Our results suggest that the vigorous efforts to stop smoking should be performed to reduce the risk of SAH.

Impact of Smoking Cessation Before Resection of Lung Cancer: A Society of Thoracic Surgeons General Thoracic Surgery Database Study

Impact of Smoking Cessation Before Resection of Lung Cancer: A Society of Thoracic Surgeons General Thoracic Surgery Database Study

234 Early improvement in peripheral vascular tone following smoking cessation using nicotine replacement therapy: aortic wave reflection analysis

Cigarette smoking induces cardiovascular pathology and worsens arterial stiffness. Arterial stiffness can be assessed non-invasively on 2 indices: pulse-wave velocity (PWV), indicating aortic stiffness, and augmentation index (AIx), indicating aortic wave reflection. The impact of smoking cessation (SC) nicotine replacement therapies (NRT) on arterial stiffness remains unknown. AIx and PWV were studied prospectively (SphygmoCor) in 26 long-term smokers (>10 cigarettes/day; mean age, 43 ± 6 yrs) before (V1) and 28 and 56 days (V2, V3) after SC supported by NRT. Two-way repeated-measures ANOVA was used with patients serving their own controls on intention-to-treat analysis. Abstinence was ascertained when exhaled carbon monoxide (CO) was <10ppm; the quantity of NRT absorbed was assessed from the serum cotinine level. 16/24 patients (67%) were abstinent at end of study; 8/24 had cut down on smoking; 2 were lost to follow-up. CO and serum cotinine levels fell after SC. Mean AIx for the population as a whole was 23.4% at V1, with significant early reduction by V2 (16.2%) and V3 (13.9%) (ANOVA p<0.001). PWV, peripheral blood pressure and heart rate were unchanged. Multivariate analysis failed to identify predictive factors among baseline characteristics, cigarette addiction levels, or evolution of expired CO or serum cotinine. The improvement in AIx and stability of PWV after SC with NRT indicate improved peripheral vascular tone. This impact may account for the early clinical benefit of SC observed even when associated to NRT.

Cytochromes P450: Roles in the Biotransformation of Chemicals in Cigarette Smoke and Impact of Smoking Cessation on Concurrent Drug Therapy

AbstractCigarette smoke contains polycyclic aromatic hydrocarbons (PAHs) that activate the expression of cytochrome P450 family 1 (CYP1) enzymes in liver and other tissues; this process is dependent on the aryl hydrocarbon receptor (AhR) transcription factor. An important CYP1 enzyme, CYP1A2, has a critical role in the oxidation of drugs such as clozapine, olanzapine and theophylline; these drugs exhibit a high incidence of adverse effects that are linked to plasma concentrations. This article reviews the impact of smoking and smoking cessation on therapy with toxic drugs that undergo CYP-mediated elimination. PAHs in cigarette smoke activate the AhR and upregulate CYP1A2, which enhances the clearance of these drugs, diminishes their efficacy and necessitates the use of higher doses. However, smoking cessation decreases PAH exposure, which leads to a decline in clearance of CYP1A2 substrate drugs. Dose reductions and close therapeutic monitoring for such drugs are recommended in patients who cease smoking.

Early Improvement in Peripheral Vascular Tone following Smoking Cessation Using Nicotine Replacement Therapy: Aortic Wave Reflection Analysis

Objectives: Cigarette smoking induces cardiovascular pathology and worsens arterial stiffness. Arterial stiffness can be assessed noninvasively based on 2 indices: pulse-wave velocity (PWV), indicating aortic stiffness, and the augmentation index (AIx), indicating aortic wave reflection. The impact of smoking cessation (SC) with nicotine replacement therapies (NRT) on arterial stiffness remains unknown. Methods: AIx and PWV were studied prospectively (using a SphygmoCor system) in 26 long-term smokers (>10 cigarettes/day; mean age 43 ± 6 years) before (visit 1) and 28 and 56 days (visit 2 and visit 3) after SC supported by NRT. Abstinence was ascertained when exhaled carbon monoxide (CO) was <10 ppm; the quantity of NRT absorbed was assessed based on the serum cotinine level. Results: Sixteen of 24 patients (67%) were abstinent at the end of the study; 8/24 had cut down on smoking, and 2 were lost to follow-up. CO and serum cotinine levels fell after SC. The mean AIx for the population as a whole was 23.4% at visit 1, with a significant early reduction by visit 2 (16.2%) and visit 3 (13.9%) (ANOVA, p < 0.001). The PWV, peripheral blood pressure, and heart rate were unchanged. Conclusions: The improvement in AIx and the stability of PWV after SC with NRT indicate improved peripheral vascular tone. This impact may account for the early clinical benefit of SC observed even when associated with NRT.