Lower Levels Of Smoking Research Articles

Determination of the nicotine metabolites cotinine and trans-3′-hydroxycotinine in biologic fluids of smokers and non-smokers using liquid chromatography–tandem mass spectrometry: Biomarkers for tobacco smoke exposure and for phenotyping cytochrome P450 2A6 activity

The nicotine metabolite cotinine is widely used to assess the extent of tobacco use in smokers, and secondhand smoke exposure in non-smokers. The ratio of another nicotine metabolite, trans-3′-hydroxycotinine, to cotinine in biofluids is highly correlated with the rate of nicotine metabolism, which is catalyzed mainly by cytochrome P450 2A6 (CYP2A6). Consequently, this nicotine metabolite ratio is being used to phenotype individuals for CYP2A6 activity and to individualize pharmacotherapies for tobacco addiction. In this paper we describe a highly sensitive liquid chromatography–tandem mass spectrometry method for determination of the nicotine metabolites cotinine and trans-3′-hydroxycotinine in human plasma, urine, and saliva. Lower limits of quantitation range from 0.02 to 0.1 ng/mL. The extraction procedure is straightforward and suitable for large-scale studies. The method has been applied to several thousand biofluid samples for pharmacogenetic studies and for studies of exposure to low levels of secondhand smoke. Concentrations of both metabolites in urine of non-smokers with different levels of secondhand smoke exposure are presented.

Alcohol use as a signal for sensitivity to nicotine dependence among recent onset smokers

Objective This study evaluated the association between alcohol use, abuse and dependence and cigarette smoking to determine whether alcohol may signal greater sensitivity to nicotine dependence at very low levels of smoking. Method Data were drawn from five annual National Surveys on Drug Use and Health and included individuals age 12 to 21 who reported first exposure to smoking within the past two years and smoking at least once in the past month. Results Both alcohol abuse and alcohol dependence were associated with increased likelihood of symptoms that seem to tap tolerance for nicotine. These included items such as “the amount you smoke has increased”; “needing to smoke a lot more now in order to be satisfied”; and “smoking much more before starting to feel anything”. Alcohol dependence, but not abuse was associated with the remaining symptoms, “after not smoking for a while, needing to smoke to feel less restless and irritable”; “craving cigarettes after not smoking for a while”; and “worrying about running out of cigarettes”. All associations were not better accounted for by either alcohol use or amount smoked. Conclusion If causally associated, treatment of alcohol-use disorders may prevent or reduce the early emergence of nicotine dependence symptoms among new smokers, very early in the smoking uptake process. If instead alcohol disorders are a signal of sensitivity for nicotine dependence best accounted for by a third variable, then adolescents with alcohol dependence and/or abuse during early exposures to smoking represents an important subgroup that may benefit from interventions directly targeting this association.

Threshold of Biologic Responses of the Small Airway Epithelium to Low Levels of Tobacco Smoke

Epidemiologic data demonstrate that individuals exposed to low levels of tobacco smoke have decrements in lung function and higher risk for lung disease compared with unexposed individuals. Although this risk is small, low-level tobacco smoke exposure is so widespread, it is a significant public health concern. To identify biologic correlates of this risk we hypothesized that, compared with unexposed individuals, individuals exposed to low levels of tobacco smoke have biologic changes in the small airway epithelium, the site of the first abnormalities associated with smoking. Small airway epithelium was obtained by bronchoscopy from 121 individuals; microarrays were used to assess genome-wide gene expression; urine nicotine and cotinine were used to categorize subjects as "nonsmokers," "active smokers," and "low exposure." Gene expression data were used to determine the threshold and induction half maximal level (ID₅₀) of urine nicotine and cotinine at which the small airway epithelium showed abnormal responses. There was no threshold of urine nicotine without a small airway epithelial response, and only slightly above detectable urine cotinine threshold with a small airway epithelium response. The ID₅₀ for nicotine was 25 ng/ml and for cotinine it was 104 ng/ml. The small airway epithelium detects and responds to low levels of tobacco smoke with transcriptome modifications. This provides biologic correlates of epidemiologic studies linking low-level tobacco smoke exposure to lung health risk, identifies the genes most sensitive to tobacco smoke, and defines thresholds at which the lung epithelium responds to low levels of tobacco smoke.

Understanding young adult physical activity, alcohol and tobacco use in community colleges and 4-year post-secondary institutions: A cross-sectional analysis of epidemiological surveillance data

BackgroundYoung adults experience many adverse health behavior changes as they transition from adolescence into adulthood. A better understanding of the relationships between health promoting and risky health behaviors may aid in the development of health promotion interventions for various types of young adult post-secondary students. Therefore, the purpose of this study was to examine associations between alcohol and tobacco use and physical activity among 2-year and 4-year college students.MethodsCross-sectional analyses were conducted using 2007 survey data, collected as part of an on-going post-secondary health surveillance system in Minnesota. Students were randomly selected to participant from 14 Minnesota colleges and universities (six 2-year community and/or technical colleges, eight 4-year post-secondary institutions). The 2007 surveillance data included 9,931 respondents.ResultsThe prevalence of demographic characteristics and health behaviors (e.g., physical activity, tobacco use) differed between young adults attending 2-year and 4-year post-secondary institutions; in general, those attending 2-year institutions are representative of more at-risk populations. Overall, higher levels of moderate, vigorous and strengthening physical activity were associated with higher levels of alcohol consumption and lower levels of smoking. In general, despite the disparities in the prevalence of these risk behaviors, the associations between the behaviors did not differ substantially between 2-year and 4-year post-secondary populations.ConclusionsThese findings illustrate links between leading risk behaviors. Interventions targeting multiple risk behaviors among young adults may warrant further consideration. Overall, future research is needed to support and inform young adult health promotion efforts that may be implemented in a wide array of post-secondary institutions.

Differences between intermittent and light daily smokers in a population of U.S. military recruits.

Few studies have assessed differences between intermittent and light smokers, particularly among young adults. Exploring these differences promotes a systematic approach to research and treatment in low-level smokers. This study explored demographic, tobacco-related, and psychosocial predictors of intermittent nondaily smoking relative to light smoking among basic military training (BMT) recruits. The impact of smoking status on abstinence rates at follow-up was also assessed. Participants were 5,603 U.S. Air Force BMT intermittent nondaily (n = 3,134) or light daily (n = 2,469) smoking recruits participating in a population-based group randomized trial targeting tobacco use prevention and cessation (Klesges et al., 2006, Efficacy of a tailored tobacco control program on long-term use in a population of U.S. military troops. Journal of Consulting and Clinical Psychology, 74, 295-306.). Participants completed baseline measures assessing demographics; tobacco use and history; and common social, attitudinal, and behavioral risk factors for tobacco use. Flights of recruits were randomly assigned to a tobacco use intervention or health education control intervention. At the 1-year follow-up, participants reported 7-day point prevalence and continuous abstinence. Intermittent nondaily smoking relative to light daily smoking was associated with lesser perceived addiction, intermittent and daily use of smokeless tobacco, nonsmoking male and female heads of household, lesser likelihood of smoking while stressed or while bored, and higher likelihood of intentions to quit smoking. Intermittent smokers were significantly more likely than light daily smokers to report abstinence at follow-up. Intermittent and daily light smokers differ on several tobacco-related and psychosocial variables. Attending to these factors in prevention and cessation programs may enhance abstinence in both groups.

Antecedents of frailty in the elderly: a systematic revision

Objective: this study has aimed to identify, from a systematic review of literature, precedents of frailty in the elderly. Methods: to achieve that, 32 studies have been analyzed, which have comprehended two chapters of books and a master’s dissertation (first national publications about the theme) and 29 scientific articles published between 2000 and 2009. The search for the articles has been undertaken through the descriptor frail elderly, in the database Scientific Electronic Library Online (SciELO), Latin-American and Caribbean Literature in Health Sciences (LACLHS) and International Literature in Health Sciences (MEDLINE). Results: the researched literature has identified that the precedents of frailty comprehend: advanced age, female sex, low income and low schooling, deficit of social support, negative auto-perception of health, decline in multiple organic systems, co morbidities, depression, low level of physical activity, cognitive deficit, anorexia, obesity, atherosclerosis, fall, and smoking. Conclusion: the results of the study indicate that frailty in the elderly is multi-determined, being involved in its occurrence, events experienced by the individual in all the course of life, which are affected by biological, psychological and social modifiers. Thus, it can be understood that frailty does not show itself in a uniform way in all the individuals.

Prenatal and postnatal parental smoking and acute otitis media in early childhood

To explore the associations between acute otitis media in early childhood and prenatal and postnatal tobacco smoke exposure. Subjects were 32 077 children born between 2000 and 2005 in the Norwegian Mother and Child Study with questionnaire data on tobacco smoke exposure and acute otitis media up to 18 months of age. Multivariate regression models were used to obtain adjusted relative risks for acute otitis media. Acute otitis media was slightly more common in children exposed to parental smoking. The incidence from 0 to 6 months was 4.7% in unexposed children and 6.0% in children exposed both prenatally and postnatally. After adjusting for postnatal exposure and covariates, the relative risk for acute otitis media 0-6 months when exposed to maternal smoking in pregnancy was 1.34, 95% confidence interval: 1.06-1.69. Maternal smoking in pregnancy was associated with acute otitis media up to 12 months of age. Compared with non-exposed children, there was a slightly increased risk of recurrent acute otitis media for children exposed both prenatally and postnatally with a relative risk of 1.24, 95% confidence interval: 1.01-1.52. Even in a cohort with relatively low exposure levels of parental smoking, maternal smoking in pregnancy was associated with an increased risk of acute otitis media in early childhood.

Cardiovascular Mortality and Exposure to Airborne Fine Particulate Matter and Cigarette Smoke

Fine particulate matter exposure from both ambient air pollution and secondhand cigarette smoke has been associated with larger risks of cardiovascular mortality than would be expected on the basis of linear extrapolations of the relative risks from active smoking. This study directly assessed the shape of the exposure-response relationship between cardiovascular mortality and fine particulates from cigarette smoke and ambient air pollution. Prospective cohort data for >1 million adults were collected by the American Cancer Society as part of the Cancer Prevention Study II in 1982. Cox proportional hazards regression models that included variables for increments of cigarette smoking and variables to control for education, marital status, body mass, alcohol consumption, occupational exposures, and diet were used to describe the mortality experience of the cohort. Adjusted relative risks of mortality were plotted against estimated average daily dose of fine particulate matter from cigarette smoke along with comparison estimates for secondhand cigarette smoke and air pollution. There were substantially increased cardiovascular mortality risks at very low levels of active cigarette smoking and smaller but significant excess risks even at the much lower exposure levels associated with secondhand cigarette smoke and ambient air pollution. Relatively low levels of fine particulate exposure from either air pollution or secondhand cigarette smoke are sufficient to induce adverse biological responses increasing the risk of cardiovascular disease mortality. The exposure-response relationship between cardiovascular disease mortality and fine particulate matter is relatively steep at low levels of exposure and flattens out at higher exposures.

Low-Level Smoking More Damaging to Women Than Men

Low-Level Smoking More Damaging to Women Than Men

Smoking among diabetes patients in Yogyakarta, Indonesia: cessation efforts are urgently needed

To document the prevalence of tobacco use among male diabetes patients in a clinic based population of Yogyakarta Province, Indonesia; to examine patient's perceptions of smoking as a risk factor for diabetes complications; and to investigate whether patients had received cessation messages from their doctors. Twelve in-depth interviews and five focus groups (n = 21) with diabetic patients in 2004-2005, followed by a cross-sectional survey of 778 male diabetic patients in diabetes clinics in 2006-2007. 65% of male diabetes patients smoked before being diagnosed, and 32% smoked in the last 30 days. Most patients incorrectly perceived low level smoking safe for diabetics (mean of 3.6 cigarettes). The median range of cigarettes smoked per day was in excess of this 'safe' amount (4-10 cigarettes). Most respondents did not associate smoking with diabetes and its complications. Only 35% of all patients recalled being asked whether they smoked by their doctors, and there were no differences between smokers and non-smokers. Quit messages received by patients were seen as general health advice and not diabetes specific. Many diabetic patients continue to smoke despite the hazard of smoking on diabetes complications and mortality. Smoking cessation is not commonly encouraged by health-care providers in Indonesia, and is not a routine part of diabetes counselling despite the risk of smoking to those with diabetes. Project Quit Tobacco International is currently developing cessation services for patients with diabetes and encouraging medical and nursing schools to incorporate disease specific tobacco education in its curriculum and skill based classes in tobacco cessation counselling.

Homogeneous charge compression ignition versus dual fuelling for utilizing biogas in compression ignition engines

In this work, biogas was used in a compression ignition (CI) engine in the homogeneous charge compression ignition (HCCI) mode as well as in the dual-fuel mode together with diesel. In the HCCI mode, the charge temperature and amount of diesel injected into the intake manifold were used to control combustion. The presence of carbon dioxide in biogas suppresses the high heat release rates normally encountered in neat-diesel-fuelled HCCI engines. Efficiencies close to diesel operation together with extremely low levels of nitric oxide (NO) and smoke were attained in a brake mean effective pressure (BMEP) range from 2.5bar to 4bar in the biogas—diesel homogeneous charge compression ignition (BDHCCI) mode. Proper control over the charge temperature was essential. Thermal efficiency was higher and NO, hydrocarbon, carbon monoxide, and smoke levels were lower than in the biogas—diesel dual-fuel mode. Thus, the BDHCCI mode is a viable option for using biogas in CI engines in the medium-load ranges. Operation of the engine in the CI mode with diesel below a BMEP of 2.5bar, then in the HCCI mode up to a BMEP of 4bar, and in the dual-fuel mode at higher BMEPs could lead to good overall performance and low emissions.

Association of <i>Mycoplasma pneumoniae</i> Infection with Myocardial Infarction

Problem statement: In addition to the major risk factors for atherosclerosis such as high plasma level of low density lipoprotein, low plasma level of high density lipoprotein, cigarette smoking, hypertension and diabetes mellitus, some studies introduce other agents such as Mycoplasma pneumoniae as risk factors for atherodclerosis and coronary artery diseases. Aim of this study was to clarify the risk of Mycoplasma pneumoniae for myocardial infarction in Iranian population. Approach: This was a case-control study, in which 90 patients studied. (March 2005-2007). First group (or case group) include 45 units who had been admitted in hospital with diagnosis of myocardial infarction and second group include 45 units, who were healthy individuals without any positive history of ischemic heart disease. IgG antibodies was assessed by ELISA technique in both groups. Results: There was significant statistic difference in antimycoplasma antibody level. In the groups (p = 0.028) and the relative risk of mycoplasma infection for myocardial infarction estimated to be 2.7. Conclusion: Mycoplasma pneumoniae infection seems to be a risk factor for myocardial infarctin, in Iranian population. It is better to design other studies to evaluate the risk of coinfection of Mycoplasma pneumoniae and Chlamydia pneumoniae and also the risk of these infection plus conventional risk factors for myocardial infarction in this country.

Low-level smoking among Spanish-speaking Latino smokers: Relationships with demographics, tobacco dependence, withdrawal, and cessation

Although recent research indicates that many Latino smokers are nondaily smokers or daily smokers who smoke at a low level (<or =5 cigarettes/day), almost no research has investigated the characteristics of low-level smokers because such individuals are typically excluded from clinical trial research. The present study examined the associations of daily smoking level and demographics, tobacco dependence, withdrawal, and abstinence during a specific quit attempt among 280 Spanish-speaking Latino smokers (54% male) who participated in a clinical trial of a telephone counseling intervention. Daily smokers were classified as low-level (1-5 cigarettes/day; n = 81), light (6-10 cigarettes/day; n = 99), or moderate/heavy smokers (> or =11 cigarettes/day; n = 100). Data were collected prior to the quit attempt and at 5 and 12 weeks postquit. Results yielded three key findings. First, smoking level was positively associated with the total score and 12 of 13 subscale scores on a comprehensive, multidimensional measure of tobacco dependence. Low-level smokers consistently reported the least dependence, and moderate/heavy smokers reported the most dependence on tobacco. Second, low-level smokers reported the least craving in pre- to postcessation longitudinal analyses. Third, despite significant differences on dependence and craving, low-level smoking was not associated with abstinence. Smoking level was not associated with demographic variables. This is a preliminary step in understanding factors influencing tobacco dependence and smoking cessation among low-level Spanish-speaking Latino smokers, a subgroup with high prevalence in the Latino population.

Smoking reduction and cessation among young adult women: a 7-year prospective analysis

This study examined transitions in smoking behavior and attributes associated with reductions in daily smoking and subsequent cessation over a 7-year period. Data came from the Australian Longitudinal Study on Women's Health. Women aged 18-23 years in 1996 were randomly selected from the national health insurance database. Mailed questionnaires were distributed in 1996 (survey 1), 2000 (survey 2), and 2003 (survey 3). The analysis sample was all 972 women who were daily smokers with complete data on smoking at survey 1, and who participated in all three surveys. The main outcome variable was transitions in smoking behavior between surveys 1, 2, and 3, which included changes in the number of cigarettes smoked, changes to nonsmoking, and changes to nondaily smoking. Explanatory variables included prior smoking history, sociodemographic, lifestyle, psychosocial, and health-related characteristics. Over the 7-year period, one-quarter of daily smokers reduced and maintained a lower level of smoking. Reducers were most likely to have been heavy smokers and to have used illicit drugs, compared with those who stopped smoking. A change from daily to nondaily smoking at survey 2 predicted cessation at survey 3 when compared with no change in baseline smoking rate. Baseline smoking level was not a significant predictor of smoking cessation, while becoming married, having a higher physical health score, and not using illicit drugs increased the odds of cessation. Our study suggests that reducing from daily to nondaily smoking may promote smoking cessation among daily smokers. This observation warrants verification in other populations and in experimental studies.

How Does IQ Affect Onset of Smoking and Cessation of Smoking—Linking the Swedish 1969 Conscription Cohort to the Swedish Survey of Living Conditions

To examine the association between intelligence quotient (IQ) measured at ages 18 to 20 and onset of smoking, and the association between IQ and smoking cessation. Data on IQ, smoking, mental health, and social background among 49,321 Swedish men born 1949 to 51, collected at conscription for military service in 1969, were used. The association between IQ and smoking cessation was investigated among those 694 members of the full cohort also interviewed in the Swedish Level of Living Conditions study 1981 to 2002. Lower IQ measured at ages 18 to 20 was weakly associated with increased prevalence of smoking, independently of indicators of mental illness and social misbehavior measured in late adolescence. By contrast, smoking cessation later in life among those who smoked at ages 18 to 20 was not associated with IQ. Among smokers, lower IQ was significantly associated with a lower level of smoking after adjusting for other factors. Low IQ was associated with an increased prevalence of smoking in adolescence. However, the main part of this association disappeared after adjustment for measures of mental health and social function in early life. IQ was not associated with likelihood of quitting smoking.

An experimental investigation of hydrogen-enriched air induction in a diesel engine system

Diesel engines are the most trusted power sources in the transportation industry. They intake air and emit, among others, the pollutants NO X and particulate matter. Continuous efforts and tests have tried to reduce fuel consumption and exhaust emissions of internal combustion engines. Alternative fuels are key to meeting upcoming stringent emission norms. We study hydrogen as an air-enrichment medium with diesel as an ignition source in a stationary diesel engine system to improve engine performance and reduce emissions. Stationary engines can be operated with less fuel than neat diesel operations, resulting in lower smoke levels and particulate emissions. Hydrogen ( H 2 ) -enriched air systems in diesel engines enable the realization of higher brake thermal efficiency, resulting in lower specific energy consumption (SEC). NO X emissions are reduced from 2762 to 515 ppm with 90% hydrogen enrichment at 70% engine load. At full load, NO X emission marginally increases compared to diesel operation, while both smoke and particulate matter are reduced by about 50%. The brake thermal efficiency increases from 22.78% to 27.9% with 30% hydrogen enrichment. Thus, using hydrogen-enriched air in a diesel engine produces less pollution and better performance.

Gender, alcohol, drugs, and health: A comparison of the Isle of Man and the UK

This paper describes findings from a survey of alcohol consumption among a general population sample of 1000 adults living on the Isle of Man. This survey was conducted in 2005. It is part of the large scale epidemiological venture entitled ‘Gender, Alcohol and Culture: An International Study’ (GENACIS). Findings were compared with those of the UK GENACIS survey. The latter had elicited information from 2027 adults. This paper examines the relationships between alcohol and other psycho‐active drug use, gender and health. For the Isle of Man sample, drinking frequency was associated with having poorer physical health. In the combined Manx and UK samples, ‘binge’ drinkers tended to have poorer mental health than other drinkers. Low income and high levels of cigarette smoking were associated with poor physical and mental health in both countries. Cannabis use was related to poor mental health. Women appeared to have better physical health than men, but there was no gender difference in relation to mental health. Once income and educational level were held constant, there were no overall differences between the Isle of Man and the UK. A complex and confusing interaction was found between age and monthly income.

Streptococcus pneumoniae Adherence in Rats under Different Degrees and Durations of Cigarette Smoke

Background: Bacterial adherence to buccal epithelial cells in chronic smokers has been reported to increase in vitro. However, it is unclear whether such adherence increases in hosts without epithelial changes linked to chronic smoking. Objective: This was an in vivo investigation of whether or not there was a change in the Streptococcus pneumoniae adherence to buccal epithelial cells of rats exposed to different periods and degrees of environmental cigarette smoke. Method: Eighteen rats were divided into acute and chronic exposure groups, each containing 9 rats. Both groups were further divided into 3 subgroups each, which were exposed to low or high levels of cigarette smoke, or none at all. After the administration of smoke, S. pneumoniae (ATCC 49619) was inoculated into the buccal mucosa. One hour later, buccal epithelial cell samples were taken and the number of bacteria adhering to 40 buccal epithelial cells was counted. Pre- and postinoculation values and the groups administered smoke and the control groups were then compared. Results: A significant increase in Gram-positive diplococci adherence was determined in all groups after S. pneumoniae inoculation. S. pneumoniae was observed to adhere to buccal epithelial cells in all the control group rats and in those in the groups exposed to cigarette smoke. Pneumococcal adherence in the chronic exposure subgroups increased approximately 4-fold with low smoke exposure (p < 0.004) and approximately 7-fold with high smoke exposure (p < 0.0005). Conclusion:S. pneumoniae adherence was significantly high in rats chronically exposed to a high level of cigarette smoke, but not in the acute exposure groups.

Contextual consistency and adolescent smoking: Testing the indirect effect of home indoor smoking restrictions on adolescent smoking through peer smoking

The present study tested the indirect effect of home indoor smoking restrictions on adolescent smoking through peer smoking. Based on a bioecological perspective of development, we hypothesized that forbidding indoor smoking would reduce the likelihood of adolescent smoking by decreasing exposure to peer smoking, even when adolescents live with at least one household member who smokes. Participants were 163 adolescents (mean age = 16 years) from a suburban southeastern Pennsylvania community. Participants completed a self-report survey evaluating home indoor smoking restrictions, smoking behavior, peer smoking, alcohol use, and demographics. Structural equation modeling indicated that forbidding smoking indoors was associated with having fewer peers who smoke, which was associated with a lower level of smoking. The indirect effect was significant (beta = -.569, 95% CI -.90 to -.24), offering some preliminary ideas about why home indoor smoking restrictions reduce the risk of adolescent smoking. However, the nature and stability of these effects on adolescent smoking behavior remain to be investigated.

Smoking in college freshmen: University Project of the Tobacco Etiology Research Network (U pTERN)

UpTERN, a study conducted by the Tobacco Etiology Research Network (TERN), was designed to examine trajectories of change in smoking behavior and the emergence of dependence over the course of the freshman year from a large sample of college students. The project included extensive quantitative and qualitative assessments of participants. In the first phase, screener data were collected from 4,690 freshmen entering Purdue University in the fall of 2002. In the second phase, 912 students were enrolled from the 2,001 who reported some prior exposure to smoking cigarettes in the first phase. These students provided extensive baseline information on a web-based assessment protocol administered in the week prior to the beginning of classes in the fall semester. In the third phase, these students participated in a web-based assessment administered for 35 consecutive weeks. Approximately 88% of the sample completed the web-based assessment each week. This report describes the rationale for the project and provides an overview of the constructs targeted across the research. In addition, the research methods, procedures, and assessments are discussed. Findings are reported for day-to-day patterns of smoking as well as alcohol and marijuana use across the 35 weeks of assessment. Finally, selected results from reports using data generated from this project are summarized, including analyses of patterns of smoking over time, associations between daily cigarette smoking and alcohol use, evaluations of the nature of nicotine dependence in low-level smokers, an exploration of early cigarette-use episodes in novice smokers, and a consideration of the role of descriptive and injunctive norms from romantic partners and friends in predicting cigarette smoking over time.