Male Cigarette Smokers Research Articles

Screening for Early Lung Cancer: Results of the Memorial Sloan-Kettering Study in New York

The Memorial Sloan-Kettering lung cancer screening program was begun in 1974 to evaluate sputum cytology as a supplement to the annual chest x-ray examination for early detection and diagnosis. The 10,040 adult, male cigarette smokers who enrolled were randomly assigned to receive annual chest x-ray examinations only or a dual screen with annual chest x-ray examination and four monthly sputum cytology evaluation. Over 40 percent of the 288 who developed lung cancer were diagnosed in stage I, and their survival was 76 percent at five years; overall survival was 35 percent. Nearly one third of the lung cancers detected on first examination on the dual screen, and 14 percent of those on subsequent examinations were found by cytologic examination. The same number of cancers developed in the x-ray screen only group, and were diagnosed at a later date. Despite the delay, survival and mortality were the same, suggesting that the squamous carcinomas detected by cytologic examination alone are very slow growing and tend to remain localized until detectable by x-ray examination.

Mortality from coronary heart disease-trends for the Republic of Ireland.

A study of certified mortality between 1968 and 1981 indicates that mortality from all causes commenced to decline from the mid 1970s in the Republic of Ireland. This trend was apparent for both sexes and for all ages except for men aged 55-64 years. A similar trend of lesser magnitude is suggested for coronary heart disease mortality in males, but not in females. The decrease in the percentage of male cigarette smokers in the population which is also reflected in a marked decline of smoking among male coronary patients, may be related to the trends in mortality.

Detection of early and roentgenologically occult bronchogenic carcinoma: preliminary report of the Sabbatsberg hospital sputum cytologic screening study.

A sputum cytologic screening project aiming at early diagnosis and study of the pathogenesis of bronchogenic carcinoma has been going on at Sabbatsberg Hospital, Stockholm, since 1964. In 1974 the project was reorganized to study a target population of male cigarette smokers without known lung disease at high cancer risk from outpatient clinics and various companies and organizations [1].KeywordsBronchogenic CarcinomaFiberoptic BronchoscopyLung Cancer DeathHigh Cancer RiskIntercurrent DiseaseThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Cigarette smoking, aging, and decline in pulmonary function: A longitudinal study.

Three serial spirometric determinations of forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1.0) were performed during a 10-yr period for 268 adult male cigarette smokers, 181 quitters, and 254 who had never smoked. Smokers were further divided into high- and low-tar consumption groups. Spirometric data were analyzed by repeated measures analyses of variance using time (aging) and smoking status as independent variables and age as a covariate. Results indicated that FVC and FEV1.0 were relatd to smoking status. For all age groups, nonsmokers performed best on spirometry, while current smokers performed worst. The decline in FEV1.0 over time was greatest in current smokers, especially the high-tar group. Loss of FVC over time was not influenced by smoking status.

Effects of cigarette smoking on immediate memory and performance in different kinds of smoker.

Changes in performance resulting from smoking were assessed in 48 male cigarette smokers who were classified both by daily consumption and by relative desire for smoking in situations inducive of high or low arousal. Each took part in four first cigarette of the day conditions involving a sham smoking control and three cigarettes differing in nicotine delivery. With increasing cigarette strength gains in letter cancellation speed on smoking increased although an inverted-U relationship was suggested; immediate memory accuracy progressively deteriorated once pre-smoking performance was controlled for. Smokers with greater desire to smoke in situations inducive of low arousal appeared to react more strongly to cigarettes and showed superior gain in cancellation speed on smoking. High cigarette consumption did not lead to between-day tolerance to cigarette effects.

Medical risk and therapeutic effectiveness of rapid smoking

To assess the potential medical risks of rapid smoking, 24 healthy, male cigarette smokers were examined under the following conditions: baseline (after 12-hr tobacco abstinence), normal smoking, and rapid smoking. After normal and rapid smoking standard 12-lead EKG, arterial blood gases, and vital signs were evaluated, and during rapid smoking each subject was monitored electrocardiographically throughout the session. During or after rapid smoking there were no EKG abnormalities. Heart rate, respiratory rate, and systolic blood pressure rose after normal and rapid smoking. Many subjects developed elevated arterial pH with lowered serum potassium after rapid smoking, and two-thirds of the subjects developed relative hypoxemia. Among those who completed treatment, 61% were still abstaining from cigarettes after 6 months. Rapid smoking was found to be safe for healthy subjects. However, the safety of the technique among persons with cardiopulmonary disease cannot be predicted from the results of this study.

Bloody Pleural Effusion Associated With an Intralobar Pulmonary Sequestration

A 50-year-old male cigarette smoker with a posterior parenchymal lung mass developed a bloody, exudative pleural effusion. Pathologic examination of the resected lung confirmed the preoperative diagnosis of an intralobar pulmonary sequestration.

Different cigarette-smoker classification factors and subjective state in acute abstinence.

On each of 4 days after abstaining from cigarettes and other psychoactive materials for at least 10 h, 48 male cigarette smokers reported their mood before smoking the first cigarette of the day. Smokers were classified both by relative desire for smoking in situations inducive of high arousal or low arousal and by average daily consumption. Greater relative desire for smoking in high-arousal situations was associated with an abstinence syndrome of dysphoria. Compared to smokers with low consumption, medium-heavy smokers showed higher levels of tension-anxiety and were less deactivated while at the same time they were more fatigued and sleepy, indicating different relationships with different components of multifactorial arousal. Effects related to levels of cigarette consumption may have been confounded by tea/coffee withdrawal, however, abstinence states disappeared on smoking.

Coexistent bronchogenic carcinoma and active pulmonary tuberculosis

Sixty-four cases of coexistent bronchogenic carcinoma and active pulmonary tuberculosis were diagnosed between 1969 and 1976. The majority were male chronic cigarette smokers in their fifth and sixth decades. Human bacilli were isolated in 48 patients (88.9 percent) and atypical bacilli in six patients (11.1 percent). All of the atypical bacilli and 8.3 percent of the human bacilli were found to be resistant to the first line antituberculous drugs. All patients, except two who died following resection, were given a course of antituberculous drugs with 93.8 percent successful sputum conversion. Uncontrolled or disseminated tuberculous infection was not observed. Forty-five patients (70.3 percent) underwent pulmonary resection. Median survival time of those who had curative resection was 14.3 months with a 5 year survival rate of 13.2 percent. Median survival times of those treated by palliative resection plus anticancer chemotherapy and by anticancer chemotherapy alone were 8.3 months and 11.1 months, respectively. None of these patients survived more than 30 months. It appears that, clinically, each disease runs its own course with little effect on the other.

CARBOXYHÆMOGLOBIN LEVELS IN SMOKERS OF FILTER AND PLAIN CIGARETTES

Blood-carboxyhæmoglobin (COHb) levels were studied in 343 healthy male cigarette smokers aged 35-64. The mean COHb level was 30% higher in the 248 men who smoked unventilatedfilter cigarettes than in the 41 men who smoked plain cigarettes, after adjusting for the number of cigarettes smoked (P<0.001). This result was consistent with the carbon-monoxide (CO) yields of these cigarettes: on average, the unventilated filter cigarettes had yields 25% higher than the plain ones. The mean COHb level was 7% higher in the 54 men who smoked ventilated cigarettes than in men who smoked plain cigarettes. Although this difference was not statistically significant, it was in the opposite direction to the result which might have been expected on the basis of the CO yields of these cigarettes: on average the ventilated filter cigarettes had yields 21% lower than the plain ones. The medical implications of these results are uncertain. COHb levels of 3-4% or more can exacerbate angina pectoris and intermittent claudication, and it is, therefore, of concern that COHb levels are higher in smokers of filter cigarettes than in smokers of plain cigarettes. However, any assessment of risk associated with either type of cigarette should take account of the observation from other studies that filter cigarettes are associated with a lower mortality from lung cancer than are plain cigarettes.

Smoking habits and pain tolerance.

In 66,410 subjects from the Kaiser-Permanente Multiphasic Screening program the limits of pain tolerance (determined through standardized mechanical pressure on the Achilles tendon) was studied in relation to smoking habits and in respect of age, race, and sex. The results indicate that deep pain tolerance is significantly diminished in white male and female cigarette smokers as compared with nonsmokers, but not in black men or in oriental subjects of either sex. Explanations for these findings are not clear at this time. The effect of smoking on pain perception needs attention but is deemed unlikely. The possible role of constitutional differences between smokers and non- smokers should be considered as well as other possible explanations.

Hearing loss in adults: relation to age, sex, exposure to loud noise, and cigarette smoking.

Auditory sensitivity was studied in 33, 146 white men and women age 30 to 59 years in relation to age, sex, noise exposure, and cigarette smoking to assess the possible contribution of each of these factors to hearing loss. Significant hearing loss (40 dB or more at 4,000 hertz) was more frequent in men than in women, increased with age, and was greater in those reporting exposure to loud noise, and slightly greater in male cigarette smokers than in male non-smokers.

Oxidative metabolism of nicotine by cigarette smokers with cancer of the urinary bladder.

Nicotine and its major basic metabolites, cotinine and nicotine-1′-N-oxide, were measured in 24-hour urine collections from normal healthy male cigarette smokers and cigarette smokers with cancer of the urinary bladder. Analysis of replicate daily urine samples from some subjects showed the metabolite ratio cotinine/ nicotine-1′-N-oxide to be an individual index of the alternate routes of oxidative metabolism of nicotine, despite variations in urinary pH, volume, and daily nicotine intake. The ratio of cotinine to nicotine-1′-N-oxide was significantly higher in cancer patients than in the control group. The implication of this finding in relation to the etiology of the disease and the metabolism of nicotine by alternate oxidative pathways in man was discussed.

A survey of respiratory disease among New York City postal and transit workers: IV. Racial differences in the FEV 1

In Negro male cigarette smokers the decline of the FEV 1 with age is significantly less than in whites. After correction for the original higher lung volumes in whites, the superiority of the Negro one-pack-per-day smoker relative to the White is estimated at +0.34 liters at age 60 (an amount equal to the difference between white nonsmokers and cigarette smokers at that age). Corrections were made for racial differences in amount smoked, age began, and inhaling. Negro and White nonsmokers do not differ in the rate of decline of the FEV 1 with age, suggesting that there is no intrinsic racial difference in the decline of the FEV 1 with age, but rather a difference in response to smoking. Prediction equations for the FEV 1 based on 2827 Negro males aged 30–59 are given for several smoking categories. For the total population the FEV 1 (in liters) = −.022 age + .0285 standing height (centimeters) −1.01.

Morphometric studies of bronchi in young smokers.

Bronchial smooth muscle and glands were quantified in 13 male cigarette smokers (mean: 24 pack-years) and 11 male nonsmokers. The men were 18 to 46 years old and had no previous clinically diagnosed respiratory disease. There was no difference in percentages of smooth muscle or glands between smokers and nonsmokers. Similarly, age and history of cough or frequent “colds” was not related to the amounts of these tissues. No pathologic changes indicative of early chronic bronchitis could be delineated in the younger, regular smokers. The presence of increased glandular tissue in nonsmokers as well as smokers implies that other irritants besides cigarette smoke are important in the development of the glandular enlargement that typifies chronic bronchitis.

An experimental attack on smoking. (Attitude manipulation in restricted environments, 3).

Forty male cigarette smokers were Ss in a study which involved 24 hr of sensory deprivation (SD) and a brief antismoking message. On a measure of belief instability (errors in scaling the extremeness of statements about smoking), SD Ss showed more instability than controls; but the scores of Ss who heard the message were about equal, regardless of SD. Agreement with antismoking statements was highest in the SD-no message and message-no SD groups. While the message induced belief instability and attitude change under normal circumstances, it had the opposite effect in SD. This may have been due to the stimulus value of the message and/or to the overt nature of the manipulation attempt. In spite of this, three months later SD Ss (regardless of message) reported smoking significantly less than controls. The results relate the known cognitive effects of SD to its effects on persuasibility, further explore the cognitive uncertainty model of attitude change, and indicate the potential usefulness of SD as a technique for bringing about significant attitudinal and behavioral change.

Relationship between cigarette smoking and high packed cell volume and haemoglobin levels.

In a study including 394 men and 339 women, all aged fifty, a positive correlation between cigarette consumption and packed cell volume (PCV) was found in both sexes. In women, we also found a statistically significant correlation between cigarette consumption and haemoglobin concentration. In male cigarette smokers, the incidences of PCV‐values over normal range and of subnormal MCHC‐values were significantly higher than in males, who did not smoke cigarettes (smokers and non‐smokers).We found a statistically significant negative correlation between cigarette consumption and lung function (forced expiratory volume in one second) but we found no evidence of any relationship between lung function and haematological variables. From these results we conclude that the association between cigarette smoking and haematological variables is probably not secondary to the relationship between cigarette consumption and lung function.

Relation of Income to Body Weight in Cigarette Smokers and Nonsmokers

To the Editor.— The tendency for male cigarette smokers to weigh less than nonsmokers does not appear to be equally prevalent at all income levels. On the lower end of the economic scale, male cigarette smokers weigh substantially less than nonsmokers. The difference diminishes as income increases. Data from a recent survey permits comparison of smoker and nonsmoker body weights among middle-aged and older men for three selected income classes. Through the facilities of the Home Testing Institute, questionnaires were mailed to 1,120 male heads of household with family income of less than $5,000 per year, 744 with family income of $5,000 through $7,000, and 1,356 with family income of $12,000 and over. The mailing was further limited to men in the 41 to 70-year-old age brackets. Except for the specifications just noted, the mailing was national in scope, with substantial representation of all geographical areas of the continental United

Metaplasia of Bronchial Epithelium

In 500 apparently healthy adults who died suddenly and unexpectedly and who lived and worked within the environs of a large urban area noted for its air pollution, autopsy studies revealed that 50% of all adult nonsmokers had metaplasia of their tracheobronchial epithelium. Metaplasia was present in 70% of male cigarette smokers. Women in each category revealed half the frequency of metaplasia present in the men. Metaplasia was present in less than 20% of men under the age of 30 years, rose to a peak of 80% at age 50 years, and gradually declined in frequency after the age of 60 years.

Early diagnosis of carcinoma of the lung. Simultaneous screening with chest x-ray and sputum cytology

Two thousand one hundred and twelve male cigarette smokers over the age of 40, who either suffered from chronic bronchitis, showed long standing radiologic abnormalities, or recently recovered from pneumonia—or who showed another factor making them particularly prone to development of cancer of the lung—were screened with sputum cytology and chest x-ray. Incidence of lung cancer was high: 17 cases (1 in 125 persons screened) were discovered. Eight of these cases were detected by x-ray alone, 7 by cytology alone, and only 2 by both of these methods. This suggests that these screening techniques are deficient when used alone. Further confirmation of this is derived from investigation of 228 patients who were screened with negative results in 1965—9 of them developed and then succumbed to lung cancer, and at least 5 of them presumably had it at the time of initial screening. In screening programs an effort should be made not to give the participants a false sense of security concerning absence of lung cancer when results of screening tests are negative. Of the 17 cases, 13 died from cancer of the lung and one from another cause. Three are alive and well. The poor survival in this group was due, to an appreciable extent, to the fact that the same selective factors, such as chronic bronchitis, which rendered these patients liable to lung cancer precluded the possibility of surgical treatment.