Mean Duration Of Smoking Research Articles

Cigarette Smoking and its Association with Dyslipidemia among Middle-aged Population in Rajshahi District

Background & objective: Dyslipidemia is one of the major risk factors for ischemic heart disease. Many factors contribute to the development of dyslipidemia. Smoking is one of them. Smoking and dyslipidemia are claimed to interact with each other and synergistically increase the risk of heart disease. The present study is, therefore, intended to find the association between smoking and dyslipidemia in the context of the Bangladeshi population. Methods:The present cross-sectional study was conducted in the Department of Biochemistry, Rajshahi Medical College (RMC), Rajshahi in collaboration with the Institute of Biological Science, Rajshahi University, Rajshahi over a period of five years between 2017 and 2022. A total of 230 adult (ranging from 30 to 60 years) male subjects who attended at Biochemistry Lab of RMC to have their blood tested for lipid profile were consecutively included in the study. However, individuals with the habit of chewing tobacco, ex-smokers, or those having any diseases influencing lipid profile, taking drugs (like β-blockers, thiazide, statins, fibric acid derivatives, and nicotinic acid) that may influence lipid profile, or obese persons under dietary restrictions were excluded from the study. The subjects who exhibited either serum TC: HDL ratio > 4.5 or serum Tg: HDL ratio > 3.5 or both conditions were considered as cases and the subjects who did not have either of the conditions were considered as controls in the present study. Result: In the present study, over one-third (34.8%) of subjects had a smoking habit with the mean duration of smoking being 13.6 ± 5.0 years. Dyslipidaemia (as defined by serum TC: HDL > 4.5) was found in 33% of subjects, while the same condition, defined by serum Tg: HDL > 3.5, was found in 42.6% of the subjects. While either of the two conditions was present in 13% of subjects, both conditions were concurrently observed in 31.3% of subjects. Of the total 230 subjects, 102(44.3%) were dyslipidaemic. Smoking habit was observed to be significantly higher in the case group (54.9%) than that in the control group (18.8%). The risk of having dyslipidaemia in smokers was > 5-fold (95% CI = 2.9 – 9.5) higher than that in non-smokers (p < 0.001). However, as the duration of smoking was correlated with different lipid profiles, it was not found to be significantly correlated with any of the lipid profiles. Conclusion: The study concluded that smokers are more likely to have dyslipidaemia than non-smokers. The risk of having dyslipidaemia in smokers is much higher than that in non-smokers. While serum total cholesterol, low-density lipoprotein (LDL) and serum triglycerides are increased, serum high-density lipoprotein (HDL) is reduced. Ibrahim Card Med J 2023; 13 (1&2): 26-31

The Association of Tobacco Smoking and Level of Apoptosis in the Long Head of the Biceps Chronic Tendinopathy—An Immunohistochemical Study

Background: The substances present in cigarette smoke have a negative impact on cellular integrity and metabolism, can reduce blood flow to tissues, and can disrupt collagen synthesis. Ultimately this can lead to cell death, which clinically may result in impaired tendon healing and the onset of chronic tendinopathy. Within the shoulder, the exact association between the extent of apoptosis in the long head of the biceps (LHB) tendon and harmful factors like cigarette smoke remains unclear. Objectives: The purpose of this study was to investigate the connection between smoking, the degree of apoptosis in LHB tendinopathy, and the long-term outcomes of surgical treatment. Design: Observational, retrospective study. Methods: This study included 22 consecutive patients who had undergone arthroscopic biceps tenodesis or tenotomy for symptomatic LHB tendinopathy with or without concomitant rotator cuff tears (RCT). The intra-articular LHB tendon remnants were histologically examined by measuring the level of expression of apoptotic cell markers such as BCL2, cleaved caspase 3, and p53. Pre- and postoperative clinical outcomes were analyzed by collecting patient report outcome measures such as the American Shoulder and Elbow Surgeons (ASES) score and the Visual Analogue Scale (VAS) for pain. Results: The smokers group had a mean pack-year history of 13.12 (SD = 9.94), mean number of cigarettes per day of 14.77 (SD = 4.64), and a mean smoking duration of 16.38 (SD = 10.1) years. Among the smoking indexes, the number of cigarettes per day showed a positive correlation with Snyder classification (p = 0.0459, rho = 0.3682). Non-smokers and smokers did not show a statistically significant difference in the expression indexes of BCL2, cleaved caspase 3, or p53 (p = 0.4216, p = 0.5449, p = 0.5613, respectively). However, the cleaved caspase 3 expression index showed a negative correlation with the severity of rotator cuff lesions in the total population (p = 0.0193, rho = −0.4651). Conclusions: While apoptotic processes in the LHB tendon were observed, no significant association was found between tobacco smoking, the extent of apoptosis, and clinical outcomes. However, the expression of the apoptotic marker cleaved caspase 3 correlated with the severity of rotator cuff pathology. Furthermore, active smoker status was associated with worse clinical outcomes in terms of pain following LHB tenodesis or tenotomy.

Correlation between smoking and brain atrophy detected by cross sectional imaging

Background and objectives: Smoking have effect on many organs in human body, we are focusing on its relation with brain atrophy. We aimed to determine whether there is an association between smoking and brain atrophy by using certain parameters from CT scan or MRI of brain. Methods: This is a case control study done from December 2019 to May 2021, a total of 100 cases of CT scans and MRI brain which is randomly selected reviewed by taking certain measurements like frontal horn index, Evans ratio, bicaudate index, huckman number, cella media. Results: Brain atrophy group involved 50 cases and control non-atrophy group 50 cases both group with equal number of male and female, there is statistically significant difference between smokers with brain atrophy 30% and smokers with no brain atrophy 6% with p-value 0.027, also the mean duration of smoking among brain atrophy was 17.83 years while among non-atrophic brain was 9.83 years. Number of cigarettes smoked per day showed statistically significant difference as it was 21.07 cigarettes among smokers with brain atrophy versus 13.83 cigarettes in non –brain atrophy smokers. Conclusions: Current brain imaging demonstrate that chronic tobacco smoking is associated with significant increase in prevalence of brain atrophy than non-smokers, smoking can be considered a risk factor for brain atrophy.

Frequency of hyperlipidemia in patients with ischemic stroke visiting at a tertiary care hospital in Karachi

Background and objective:
 Stroke is the second leading cause of death and the third leading cause of disability. This study was designed to determine the frequency of hyperlipidemia in patients with ischemic stroke visiting at a tertiary care hospital in Karachi.
 Methods:
 This was a descriptive cross-sectional study and was done in Department of Medicine, LCMD/ Dar-ul-Sehat Hospital Karachi, Pakistan. A total of 184 patients were studied during the study period of six months and all the consecutive patients were recruited who presented with acute stroke in the department of medicine from the duration April 1st 2022 to September 30th, 2022.Those fulfilling the inclusion criteria for this study were included for data analysis, while the patients who did not meet the said criteria were excluded. Their serum lipid levels were collected within 24 hours of admission. Hyperlipidemia was measured through fasting lipid profile and was labeled as present if any one or more of the following profile like total cholesterol >200 mg/dl, LDL cholesterol > 100 mg/dl, TGL > 150 mg/dl, HDL cholesterol < 40 mg/dl, as appropriate.
 Results:
 The mean age of the patients was 65.17±12.73. Average systolic and diastolic blood pressure was 152.34±21.31 & 83.35±13.71 mm Hg respectively. Mean duration of smoking and diabetes mellitus in first ever ischemic stroke patients was 9.33±4.03 & 13.65±5.8 years respectively, whereas average fasting blood sugar was found 151.98±69.73mg/dl; 118 (64%) were males and 66 (36%) were females. A total of 124 (67.4%) of patients had a history of hypertension, while 94 (51.1%) were diabetic. Fifty-three (28.8%) of patients had a history of coronary artery disease while 22 (11.95%) patients had history of smoking. Increased triglycerides level was seen in 47 (25. 5%). The frequency of hyperlipidemia was 145 (79%) patients respectively.
 Conclusion: Frequency of hyperlipidemia was 145 (79%) in patients with ischemic stroke which is moderately high in our setup. A high prevalence of hyperlipidemia is alarming in our setup and requires attention of the physicians on modifiable risk factors.

Investigating the Molecular Epidemiology and Prognosis of Smoking and Gliomas (P7-13.004)

Investigating the Molecular Epidemiology and Prognosis of Smoking and Gliomas (P7-13.004)

Assessment of pulmonary hypertension by cardiac MRI and right sided heart catheter in COPD patients

Background: Pulmonary hypertension (PH) is a progressive disorder characterized by abnormally elevated blood pressure of the pulmonary circulation which results, over time, from extensive vascular remodeling and increased pulmonary vascular resistance (PVR). Recent advances in cMRI technology have led to the development of techniques for noninvasive assessment of the morphology of the right side of the heart to be correlated to the hemodynamic parameters collected by RHC which is still the golden standard technique of PH diagnosis. Aim: To assess the role of Cardiac MRI in severe COPD patients with pulmonary artery pressure more than 35 mmHg as evaluated by Echocardiography and right sided cardiac catheterization. Patients and methods: The current study was conducted upon 20 patients with moderate or severe chronic obstructive pulmonary disease (COPD) by spirometry according to GOLD 2022 criteria who had been assessed for severe pulmonary hypertension with Pulmonary Artery Pressure more than 35 mmHg by cardiac Magnetic resonance imaging (cMRI) and right sided heart catheter (RHC). They were recruited from the outpatient clinic and department of chest specialized hospital Kobry Elkobba Armed Forces. Results: Twenty patients included in the study were 90% males, mean age about 64.50 ± 7.94 years old with mean smoking duration 33.89 ±7.03 years and 45% with co-morbidities. Spirometry done for all studied cases included FEV1/FVC, FEV1 and FVC parameters with mean range 43.40 ± 5.17, 38.90 ± 8.60, 79.45 ± 16.59 respectively. The descriptive data of HRCT showed 60% of the patients with emphysema while the rest showed mixed emphysema and ILD. V/Q scan study was positive in 4 patients which represented 20% of the patients whose all included in group B (mPA > 43.5 mmHg). All studied COPD patients who showed severe PHT by a measurement of mPAP > 35 mmHg by RHC with normal PCW pressure underwent cMRI study to assess right ventricular structure and morphology. Conclusion: Cardiac MRI showed a great rule in the evaluation of the morphological changes associated with the condition of COPDPH in the right side of the heart which should affect its functions. The cardiac MRI is not the best tool in assessment of the right side of the heart in COPD patients due to many causes like the difficulty of holding breaths with COPDPH patients during the maneuver to snap accurate clear shots of the heart, the hypoxia in those patients which makes the maneuver more difficult, the associated co-morbidities may interfere with completing the maneuver like the chronic kidney disease that prohibit the use of gadolinium dye and other co-morbidities like morbid obesity that will not allow the patient to get through the MRI

Smoking Histories by State in the U.S.

Smoking rates across U.S. states have declined at different rates over time because some states have progressive tobacco control policies, whereas others have yet to adopt them. Therefore, each state has its own unique historical experience of smoking initiation, cessation, and prevalence. This study characterizes smoking histories for each U.S. state by birth cohort. Using 1965-2018 National Health Interview Survey and 1992-2019 Tobacco Use Supplement to the Current Population Survey data, statistical methods applied an age‒period‒cohort modeling framework to reconstruct population-level smoking histories for each state. Smoking initiation, cessation, and intensity by age, gender, and cohort were estimated for each state. These were used to construct state-specific trends in the prevalence of current, former, and never smoking as well as the mean smoking duration and pack years. Analysis was conducted from 2017 to 2022. California and Kentucky, respectively, are exemplar states of more and less aggressive tobacco control. Initiation probabilities were consistently lower in California than in Kentucky, and cessation probabilities were higher. Hence, the smoking prevalence derived from these parameters is higher in Kentucky. The intensity of cigarette smoking was higher in Kentucky than in California, yielding considerably higher estimated pack years when used with the other parameters. Summaries of smoking trends are given for all states. Smoking initiation, cessation, and intensity trends vary substantially across states, resulting in major differences in estimated smoking prevalence, duration, and pack years. Some states show improvements in smoking metrics over time with more recent birth cohorts, but others have shown very little.

Urinary Cotinine: A Promising Marker of Recurrence of Non-muscle Invasive Bladder Tumor

Introduction and objectives: Nicotine is well known to be an addictive compound of tobacco, but it is not primarily carcinogenic. It is metabolized to cotinine, which is considered the best marker of tobacco exposure. Little is known whether recurrence rate of bladder cancer is related to nicotine metabolites eliminated in urine. We aim by this study to evaluate the relation between urinary cotinine level and the recurrence of bladder cancer. Materials and Methods: Between January 2018 and June 2022, a cross sectional study was conducted. Enrolled patients were smokers already diagnosed with non-muscle invasive bladder cancer, treated by resection only, and presenting for a follow up cystoscopy. Included patients had unchanged smoking habits in the day before the procedure, same ethnicity (Caucasians) and no additional professional exposure. Cotinine level was measured on a sample of voided urine before cystoscopy. Tumor recurrence was considered positive independently from the histological type, and was assessed by direct vision cystoscopy. Patients were considered moderate or heavy smokers depending on the level of cotinine in their urine samples (< or > 550 ng/ml respectively). A Fisher Exact Test was used to assess the relationship between variables. Results: A total of 135 patients was included. Mean age was 64 years (range 36 to 78). The mean duration of smoking was 30.3 years. Urinary cotinine level was > 550 ng/ml in 80 patients (59.26%) and < 550 ng/ml in 55 patients (40.74%). Recurrence was identified in 70 patients (51.85%) and was absent in the remaining 65 (48.15%). Recurrence was observed in 68.75% of the heavy smokers and in 27.27 % of moderate smokers. Cotinine level higher than 550 ng/mL was linked to an increased risk of bladder cancer, with a relative risk of 4.16 (p-value < 0,025). Conclusion: High urinary cotinine levels (>550 ng/ml) conveys a 4 folds’ risk for the recurrence of bladder cancer in smokers. Additional prospective studies are needed to better understand the relation between urinary cotinine levels and bladder cancer, and its usefulness in bladder cancer surveillance.

CYP2A6 gene polymorphism and severity of coronary atherosclerosis in Indonesian male smokers: A pilot study.

Nicotine is a toxic alkaloid known to be responsible for the addictive feature of cigarettes. CYP2A6 genetic polymorphism among individuals was suspected to explain the relationship between cigarette smoking and related diseases. CYP2A6 works to slow nicotine metabolism and thus maintain a more prolonged nicotine concentration and increase nicotine exposure to the blood. We aimed to investigate the correlation between the CYP2A6 gene with the severity of coronary atherosclerosis. This cross-sectional study was conducted from April to July 2010 in Makassar Cardiac Centre, Dr Wahidin Sudirohusodo Hospital, Indonesia. Sixty-four male active smokers at the age of ≥45 years, diagnosed with coronary artery disease (CAD), were recruited and asked to smoke the usual number of cigarettes in the last 1 month prior to blood collection for CYP2A6 genotyping. Spearman correlation was performed to analyze the association between the allele variants and coronary stenosis degree, adjusted for CAD risk factors. Furthermore, we estimated the risk ratio to quantify the correlation. Of the 64 male smokers with CAD, the mean duration of smoking was 36.9 ± 8.6 years, and 49 (76.6%) were heavy smokers with >20 cigarettes per day. All 128 alleles were observed. Our results showed that all participants with CYP2A6 variants had a significant correlation with severe coronary artery stenosis (P = .006). Thus, this study suggests that the mutant CYP2A6 gene allele significantly increased the risk of having severe coronary stenosis 1.2 times higher compared to the wild type. This pilot study showed that CYP2A6 gene has an influential role in atherosclerotic development in male smokers. However, our findings should be confirmed with further more extensive studies.

The Relationship Between Smoking and Multiple Sclerosis Severity in Saudi Arabia.

IntroductionMultiple sclerosis (MS) is an autoimmune disease that can be disabling to patients. Smoking has been proposed to be a risk factor for MS and to increase the risk of progression of the disease and its severity. However, it is still not clear how smoking affects people with MS (PwMS) regarding disease phenotype, symptoms, relapses, course, and disability. The aim of this study is to investigate the effect of smoking on PwMS in Saudi Arabia.MethodsThis is an online questionnaire-based cross-sectional study. PwMS were randomly contacted through different MS societies and associations to participate in the study. The questionnaire inquired about demographics, MS phenotype and severity, and smoking status of the participants. Data were collected between May 30, 2021, and July 5, 2021.ResultsFour hundred twenty-nine PwMS participated in the study. The mean age was 33.7, with a mean disease duration of 8.1 years. About 61.1% of the participants were female. About 62.2% did not know the specific MS phenotype they have. About 35.7% were current or previous smokers, with a mean smoking duration of 13.9 years. Smoking was significantly associated with the presence of multiple MS symptoms (p-value = 0.009) and their number (p-value = 0.050). In addition, there was a significant positive correlation between pack-years smoking and the number of MS symptoms with a Pearson's r value of 0.165 (p-value = 0.001). No significant associations were found between smoking and recent relapses and disease progression, disability in terms of walking, needing a cane, or needing a wheelchair.ConclusionSmoking was shown to have a significant effect on the number of symptoms experienced by PwMS. Higher pack-years of smoking correlates positively and significantly with a higher number of MS symptoms. Further studies to examine these relations are hence warranted.

ХРОНІЧНЕ ОБСТРУКТИВНЕ ЗАХВОРЮВАННЯ ЛЕГЕНЬ ТА СЕРЦЕВО-СУДИННА ПАТОЛОГІЯ З ФОКУСОМ НА АРИТМІЯХ

Chronic obstructive pulmonary disease is a third leading cause of death worldwide according to the WHO data. But often the direct mortality cause in these patients is cardiovascular complications, including arrhythmias. The aim of the study was to evaluate the concomitant cardiovascular pathology with focus on arrhythmia in patients with COPD. Materials and methods. 100 COPD patients were enrolled, mean age (64,09 ± 1,94) years, 66 male (66 %) and 34 female (34 %). There were 68 smokers (68 %), mean smoking duration — (24,44 ± 4,84) pack-years. Mean COPD duration — (9,35 ± 2,42) years. Source medical document data analysis regarding ongoing cardiovascular conditions was conducted. Results. Arterial hypertension was the most prevalent concomitant cardiovascular condition in COPD patients (77 %). Ischemic heart disease was the second by prevalence (67 %). Heart failure, as possible complication of pulmonary hypertension, cor pulmonale and/or cardiovascular conditions was found in 70 % of cases. Atrial fibrillation was observed in 18 % patients with COPD. Most patients suffered from atrial fibrillation with ventricular tachysystolia (14 %), which was quite typical for COPD due to hypoxia-related sympathetic nervous system activation. Conclusions. COPD and cardiovascular conditions have common pathogenetic mechanisms, leading to the occurrence of the mutual risks. COPD increases the risk of cardiovascular diseases progression and, conversely, presence of cardiovascular disease increases risk of COPD worsening. This connection creates a vicious circle of these diseases progression. Key words. COPD, cardiovascular diseases, arrhythmias.

Perceptions of Students of a Medical School on Combined Health Warnings in Plain Packs.

Turkey has recently adopted the regulation of plain and standard packaging for tobacco products and introduced newly designed combined health warnings. In this study, we aimed to reveal how the new combined health warnings are perceived among medical students. The study was descriptive and the data were collected by a 3-part questionnaire. The first part covered demographic characteristics, the second part was designed to measure the saliency of the combined health warnings, and the third part evaluated their effect on the motivation to quit. Out of 484 students of medicine, 287 (59%) were included in the study; 54.4% of the participants were female and 45.6% were male; and the average age was 21.18 ± 1.94 years. There were 79 (27.5%) smokers and the mean duration of smoking was 39.07 ± 24.07 months. The combined health warning that reads "Smoking causes laryngeal cancer" had the highest score both in terms of saliency and motivation to quit smoking. The one that reads "Protect children: don't let them inhale your smoke" had the lowest score in both categories. Non-smokers found the stimuli more effective than smokers and quitters (P > .05). The findings point out that smoking rate is unexpectedly high among participants, and medical students perceived the warnings emphasizing the physical deformities caused by tobacco products on individuals as more effective than combined health warnings aimed at protecting "others." This study suggests that the combined health warnings should be selected in a more nuanced way for different target groups.

ВПЛИВ КОМБІНАЦІЇ ТІОТРОПІЮ/ОЛОДАТЕРОЛУ НА ФУНКЦІЮ ЗОВНІШНЬОГО ДИХАННЯ У ХВОРИХ НА ХОЗЛ В РЕАЛЬНІЙ КЛІНІЧНІЙ ПРАКТИЦІ

EFFECT OF COMBINATION OF TIOTROPIUM/OLODATEROL ON PULMONARY FUNCTION IN PATIENTS WITH COPD IN THE REAL CLINICAL PRACTICE Y. M. Mostovoy, K. D. Dmytriiev, N. S. Slepchenko Abstract Aim — to evaluate the effect of combination therapy with tiotropium/olodaterol on pulmonary function in real clinical practice. Materials and methods. 100 patients with the diagnosis of COPD were included into the study (mean age was 64,09±1,94 years, 66 men and 34 women). Smokers — 68 %, mean smoking duration (24,44 ± 4,84) packyears. Average COPD duration was 9,35±2,42 years. All patients underwent spirometry at screening, 4-6 weeks and at 1 year after inclusion. FEV1, FVC, FEV1/FVC, FEF25, FEF50, FEF75, PEF, MMEF75/85, FEF75/85 were calculated. Results. There was statistically significant improvement in FEV1 and FVC values between visits 1 and 3 (p < 0,05). At visit 3 there was a statistically significant difference in FEV1 and FVC values when compared with same values at visit 1 after the inhalation of salbutamol, demonstrating better bronchodilation effect of tiotropium/olodaterol. Absolute increase of FEV1 between visits 1 and 3 was 221,31±34,9 ml; FVC — 411,01±66,08 ml. There was statistically significant increase of FEF75, MMEF75/25, FEF75/85 between visits 1 and 3 (p < 0,05). There was statistically significant increase of FEF75 at visits 2 and 3 in comparison with postBD FEF75 at visit, confirming better bronchodilation effect of tiotropium/olodaterol combination of at the level of small bronchi when compared with salbutamol (p < 0,05). Conclusions. Tiotropium/olodaterol combination showed good effect on pulmonary function in patients with COPD in real clinical settings. This combination demonstrated better bronchodilation than salbutamol, especially at the level of small bronchi. Key words: COPD, tiotropium/olodaterol, spirometry. Ukr. Pulmonol. J. 2020;29(3):28–30.

Correlates of tobacco smoking among residents of an urban community in Northern Nigeria

Smoking is a public health problem that is a significant risk factor for heart attacks, strokes, chronic obstructive pulmonary diseases and cancers. Smoking accounts for one in every five deaths among men and one in every 20 deaths among women globally. World health organization (WHO) has estimated that about 1.3 billion people smoke worldwide, and the vast majority of these people live in developing countries. This study seeks to determine the correlates of tobacco smoking among residents of Katsina local government. A cross-sectional study that enrolled 384 respondents was adopted in this study. A multi-stage sampling technique was employed to select the respondents for the survey. Data collected were analyzed with SPSS v22 software. The results showed that the questionnaire response rate was 98.9% (n=380). The mean age of the respondents was 25.7 ± 11.8 years, all-time prevalence of smoking is 28.9% (n=110), and prevalence among those actively smoking is 21.5% (n=82). The mean number of cigarettes smoked by individual respondents daily was 8.9 ± 5.6, with a mean smoking duration of 4.6 ± 4.2 years. The mean number of people that smoke in households was 2.0 ± 1.5. Males are almost three times (aOR=2.8, 95% CI=1.94-4.02) more likely to smoke. Parental smoking (aOR=3.3, 95% CI= 2.61-4.30), peer influence (aOR=6.9, 95% CI=4.45-10.7), and media advertisements (aOR=4.5, 95% CI=3.52-5.99) are strong predictors of smoking in the community. In conclusion, the prevalence of smoking in the community was high, and the likelihood of smoking behaviour of the individual is influenced by peer group, parental smoking and exposure to pro-smoking advertisements. Health education and strong tobacco control policies are needed to address the problem of smoking.

Frequency of obstructive pattern on spirometry in asymptomatic chronic smokers.

Objectives: To know the frequency of obstructive pattern on spirometry in asymptomatic chronic smokers. Study Design: Cross-sectional study. Settings: Department of Pulmonology, Sahiwal Medical College Sahiwal. Period: 1st Nov, 2019 to 1st May 2020. Materials & Methods: A total of 205 chronic smokers aged 30-60 years were included. Patients with history of Ischemic heart disease, previously diagnosed cases of COPD and asthma were excluded. Spirometry was done by using portable spirometer by consultant pulmonologist (at least 2 years of post-fellowship experience) and obstructive pattern (COPD) was noted. Results: Majority males with ages between 41 to 50 years( mean age 47.78 ± 4.90 years) out of the 205 patients, 137 (66.83%) were male and 68 (33.17%) were females with male to female ratio of 2:1. Mean duration of smoking was 8.81 ± 4.67 years. Mean height was 161.81 ± 9.23 cm. Mean weight was 78.81 ± 5.67 kg. Mean BMI was 26.21 ± 5.39 kg/m2. In this study, frequency of obstructive COPD on spirometry in asymptomatic chronic smokers was found in 29 (14.15%) patients. Conclusion: This study established that frequency of obstructive pattern on spirometry in asymptomatic chronic smokers is high.

A CASE CONTROL STUDY ON THE PATTERNS OF BLOOD PRESSURES AND AEROBIC CAPACITY AMONG YOUNG ADULT SMOKERS

Introduction: - India is home to about 12% of the world’s smokers. More than 1 million people die every year due to tobacco related illnesses. Smokers have tendencies to be less physically active than non-smokers. We hypotheses that there was a significant relation between smoking and decrease in cardiovascular fitness. The purpose of this study was to examine the chromic effects of smoking on cardiovascular fitness and Blood pressure in young and adult smokers.
 Methods: This was case control study conducted in a span of 3 months in local General Medicine OPDs. 80 Subjects chosen for the study (40smokers & 40 non-smokers) involving both the genders, aged 18 years to 25 years and all classes of socio economic strata. 80 male participant were recruited & divided into two group 40 smoker (A) , 40 non-smoker (B). BP & Heart rate (HR) were non-invasively measured in young non-smoking and subjects at rest, during the accomplishment of a sub maximal exercise test and recovery period. Smoking status of smokers was analyzed by three parameters, i.e., years of smoking, number of cigarettes smoke per day, and pack year.
 Result: There was no significant difference between both groups regarding to age, weight and height. The mean duration of smoking among smoker group was 4.84±2.57 years. No. Of Cigarettes were 4.62±2.35 SBP, DBP & PP were pre-hypertensive, 40% were hypertensive. There was Significant difference w.r.t Resting Heart Rate, HR after Exercise, Recovery HR & Exercise duration among smoker and non-smoker group.
 Conclusion: Smoking was found to affect young smokers’ HR, increasing HR at rest, slowing HR increase during exercise, and impairing their ability to reach the age predicted HR max. In addition, smoking was associated with an attenuated HR decline during recovery. Smokers had a higher resting HR and showed a higher HR response during sub maximal exercise compared to Non smokers.
 Keyword: Smokers, aerobic capacity, Blood pressure, Heart rate.

Estimated Worldwide Mortality Attributed to Secondhand Tobacco Smoke Exposure, 1990-2016

The World Health Organization estimates that the 1 billion individuals who smoke worldwide contribute to the 880 000 secondhand smoke (SHS)-related deaths among individuals who do not smoke each year. A better understanding of the scale of harm of SHS to those who do not smoke could increase awareness of the consequences of smoking and help to design measures to protect individuals who do not smoke, especially children. To calculate the number of individuals who smoke associated with the death of 1 individual who died of SHS exposure both on a global scale and in various World Bank regions. In this cross-sectional epidemiologic assessment, data from Our World in Data were used to tabulate the number of individuals who smoke in each country and number of premature deaths related to SHS in that country from 1990 to 2016. The mean number of cigarettes consumed in all countries was also included in analyses. Data were collected for the following World Bank regions: North America, Latin America and the Caribbean, Europe and Central Asia, the Middle East and North Africa, sub-Saharan Africa, South Asia, and East Asia and the Pacific from 1990 and 2016. Statistical analysis was conducted in July 2019. Secondhand smoke. The pack-year index, calculated as the number of pack-years associated with the death of 1 individual who does not smoke but was exposed to SHS, and the SHS index, calculated as the number of individuals who smoked for 24 years (ie, the mean duration of smoking) associated with the death of 1 individual who does not smoke. Globally, the SHS index changed favorably, from 31.3 (95% CI, 30.6-32.0) individuals who smoked associated with the death of 1 individual who did not smoke in 1990 to 52.3 (95% CI, 51.2-53.5) individuals who smoked in 2016. There was a wide regional variation in the 2016 secondhand smoke index, from 42.6 (95% CI, 41.6-43.5) individuals who smoked in the Middle East and North Africa to 85.7 (95% CI, 83.8-87.7) individuals who smoked in North America. Worldwide, the pack-year index also changed favorably from 751.9 (95% CI, 736.3-770.7) pack-years associated with 1 death in 1990 to 1255.9 (95% CI, 1227.2-1284.4) pack-years in 2016. In this study, the substantial disparity among regions in both the SHS index and pack-year index reflected large differences in the scale of the harm of SHS on those who do not smoke. This information may help local policy makers implement measures to better protect those who do not smoke and increase public engagement. Although the number of pack-years and the number of individuals who smoke associated with the death of 1 individual who did not smoke favorably changed over the study period, as of 2016, 52.3 individuals who smoked were associated with the death of 1 individual who did not smoke.

Pattern of Tobacco Use Among the Students of Selected Public and Private Universities

Background: The objective of the study performed were to compare the pattern of tobacco use among the students of selected public and private universities. Materials and methods: A cross-sectional comparative study was conducted on 250 students of Dhaka University and East West University who were selected by convenient non probability sampling technique by face-to-face interview using a written questionnaire which was pre-tested on small number of students of NIPSOM. During the study period (January to June 2011) data concerning socio-demographic differentials with distribution, duration and pattern of smoking, per day frequency, smoking-initiation, daily expenditure for smoking and relation of type of university to tobacco use. Results: 61.2% was male and 38.8% was female and their age ranged between 18 to 29 years. 31.6% was habituated to tobacco use. 38.4% and 24.8% were habituated of smoking in public and private university respectively. Pattern of smoking showed that 59.5% had used filter tipped cigarette and 32.91% had used plain cigarette among the smokers. The mean smoking duration was 2.2 years, per day mean frequency was 8.58 times, mean daily expenditure for smoking was Tk. 49.70 and 56.96% initiated their smoking by friends. Conclusion: There was restriction of tobacco use in private university campus, but in public university, there was no restriction. Restriction of tobacco use in campus and an effective awareness program is required to discourage the use of tobacco.
 JCMCTA 2019 ; 30 (1) : 16-20

Smoking cessation improves olfactory functions.

The aim of this study was to investigate changes in olfactory function after smoking cessation. We conducted a cross-sectional study involving 28 volunteers who were admitted to the smoking cessation section of our hospital. Olfactory tests were performed immediately before smoking cessation and 45 days after smoking cessation. The duration of smoking and the number of cigarettes smoked per day were noted. The mean duration of smoking was 25.5 ± 12 years, and the participants smoked 21.6 ± 6.6 cigarettes per day. There was a significant improvement in odor discrimination, odor identification, and TDI scores (i.e., the total score of odor threshold, odor discrimination, and odor identification tests) 45 days after smoking cessation (P = .003, P = .002, and P < .001, respectively). Furthermore, a statistically significant negative correlation was found between the duration of cigarette smoking and the Sniffin' Sticks olfactory tests performed after smoking cessation, namely odor discrimination, odor identification, and TDI (P = .008, P = .002, P = .001, respectively). A significant improvement was observed in odor discrimination, odor identification, and TDI scores after smoking cessation. However, this improvement was inversely associated with the duration of smoking, indicating that a longer duration of smoking may result in an insufficient improvement after smoking cessation. 4 Laryngoscope, 130:E35-E38, 2020.

Aile Hekimliğine Yeni Başlamış Hekimlerin Sigara İçme Davranışları

Objective: In this study, it was aimed to determine the smoking behavior and related factors of family physicians, working in seven different regions of Turkey. Material and Methods: The data of this descriptive and cross-sectional study were collected between 2015-2016. In the study, 724 family physicians were interviewed face to face and a questionnaire form was applied. No sample was selected in the study, and all family physicians participating in the Ministry of Health trainings were included in the survey. Inferential statistics were used in the research. Results: While 48.1% of family physicians never smoked, 10.4% quit smoking, and 41.6% are still smoking. Of the smokers, 15.0% are mildly smokers, 25.2% are moderate smokers, and 59.8% are heavy smokers. The mean duration of smoking was found to be 98.6 months. The age of starting smoking was 20.6. Difference in the average smoking duration of physicians were found to be statistically significant according to age, marital status, child ownership status, and working zone. In addition, a statistically significant difference was found between the smoking status of the physicians and age, gender, marital status, child ownership status and adequate sleep time. Conclusion: Today, fighting with smoking is an issue that should be prioritized for communities to live a healthy life. The development of policies to reach all segments of the society in this regard is important in terms of achieving the desired target in a shorter time. Results of the study emphasize the importance that studies about non-smoking are also necessary for physicians in addition to the studies that are carried out in the society as a whole to prevent smoking.