Importance Of Smoking Cessation Research Articles

A Potential Pneumothorax Induced by Immune Checkpoint Inhibitors: A Case Report and Literature Review

Background and Objectives: Immune checkpoint inhibitors (ICIs), which target immune checkpoints in cancer cells, are increasingly used as a mainstay in anticancer treatment. The combination of atezolizumab and bevacizumab is also a first-line treatment for hepatocellular carcinoma (HCC). However, ICIs can cause immune-related adverse events (IrAEs) which range from mild to severe, potentially leading to the need for discontinuing immunotherapy. We report a case of a pneumothorax, a rare side effect caused by IrAEs. Materials and Methods: This paper reports a case of a 78-year-old male HCC patient who developed a recurrent pneumothorax, suspected to be an adverse effect of ICIs. Results: The patient was a current smoker with a 30 pack-year smoking history. Prior to initiating ICIs, a chest CT scan showed mild emphysema and fibrosis attributable to smoking. Following ICI treatment, the patient developed a recurrent pneumothorax. Further tests revealed no underlying cause for the pneumothorax other than the ICIs and smoking, and there were no signs of intrapulmonary metastasis or pneumonitis. Conclusions: When a pneumothorax occurs in a patient undergoing immunotherapy, it is important to consider it as a potential adverse effect of the treatment. Special attention should be given to the possibility that immunotherapy may exacerbate underlying lung conditions. Patients should be advised on the importance of smoking cessation. As there are currently no guidelines for resuming immunotherapy after a pneumothorax, it is crucial to weigh the risks and benefits and consider dose reduction or discontinuation of the medication.

Smoking's impact on pocket closure after nonsurgical periodontal treatment in relation to bleeding on probing.

Our aim was to investigate the impact of smoking on pocket closure at six months after treatment of severe periodontitis, in relation to residual clinical inflammation. The clinical records of deep pockets (probing depth≥6 mm, n&#61;984) in 46 individuals with periodontitis were analyzed. Following baseline clinical assessments (plaque index, probing depth, clinical attachment level, and bleeding on probing), non-surgical periodontal treatment was performed. Clinical assessments were repeated at 2 and 24 weeks after periodontal therapy. A logistic regression model using generalised estimation equations (GEE) adapting the cluster robust standard errors was performed to investigate potential associations between bleeding on probing and pocket closure at post-treatment 24 weeks. Absence of bleeding at two weeks after non-surgical treatment related to pocket closure after six-months. Pockets that do not bleed neither at baseline nor two weeks (OR&#61;2.7; P <.005) and pockets of non-smokers (OR&#61;6.32; P <.001) and females (OR&#61;1.79; P &#61;.022) associated with pocket closure at six months. Pocket closure is associated with being a non-smoker and the absence of inflammation after non-surgical periodontal treatment, which indicates the importance of smoking cessation and inflammation control in achieving optimal clinical outcomes.

The Effect of Varenicline on Smoking Cessation in Hospitalized Patients: A Systematic Review and Meta-Analysis.

Varenicline tartrate is a new and selective agonist of the nicotinic acetylcholine receptor (nAChR). This systematic review and meta-analysis aimed to determine varenicline efficacy in smoking cessation among hospitalized patients. We looked through worldwide databases such as Web of Science, Embase, PubMed, Cochrane, and Scopus. Relevant pieces of research published on varenicline efficacy on smoking cessation among hospitalized patients were discovered using proper keywords. The data were analyzed using Stata software version 14 and a random-effects model meta-analysis. Nine studies were eligible to be included in this study, with a total sample size of 2131. Generally, the point abstinence rate was significantly greater in the varenicline group than in the placebo group at weeks 12 (odds ratio [OR]=0.59; 95% CI: 053-0.65; P<0.001), 24 (OR=0.78; 95% CI: 0.72-0.84; P<0.001), and 52 (OR=0.86; 95% CI: 0.80-0.92; P<0.001). Furthermore, the continuous abstinence rate for weeks 4 (OR=0.70; 95% CI: 019-0.54; P=0.000), 12 (OR=0.26; 95% CI: 019-0.54; P<0.001), 24 (OR=0.32; 95% CI: 019-0.53; P<0.001), and 52 (OR=0.32; 95% CI: 019-0.54; P<0.001) was significantly greater in the varenicline group than in the placebo group. According to the high efficacy of varenicline in both short- and long-term smoking settings and considering the importance of smoking cessation in high-risk hospitalized patients, varenicline consumption could be considered as a main smoking cessation strategy in these patients.

Smoking cessation among tuberculosis patients during the coronavirus disease-2019 pandemic.

Smoking has been recognized as a significant risk factor for COVID-19 and mortality. The World Health Organization (WHO) has recommended smoking cessation to reduce the impact of COVID-19. This study aimed to evaluate the smoking cessation rate of patients starting tuberculosis (TB) treatment at six months using motivational interviewing based on the WHO "five steps to quit" model. In addition, we assessed the knowledge about smoking and the barriers to smoking cessation. We conducted a retrospective cohort study. Outpatients aged >18 years, smokers, and those who are starting TB treatment in two outpatient TB clinics were invited to participate. Patients received information about the importance of smoking cessation, especially in TB patients, and standardized advice based on guidelines. This information was repeated during phone calls during the second and fourth months of treatment. During the study period, 111 patients were included. The primary outcome was the smoking cessation rate at the end of the sixth month of treatment, which was 26.8% (19/71). The barriers to smoking cessation described by the patients were anxiety/depression (47.4%), seeing someone smoking (38.5%), drug use (19.2%), and alcohol abuse (2.6%). The assessment of knowledge about smoking showed that patients had some information gaps. In conclusion, TB smokers who tried to quit smoking during the COVID-19 pandemic faced many challenges. Despite this, we demonstrated a reasonable smoking cessation rate with a nurse-conducted motivational interview.

Risk factors for head and neck squamous cell carcinoma in disease pathogenesis and prognosis: the importance of smoking cessation and the concept of harm reduction

Introduction. Cigarette smoking along with alcohol consumption, infection with human papilloma (HPV) and the Epstein–Barr viruses, is one of the main risk factors for head and neck squamous cell carcinoma. It can also contribute to virus-associated carcinogenesis and affect the clinical and prognostic features of the tumor. Continued smoking at diagnosis of head and neck squamous cell carcinoma is a negative prognostic factor and contributes to reduced patient survival rates. Aim. To analyze the smoking status and the effect of etiopathogenesis on molecular and clinical features in patients with oropharyngeal squamous cell carcinoma (OpSCC). Materials and methods. In patients with OPSCC, the smoking status and the level of motivation to its cessation were clarified. Immunohistochemical analysis of tumor sections from paraffin blocks from the ThermoScentific immunohis-tosteiner was performed using monoclonal antibodies to estrogen receptors α (ERα), programmed death-ligand 1 (pD-L1), Bcl-2, p53 and p16. The percentage of tumor-infiltrating lymphocytes (TILs) in the stromal component of the tumor (hematoxylin and eosin staining) was also analyzed. Results. Of 113 patients with OpSCC, 80 % of patients were current smokers, including 75 % of patients with Hpv-positive tumor status. men with OpSCC were statistically significantly more likely to smoke than women (p = 0.001), as were men with Hpv-positive tumor (p = 0.015). Smoking patients were characterized by a larger size of the primary tumor (T3–4), including those with Hpv (p = 0.015). positive Hpv status of the tumor is associated with autoimmune diseases (autoimmune thyroiditis, psoriasis) (p ˂ 0.05). A high level of TILs is characteristic of smokers, including those with p16+-status (p ˂0.05), but not for all patients with this status. The positive expression of ERα is associated with p16+-status, and the latter is associated with the absence of p53 expression (p ˂0.05). During conservative therapy, tumor regression is associated with the primary tumor size T1–2, p16 + status, female sex, age less than 55 years, TILs level ≥ 57.5 %, pD-L1 expression levels on tumor cells ≥2.2 %, Bcl-2 ≥5 % and ERα ≥65 % (p ˂ 0.05). At the same time, quality of good predictive model for tumor regression showed a TILs level of ≥57.5 % (area under curve, AuC) 0.796; sensitivity 78.6 %; specificity 75 %) and ERα (AuC 0.725; sensitivity 65 %; specificity 83 %). The level of motivation to quit smoking ranged from 1 to 7 points according the 10-point motivation scale in 89 % of respondents. Only 10 patients were ready to quit smoking immediately (10 points on the motivation scale). Conclusion. Molecular heterogeneity of OPSCC was revealed, including in the group of p16+-tumors. Correlation of clinical and molecular parameters with response to conservative therapy can be used in planning of primary therapy and earlier use of surgical treatment. The level of motivation to quit smoking in patients with squamous cell carcinoma of the head and neck may be increased by drawing attention to the problem at each doctor’s appointment as well as by informing about how to quit smoking and therapeutic approaches. In unmotivated patients, the concept of reducing the harm of smoking can be used involving the replacement of cigarettes with electronic tobacco heating systems, eliminating the carcinogenic effect of its combustion products.

308-nm excimer light is effective for palmoplantar pustulosis regardless of the presence or absence of focal infection: Single-center real-world experience of treatment for palmoplantar pustulosis.

Palmoplantar pustulosis (PPP) is relatively rare and recognition of PPP is different in different countries. Therefore, real-world data are limited. Local phototherapy for the palms and the soles is commonly used to treat PPP due to tolerable safety. However, data on the effectiveness of 308-nm excimer light are limited. In our study, we retrospectively investigated the effectiveness of treatments for PPP, especially phototherapy (308-nm excimer light), in our department. In addition, we examined whether smoking status and focal infection affected responsiveness to treatment of PPP. Patients who were diagnosed with PPP by board-certified dermatologists and visited our hospital from April 2015 to August 2018 were analyzed in this study. We collected data on PPP area severity index (PPPASI) before treatment. We also collected data on PPPASI in May to August 2018 as "after treatment" from all patients. Patients who received any treatment for less than 3 months were excluded. Nineteen patients (16 women and three men) were analyzed in this study. In patients treated with phototherapy (n = 12), PPPASI significantly decreased from a mean ± SD of 16.5 ± 10.3 to 4.5 ± 3.6 (p = 0.004), whereas it did not in patients treated without phototherapy (n = 7). Patients who quit smoking showed a significant decrease in PPPASI after treatment (16.8 ± 12.7 to 2.4 ± 2.9, p = 0.008). Regarding focal infection, in patients treated without phototherapy, the reduction rate of PPPASI was significantly lower in patients with focal infection than in those without focal infection (17.7 ± 21.5%, 71.1 ± 19.3%, p = 0.035), indicating that focal infection is associated with intractability. Meanwhile, in patients treated with phototherapy, PPPASI decreased regardless of the presence or absence of focal infection. In conclusion, our study demonstrated the effectiveness of local phototherapy consisting of 308-nm excimer light, regardless of focal infection. Patients who quit smoking were responsive to any treatment, indicating the importance of smoking cessation.

Factors influencing outcomes of surgical therapy of peri-implantitis: A secondary analysis of 1-year results from a randomized clinical study.

To identify predictors of treatment outcomes following surgical therapy of peri-implantitis. We performed a secondary analysis of data from a randomized controlled trial (RCT) comparing access flap with or without bone replacement graft. Outcomes at 12 months were probing pocket depth (PPD), bleeding on probing (BOP), soft-tissue recession (REC) and marginal bone level (MBL) change. Multilevel regression analyses were used to identify predictors. We also built an explanatory model for residual signs of inflammation. Baseline PPD was the most relevant predictor, showing positive associations with final PPD, REC and MBL gain, and negative association with probability of pocket closure. Smokers presented higher residual PPD. Absence of keratinized mucosa at baseline increased the probability of BOP but was otherwise not indicative of outcomes. Plaque at 6 weeks was detrimental in terms of residual PPD and BOP. Treatment allocation had an effect on REC. Final BOP was explained by residual PPD ≥6 mm and plaque at more than two sites. Baseline PPD was the most relevant predictor of the outcomes of surgical therapy of peri-implantitis. Pocket closure should be a primary goal of treatment. Bone replacement grafts may be indicated in aesthetically demanding cases to reduce soft-tissue recession. The importance of smoking cessation and patient-performed plaque control is also underlined.

The importance of smoking cessation in pancreatitis.

The importance of smoking cessation in pancreatitis.

“It’s a decision I have to make”: Patient perspectives on smoking and cessation after lung cancer screening decisions

Few studies exist showing that involvement in lung cancer screening (LCS) leads to a change in rates of cigarette smoking. We investigated LCS longitudinally to determine whether teachable moments for smoking cessation occur downstream from the initial provider-patient LCS shared decision-making discussion and self-reported effects on smoking behaviors. We performed up to two successive semi-structured interviews to assess the experiences of 39 individuals who formerly or currently smoked cigarettes who underwent LCS decision-making discussions performed during routine care from three established US medical center LCS programs.The majority of those who remembered hearing about the importance of smoking cessation after LCS-related encounters did not report communication about smoking influencing their motivation to quit or abstain from smoking, including patients who were found to have pulmonary nodules. Patients experienced little distress related to LCS discussions. Patients reported that there were other, more significant, reasons for quitting or abstinence. They recommended clinicians continue to ask about smoking at every clinical encounter, provide information comparing the benefits of LCS with those of quitting smoking, and have clinicians help them identify triggers or other motivators for improving smoking behaviors. Our findings suggest that there may be other teachable moment opportunities outside of LCS processes that could be utilized to motivate smoking reduction or cessation, or LCS processes could be improved to integrate cessation resources.

Raising awareness of the importance of smoking cessation for the public and people living with lung conditions

Raising awareness of the importance of smoking cessation for the public and people living with lung conditions

Smoking Cessation Efforts Among WISEWOMAN Program Participants, 2014-2018.

Smoking is a preventable risk factor for cardiovascular disease (CVD), indicating the importance of smoking cessation. The Centers for Disease Control and Prevention's Well-Integrated Screening and Evaluation for WOMen Across the Nation (WISEWOMAN) Program funded 21 recipients to provide preventative health services, including healthy behavior support services, to low-income, uninsured, or underinsured women, between 40 to 64 years of age, aimed at lowering CVD risk for women from January 2014 to June 2018. This article explores WISEWOMAN's smoking prevalence and smoking cessation efforts. Analyses were conducted to assess smoking status and other CVD risk factors among 71,671 unique women from all 21 WISEWOMAN funded recipients. Information on CVD risk factors, including smoking status, were collected. Women who were identified as currently smoking during their initial visit were referred to smoking cessation services and their smoking status was revisited during their rescreening. The overall smoking cessation prevalence was 16.9% during the funding cycle. This small increase from the previous iteration of WISEWOMAN (14.9%), supports WISEWOMAN's continued emphasis on smoking cessation through community-clinical linkages. The distribution of smoking cessation did vary by race and ethnicity (p < 0.001). Hispanic women had a higher smoking cessation (38.1%) compared to non-Hispanic American Indian/Alaska Native, non-Hispanic Black, and non-Hispanic White women (17.4%, 15.1%, and 13.7% respectively). In the next iteration of the WISEWOMAN Program, it is anticipated that continued emphasis will be placed on achieving health equity among women who smoke, to reduce CVD risk.

Organizational Characteristics and Smoking Cessation Support in Community-Based Lung Cancer Screening Programs.

After the National Lung Screening Trial demonstrated that annual lung cancer screening (LCS) with chest CT can reduce lung cancer mortality by 20% [1], CMS released beneficiary screening eligibility as age 55 to 77 years, asymptomatic for lung cancer, smoking history of at least 30 pack-years, and current smoker or a quit time of less than 15 years for former smokers. In addition, screening was to be performed in conjunction with a LCS shared decision making (SDM) visit (to include counseling on the importance of smoking cessation or continued abstinence from smoking for former smokers) and imaging facilities performing LCS were to offer smoking cessation interventions [2].

Abstract P025: Cigarette Smoking And Risk Of Hospitalization With Acute Kidney Injury: The Atherosclerosis Risk In Communities (aric) Study

Title: Cigarette smoking and risk of hospitalization with acute kidney injury: The Atherosclerosis Risk in Communities (ARIC) Study Background: Smoking has been associated with progression of chronic kidney disease. However, its association with the development of acute kidney injury (AKI) has not been prospectively assessed in the community. AKI poses significant morbidities and healthcare costs, thus understanding modifiable risk factors of AKI is crucial. Methods: Among 14,587 participants (mean age 54 [standard deviation: 6] years, 55% females and 25.4% Blacks) from the Atherosclerosis Risk in Communities Study, we quantified the association of smoking status with incident hospitalization with AKI (AKI diagnosis on discharge records in any diagnostic position) through 2019 using Cox models. Sensitivity analyses included censoring interim CVD events during follow-up and restricting to AKI as the primary diagnosis. Results: Over a median follow-up of 26.3 years, 2,986 participants had incident hospitalization with AKI (incidence rate per 1,000 person-years: 8.8; 95% CI: 8.4-9.1). In multivariable Cox models, current smokers had a &gt;2-fold higher risk of AKI compared with never smokers (HR: 2.25; 95% CI: 2.04-2.48) (Table). There was a dose-response relationship between smoking pack-years at baseline and risk of AKI (e.g., HRs 1.34 [1.21, 1.50] with 10-25 pack-years, 1.78 [1.59, 1.99] with 25-40 pack-years, and 2.03 [1.80-2.29] with ≥40 pack-years vs. never smokers). These associations were consistent with similar HRs in the two sensitivity analyses censoring interim cardiovascular diseases and analyzing AKI as the primary cause of hospitalization (Table). Conclusions: In a community-based cohort, smoking was associated with the risk of incident hospitalization with AKI, which was independent of potential confounders and robust in a few sensitivity analyses. These results suggest the importance of smoking cessation to reduce the risk of AKI.

The importance of smoking cessation in follow-up protocols for cardiovascular patients.

The importance of smoking cessation in follow-up protocols for cardiovascular patients.

Understanding of risk factors and preventive measures of osteoporosis in postmenopausal women among the general population in Aseer region, Saudi Arabia

Millions of adults over the age of 50 suffer from devastating hip fractures each year, with millions more suffering from pelvic, spine, wrist, and shoulder fractures. Osteoporosis is a major public health concern around the world. In the United States, an estimated 10 million adults aged 50 and up had osteoporosis, with more than 5 million suffering from femoral neck osteoporosis, including 4.5 million women and 800,000 men. Methods: In this cross-sectional study, data were collected by the purposely constructed questionnaire. Results: Out of total 600 questionnaire distributed (Electronically and manually ), 576 questionnaire were received , so the response rate was 96.0% , Cronbach alpha was 0.84. 42.6% were male respondents while 57.4% were females. Average age (S.D) was 35.6(12.5) .Conclusion, Nursing staff should actively educate women, particularly postmenopausal women, about the importance of smoking cessation, walking/active lifestyle, and exercise regimens. Keywords: preventive measures of osteoporosis, osteoporosis, postmenopausal women, Asir region, Saudi Arabia

Maternal Smoking During Pregnancy Affects Adult Onset of Asthma in Offspring: A Follow Up From Birth to Age 46 Years

Previous evidence has revealed an effect of environmental tobacco smoke (ETS) exposure on the development of childhood asthma. However, few studies have investigated the link between prenatal ETS exposure and adult-onset asthma. Therefore, in this study, we aim to determine if an association exists between adult-onset asthma and prenatal ETS exposure. Genetic predisposition to the development of asthma was also examined in conjunction with prenatal ETS exposure.This study was comprised of mothers and their offspring who were included in the Northern Finland Birth Cohort in 1966, a total of 12053 births. Data were collected from 7148 subjects, and 5491 met the inclusion criteria. The final study population consisted of 5200 subjects.Analysis was conducted on maternal smoking status in the last 3 months of pregnancy, and asthma status was conducted at 31 and 46 years of age (n = 5200). Questionnaire data were collected from subjects at 31 and 46 years of age regarding history of asthma or wheeze to determine incident asthma between 31 and 46 years. Information regarding maternal smoking status was gathered at clinical visits via questionnaire at 6- and 7-months’ gestation. Association between the development of asthma and maternal smoking (1 or more cigarette/pipe per day) was analyzed via Pearson’s χ2 test. Maternal smoking and associated changes in forced expiratory volume in 1 second (FEV1) and the FEV1 to forced vital capacity ratio were examined by using linear regression. Binary logistic regression was used to evaluate the relationship between maternal smoking status, adult-onset asthma, and single-nucleotide polymorphisms (SNPs). Linear regression controlled for covariates including maternal education and parental asthma as well as offspring smoking status, education, ponderal index, parity, and Apgar score at first minute.Maternal smoking during the last 3 months of pregnancy was associated with an increased risk for the development of asthma in offspring between 31 and 46 years of age, and reduced offspring FEV1 to forced vital capacity ratio at 31 years of age. This association was more prominent in individuals with haplotype rs11702779-AA and with the subgroup that reported previous wheeze. No association was found between maternal smoking during the last 3 months of pregnancy and offspring FEV1 at 31 years.Gestational smoke exposure is associated with increased incidence of adult-onset asthma and reduced pulmonary function in adult offspring.The results of this study are consistent with previous research revealing an association between gestational maternal smoke exposure and the subsequent development of asthma in offspring. This reveals susceptibility of the developing airway to maternal ETS exposure and the importance of smoking cessation during pregnancy. A limitation of this study is the inability to distinguish the role of prenatal maternal smoke exposure from maternal smoking in the home during the postnatal period.

The importance of smoking cessation during pregnancy and its association with perinatal outcomes

Abstract In utero exposure to tobacco smoke is associated with an increased risk of multiple adverse perinatal outcomes. Smoking cessation during pregnancy has been related to the improvement of these outcomes, but often relies on self-reporting, impairing an accurate assessment of smoking cessation impact on newborńs health. Building on data obtained in the frame of the NEOGENE project, this work aimed to estimate the association between smoking cessation among pregnant women, confirmed by maternal urinary cotinine concentrations, and perinatal outcomes. The study population included 595 pregnant women who sought prenatal care in a public hospital in Porto (Portugal), from April 2017 to July 2018. Data on tobacco consumption and cessation was obtained in a face-to-face interview, during the hospital stay. Perinatal outcomes, namely birth weight (BW), length (BL) and head circumference (HC) were retrieved from the hospital medical records. Maternal self-reported tobacco use was validated by urinary cotinine concentrations, using the solid-phase competitive ELISA technique. Maternal active smoking was associated with a significant decrease in BW, BL and HC of 157.66 g (p &amp;lt; 0.001), 0.78 cm (p = 0.001) and 0.39 cm (p = 0.016). Notably, maternal smoking cessation led to a significant increase in BW of approximately 172 g (p = 0.006), when compared to mothers who have not ceased. Increases in BL and HC did not reach significance. This study upholds that tobacco consumption is still an important public health threat in Portugal and that smoking cessation during pregnancy reverses smoking-associated deficits in perinatal outcomes, emphasizing the crucial need for awareness campaigns to promote smoking cessation during pregnancy. Acknowledgments: This work was supported by FCT and FAPESP (FAPESP/19914/2014). AIS, JM and CC also acknowledge FCT for individual funding (SFRH/BD/145101/2019, SFRH/BPD/115112/2016 and SFRH/BPD/96196/2013 grants, respectively). Key messages Maternal active smoking was significantly associated with lower birth weight, length and head circumference. Maternal smoking cessation reverses the smoking-associated deficits in birth weight.

Increased risk of complications in smokers undergoing reversal of diverting ileostomy.

Diverting ileostomy (DI) is utilised in rectal cancer surgery to mitigate the effects of anastomotic leak. The aim of this study was to assess the clinical risk factors associated with post-operative complications of DI reversal. A single-centre retrospective analysis of patients who underwent surgical resection for rectal cancer and subsequent DI reversal between January 2012 and December 2020 was undertaken. Medical records were reviewed to extract clinical, operative and pathologic details and post-operative complications according to the Clavien-Dindo classification. Univariate and multivariable analyses were undertaken to assess risk factors associated with post-operative complications of DI reversal. One hundred and twenty-six adult patients who underwent DI reversal were included of which 49 had a post-operative complication (39%). The most common complication was prolonged post-operative ileus, which occurred in 24 patients (19%). On multivariable analysis smoking was significantly associated with overall complications (odds ratio [OR]=5.60, 95% confidence interval [CI] 1.90-16.52, p=0.0018), and high Clavien-Dindo (2-5) category complications (OR=4.60, 95% CI 1.81-11.68, p=0.0013). In addition, patients who received adjuvant chemotherapy were less likely to have a reversal of DI complication (OR=0.43, 95% CI 0.19-0.94, p=0.0342) and less likely to have a high Clavien-Dindo (2-5) category complication (OR=0.44, 95% CI 0.20-0.93, p=0.0311). Smokers who have undergone surgical resection of rectal cancer have a significantly increased risk of post-operative complications after DI reversal. In these patients, the importance of smoking cessation must be emphasised. The decreased complication rate observed in patients who received adjuvant chemotherapy was an unexpected finding.

Ongoing challenges in implementation of lung cancer screening.

Lung cancer is the leading cause of cancer deaths in Europe and around the world. Although available therapies have undergone considerable development in the past decades, the five-year survival rate for lung cancer remains low. This sobering outlook results mainly from the advanced stages of cancer most patients are diagnosed with. As the population at risk is relatively well defined and early stage disease is potentially curable, lung cancer outcomes may be improved by screening. Several studies already show that lung cancer screening (LCS) with low-dose computed tomography (LDCT) reduces lung cancer mortality. However, for a successful implementation of LCS programmes, several challenges have to be overcome: selection of high-risk individuals, standardization of nodule classification and measurement, specific training of radiologists, optimization of screening intervals and screening duration, handling of ancillary findings are some of the major points which should be addressed. Last but not least, the psychological impact of screening on screened individuals and the impact of potential false positive findings should not be neglected. The aim of this review is to discuss the different challenges of implementing LCS programmes and to give some hints on how to overcome them. Finally, we will also discuss the psychological impact of screening on quality of life and the importance of smoking cessation.

Effects of tumor necrosis factor (TNF) gene polymorphisms on the association between smoking and lung function among workers in swine operations

ABSTRACT Workers in swine operations may be at increased risk of developing respiratory problems. These respiratory conditions are more prevalent among workers who are smokers. Tumor necrosis factor (TNF) genes play an important role in human immune responses to various respiratory hazards. This study aimed to investigate whether polymorphisms in TNF genes might alter the effects of smoking on lung function among workers in swine operations. Three hundred and seventy-four full-time workers from large swine operations and 411 non-farming rural dwellers in Saskatchewan were included in this study. Information on demographic and lifestyle characteristics, pulmonary function, and blood samples were obtained. Multiple linear regression analyses were used in the statistical analysis. Three promoter polymorphisms (rs1799724, rs361525, and rs1800629) in the TNF gene were investigated. Only the interaction term between smoking status and rs1799724 was significant in the multiple regression models. Among workers with the rs1799724 polymorphism (TT+TC), current smokers exhibited significantly lower lung function than nonsmokers. These associations were not observed among workers with the wild-type (CC). These findings were not observed among non-farming rural dwellers. Data demonstrated the possible involvement of TNF gene in (1) development of adverse respiratory conditions among workers who are smokers, (2) importance of smoking cessation among workers, especially those with polymorphisms in the TNF gene, and (3) potential implications in treatment, screening, and prevention.