Number Of Years Smoking Research Articles

External beam radiotherapy combination is a risk factor for bladder cancer in patients with prostate cancer treated with brachytherapy

To investigate the risk of bladder cancer (BCa) in patients treated with brachytherapy for prostate cancer (PCa). We retrospectively analyzed 583 patients with PCa who underwent brachytherapy with or without external beam radiotherapy (EBRT). We analyzed the disease-free survival (DFS) of BCa in patients with PCa who underwent brachytherapy with or without EBRT. We performed multivariate Cox regression analyses of DFS using age, EBRT, and Brinkman index (BI) score (number of cigarettes smoked per day × number of years smoking) ≥ 200 as variables for BCa after brachytherapy. Fourteen patients (2.4%) developed BCa after brachytherapy with or without EBRT. The percentage of high-grade urothelial carcinoma (UC) was 63.6%. A total of 85.7% of patients had non-muscle invasive BCa, and 14.3% of patients had muscle invasive BCa. DFS was longer in brachytherapy monotherapy than in combination therapy (brachytherapy + EBRT). Multivariate Cox regression analysis showed that a BI score ≥ 200 (Hazard Ratio (HR 8.61; 95% Confidence Interval (CI) 1.12-65.98) and EBRT combination (HR 3.29; 95% CI 1.03-10.52) were significantly associated with BCa development in patients with PCa treated with brachytherapy. Furthermore, patients with BI score ≥ 200 and EBRT combination had a significantly higher risk of BCa compared with patients with BI score < 200 (HR Log-rank test P = 0.010). Most cases of BCa after brachytherapy with or without EBRT are high grade and invasive. We hypothesized that the EBRT combination might be a risk factor for BCa in patients with PCa who underwent brachytherapy.

Association of Cigarette Smoking and Alcohol Consumption With Subsequent Mortality Among Black Breast Cancer Survivors in New Jersey

There are limited data about how lifestyle factors are associated with breast cancer prognosis among Black or African American women because most of the evidence is based on studies of White breast cancer survivors. To examine the association of prediagnostic cigarette smoking and alcohol consumption with all-cause mortality and breast cancer-specific mortality in a cohort of Black breast cancer survivors. This population-based cohort study included 1926 Black or African American breast cancer survivors who received a diagnosis from June 6, 2005, to May 21, 2019, identified in 10 counties in New Jersey through rapid case ascertainment by the New Jersey State Cancer Registry. Statistical analysis was conducted from January 1, 2021, to August 1, 2022. Information on prediagnostic cigarette smoking, alcohol consumption, and additional covariates was collected during in-person interviews. The covariates examined included smoking status at the time of breast cancer diagnosis (currently smoking at the time of breast cancer diagnosis, formerly smoking, or never smoking), smoking duration (number of years smoking), smoking intensity (cigarettes smoked per day), number of pack-years of smoking, and regular alcohol consumption the year before diagnosis (categorized as nondrinkers, ≤3 drinks per week, or >3 drinks per week). Primary outcomes included breast cancer-specific mortality and all-cause mortality. Among the 1926 women in the study, the mean (SD) age at breast cancer diagnosis was 54.4 (10.8) years. During 13 464 person-years of follow-up (median follow-up, 6.7 years [range, 0.5-16.0 years]), there were 337 deaths, of which 187 (55.5%) were breast cancer related. Compared with never smokers, current smokers at the time of breast cancer diagnosis had a 52% increased risk for all-cause mortality (hazard ratio [HR], 1.52; 95% CI, 1.15-2.02), which was most pronounced for those with 10 or more pack-years of smoking (HR, 1.84; 95% CI, 1.34-2.53). Similar findings were observed for breast cancer-specific mortality (current smokers vs never smokers: HR, 1.27; 95% CI, 0.87-1.85), although they were not statistically significant. There was no statistically significant association between alcohol consumption and all-cause mortality (>3 drinks per week vs nondrinkers: HR, 1.05; 95% CI, 0.73-1.51) or breast cancer-specific mortality (>3 drinks per week vs nondrinkers: HR, 1.06; 95% CI, 0.67-1.67). This population-based cohort study of Black breast cancer survivors suggests that current smoking at the time of diagnosis was associated with an increased risk of all-cause mortality, particularly among women with greater pack-years of smoking.

Towards a Future of Personalized Vaccinology: Study on Individual Variables Influencing the Antibody Response to the COVID-19 Vaccine.

The COVID-19 pandemic has hugely impacted many different aspects of human health, and vaccination is one of the most effective weapons to manage it. However, many different factors, such as age, gender, comorbidities and lifestyles, play a role in the response to infections and vaccines. We carried out this study to evaluate the potential role played by some individual factors in the production of anti-COVID-19 antibodies in the light of personalized and future vaccinology. We conducted an observational study consisting of a retrospective phase, exploiting previous data about anti-COVID-19 antibody responses, with a prospective phase to investigate individual variables through the use of a questionnaire. The antibody response after the COVID-19 vaccination was inversely related to old age, increased BMI and the number of smoking years, while a positive correlation was found with moderate alcohol consumption and especially with circulating levels of vitamin D, as clearly shown by the multivariate regression analysis. Our study showed that a number of variables are involved in the COVID-19 vaccine antibody response. These findings are very important and can be considered in the light of a future and personalized vaccinology.

Heterogeneous treatment effects of a text messaging smoking cessation intervention among university students.

IntroductionDespite tobacco being an important preventable factor with respect to ill health and death, it is a legal substance that harms and kills many of those who use it. Text messaging smoking cessation interventions have been evaluated in a variety of contexts, and are generally considered to have a positive effect on smoking cessation success. In order for text messaging interventions to continue to be useful as prevalence of smoking decreases, it may be necessary to tailor the interventions to specific individuals. However, little is known with regard to who benefits the most and least from existing interventions.MethodsIn order to identify heterogenous treatment effects, we analyzed data from a randomized controlled trial of a text messaging smoking cessation intervention targeting university students in Sweden. We used a Bayesian hierarchical model where the outcome was modelled using logistic regression, and so-called horseshoe priors were used for coefficients. Predictive performance of the model, and heterogeneous treatment effects, were calculated using cross-validation over the trial data.ResultsFindings from the study of heterogenous treatment effects identified less effect of the intervention among university students with stronger dependence of nicotine and students who smoke a greater quantity of cigarettes per week. No heterogeneity was found with respect to sex, number of years smoking, or the use of snuff.DiscussionResults emphasize that individuals with a more developed dependence of nicotine may have a harder time quitting smoking even with support. This questions the dissemination and development of text messaging interventions to university students in the future, as they may not be the optimal choice of intervention for those with a more developed dependence. On the other hand, text messaging interventions may be useful to disseminate among university students that are at risk of developing a strong dependence.Trial registrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 75766527; http://www.controlled-trials.com/ISRCTN75766527.

Relationship between the rs1414334 C/G polymorphism in the HTR2C gene and smoking in patients treated with atypical antipsychotics.

An association has been found between the C allele of the rs1414334 polymorphism in the HTR2C gene and the metabolic syndrome in psychiatric patients. However, no study has yet evaluated whether this allele is associated with smoking. To assess this issue, therefore, we performed a cross-sectional study with a sample of 166 adult patients treated with atypical antipsychotics in 2012-2013 in a region of Spain. The primary variable was the presence of the C allele of the rs1414334 polymorphism in the HTR2C gene. Secondary variables were the number of pack-years (number of cigarettes per day x number of smoking years ÷ 20), age, gender, schizophrenia, years since diagnosis, metabolic syndrome criteria and SCORE. A stepwise binary logistic regression model was constructed to determine associations between primary and secondary variables and their area under the ROC curve (AUC) was calculated. Of the total sample, 33 patients (19.9%) had the C allele of the polymorphism analyzed. Mean cigarette consumption was 11.6 pack-years. The multivariate analysis showed the following factors as associated with the polymorphism: higher cigarette consumption, being a woman, and not having abdominal obesity. The AUC was 0.706. An association was found between increased cigarette consumption over the years and the presence of the C allele of the rs1414334 polymorphism in the HTR2C gene.

Incidence of and Risk Factors Associated With Age-Related Macular Degeneration

While the prevalence of age-related macular degeneration (AMD) differs according to continents and races/ethnicities, its incidence in the European continent has been scarcely documented. To describe the incidence and associated risk factors of AMD in elderly French individuals. This population-based cohort study of 963 residents of Bordeaux, France, who were 73 years or older at baseline and participated in the Antioxydants, Lipides Essentiels, Nutrition et Maladies Oculaires (ALIENOR) Study between October 2, 2006, and December 21, 2012. Of 829 participants at risk for incident AMD, 659 (79.5%) were observed for a mean (SD) duration of 3.8 (1.1) years. Data were analyzed from August 2016 to March 2017. Age-related macular degeneration was graded from retinal photographs and spectral-domain optical coherence tomography into 5 exclusive stages: no AMD, early AMD1, early AMD2, late atrophic AMD, and late neovascular AMD. Of the 659 eligible participants, 413 (62.7%) were women, and the mean (SD; range) age was 79.7 (4.4; 73-94) years. A total of 120 incident cases of early AMD and 45 incident cases of advanced AMD were recorded. Incidence rates of early and advanced AMD were 79.9 (95% CI, 66.8-95.5) per 1000 person-years and 18.6 (95% CI, 13.9-24.9) per 1000 person-years, respectively, corresponding to 5-year risks of 32.9% and 8.9%. Incidence of advanced AMD per 1000 eye-years was 1.5 in eyes without any AMD at baseline, 42.4 in those with early AMD1, and 85.1 in those with early AMD2. In multivariate analysis without correction for multiple testing, progression from early to advanced AMD was associated with AMD grade in the fellow eye (hazard ratio [HR] according to grade, 13.0 [95% CI, 2.8-61.2] to 22.5 [95% CI, 2.6-195.9]), having smoked at least 20 pack-years (calculated as number of smoking years × mean number of cigarettes per day / 20; HR, 3.0; 95% CI, 1.4-6.5), and complement factor H (CFH) Y402H genotype (CC genotype: HR, 2.3; 95% CI, 1.0-5.3; TC genotype: HR, 1.5; 95% CI, 0.6-3.7). Incidence of early AMD was associated with early AMD in the fellow eye (early AMD1: HR, 2.6; 95% CI, 1.6-4.2; early AMD2: HR, 5.6; 95% CI, 3.3-9.4) and high plasma high-density lipoprotein cholesterol levels (HR, 1.2; 95% CI, 1.0-1.4). In this cohort, AMD incidence rates were similar to those observed in other European populations. This study suggests a high risk for incident early AMD in individuals with high plasma high-density lipoprotein cholesterol levels while confirming the high risk for progression from early to advanced AMD in heavy smokers and carriers of CFH Y402H at-risk genotypes.

Is Perineural Invasion of Head and Neck Squamous Cell Carcinomas Linked to Tobacco Consumption?

Perineural invasion (PNI) is an underrecognized path of cancer spread, and its causes and mechanisms are poorly understood. Recent research indicates a mutual attraction of neuronal and cancer cells, largely dependent on neurotrophic factors and their receptors. Interestingly, the release of neurotrophic factors occurs upon cigarette smoke/nicotine exposure in a dose-dependent manner, and serum levels correlate with current smoking, number of smoking years, and smoking severity. Among cell types capable of neurotrophic factors secretion are lung and oral fibroblasts. In our study of 178 patients with head and neck squamous cell carcinoma, tumors of current and former smokers showed PNI significantly more often than tumors of never smokers. Moreover, PNI was a marker for aggressive tumor growth. Surprisingly, PNI was more significant for survival than p16 status. Our study warrants further research on PNI in head and neck squamous cell carcinoma with special emphasis on the impact of tobacco consumption to identify suitable candidates for therapeutic interventions.

Management and Point-of-Care for Tobacco Dependence (PROMPT): a feasibility mixed methods community-based participatory action research project in Ottawa, Canada

ObjectiveTo determine the feasibility of a Community-Based Participatory Tobacco Dependence Strategy (PROMPT) in the inner city population of Ottawa (Canada).DesignA feasibility mixed methods prospective cohort study following principles of community-based...

Effects of Social Attitude Change on Smoking Heritability

Societal attitudes and norms to female smoking changed in Spain in the mid-twentieth century from a restrictive to a tolerant, and an even pro-smoking, posture, while social attitudes remained stable for males. We explored whether this difference in gender-related social norms influenced the heritability of two tobacco use measures: lifetime smoking and number of years smoking. We used a population-based sample of 2285 twins (mean age = 55.78; SD = 7.45; 58% females) whose adolescence began between the mid-1950s and the early 1980s. After modeling the effect of sex and year of birth on the variance components, we observed that the impact of the genetic and shared environmental factors varied differently by birth cohort between males and females. For females, shared environment explained a higher proportion of variance than the genetic factors in older cohorts. However, this situation was inverted in the younger female cohorts. In contrast, no birth cohort effect was observed for males, where the impact of the genetic and environmental factors remained constant throughout the study period. These results suggest that heritability is larger in a permissive social environment, whereas shared-environmental factors are more relevant in a society that is less tolerant to smoking.

Genome-wide association study (GWAS) of chemotherapy-induced Raynaud's phenomenon (RP) to reveal shared pathways with cardiovascular disease (CVD).

e18162 Background: RP is an adverse drug reaction characterized by reduced blood flow to the extremities causing pain and sensations of cold. Few studies have examined the genetic basis for RP, although family studies suggest a heritable component to primary RP. Methods: Eligible testicular cancer survivors (TCS) were &lt; 55 y at diagnosis, treated with first line cisplatin-based chemotherapy, and completed questionnaires. Genotyping with standard quality control and imputation were performed. A case-control RP phenotype was derived from patient-reported outcomes and associations were computed by logistic regression. GWAS used cumulative bleomycin dose and 10 genetic principal components as covariates. Gene set enrichment analysis (GSEA) utilized genes ranked by the most significant GWAS SNP in/within 20 kilobases. A polygenic risk score for CVD derived from four prior independent GWAS (Khera et al. NEJM 2016) was assessed for association with RP. Results: Of 749 patients (median age 38 y, median time since chemotherapy 5 y), 38% reported RP. Bleomycin dose was the most significant predictor of RP (OR100 mg/m2 = 1.25, p &lt; 0.0001). Number of years smoking also correlated with RP (ORyear = 1.05, p = 0.002). Age and hypertension showed no significant correlation with RP. GSEA revealed several significant pathways (FDR q &lt; 0.1), including “ cellular response to VEGF stimulus” (q = 0.05) and “ cardiac muscle cell action potential” (q = 0.09). We hypothesized that RP may share genetic architecture with CVD. Deriving a polygenic risk score from genome-wide significant SNPs in prior CVD GWAS (n = 4260-22,389), we showed nearly significant case-control differences in CVD polygenic risk score (two-tailed t-test, p = 0.053). RP frequency significantly increased with polygenic risk score quartile (OR = 1.19, p = 0.008). Conclusions: Over one third of TCS report RP, with greater frequency among bleomycin-treated patients and smokers. Implicated genetic pathways include ones established in CVD. Although shared genetic risk between chemotherapy-induced RP and CVD may be possible, further investigation is required. Primary RP has been inconsistently linked with CVD.

Association of the Interaction Between Smoking and Depressive Symptom Clusters With Coronary Artery Calcification: The CARDIA Study

ABSTRACTObjective: Depressive symptom clusters are differentially associated with prognosis among patients with cardiovascular disease (CVD). Few studies have prospectively evaluated the association between depressive symptom clusters and risk of CVD. Previously, we observed that smoking and global depressive symptoms were synergistically associated with coronary artery calcification (CAC). The purpose of this study was to determine whether the smoking by depressive symptoms interaction, measured cumulatively over 25 years, differed by depressive symptom cluster (negative affect, anhedonia, and somatic symptoms) in association with CAC. Methods: Participants (N = 3,189: 54.5% female; 51.5% Black; average age = 50.1 years) were followed from 1985–1986 through 2010–2011 in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Smoking exposure was measured by cumulative cigarette pack-years (cigarette packs smoked per day × number of years smoking; year 0 through year 25). Depressive symptoms were measured using a 14-item, 3-factor (negative affect, anhedonia, somatic symptoms) model of the Center for Epidemiologic Studies Depression (CES-D) Scale (years 5, 10, 15, 20, and 25). CAC was assessed at year 25. Logistic regression models were used to evaluate the association between the smoking by depressive symptom clusters interactions with CAC ( = 0 vs. > 0), adjusted for CVD-related sociodemographic, behavioral, and clinical covariates. Results: 907 participants (28% of the sample) had CAC > 0 at year 25. The depressive symptom clusters did not differ significantly between the two groups. Only the cumulative somatic symptom cluster by cumulative smoking exposure interaction was significantly associated with CAC > 0 at year 25 (p = .028). Specifically, adults with elevated somatic symptoms (score 9 out of 18) who had 10, 20, or 30 pack-years of smoking exposure had respective odds ratios (95% confidence intervals) of 2.06 [1.08, 3.93], 3.71 [1.81, 7.57], and 6.68 [2.87, 15.53], ps < .05. Negative affect and anhedonia did not significantly interact with smoking exposure associated with CAC >0, ps > .05. Conclusions: Somatic symptoms appear to be a particularly relevant cluster of depressive symptomatology in the relationship between smoking and CVD risk.

Severity of Menopausal Symptoms and Nicotine Dependence amongst Postmenopausal Women Smokers

Rationale: Cigarette smoking has antiestrogenic properties, which may worsen the symptoms and health risks associated with menopause.Objectives: In the present study, it was hypothesised that menopausal symptoms would improve with smoking abstinence.Methods: Postmenopausal smokers (n = 76) were assessed with the Kupperman Index (KI) of menopausal symptoms and smoking-related indices of nicotine dependence, cotinine level, cigarettes per day (CPD), and number of years smoking.Results: Participants were 67% Caucasian, 33% African-American, 52.3(SD = 7.8) mean years of age, follicle stimulating hormone (FSH) level, m = 42.6(SD = 25.7) mlU/ml, mean number of months since last menses was 145.1(SD = 118.9), and mean body mass index (BMI) was 27.4(SD = 6.2). Mean cigarettes smoked per day (CPD) was 20.3(SD = 11.5), for m = 29.4(SD = 10.7) years; m = 6.4(SD = 2.1) Fagerström Test for Nicotine Dependence (FTND), m = 23.8(SD = 13.0) ppm carbon monoxide, and m = 19.7(SD = 12.5) KI total score. Most participants (78.9%) were currently taking hormone therapy (HT). Hierarchical linear regression analyses revealed that FTND (β = 0.48, p = 0.001) and cotinine level (β = −0.27, p = 0.02) predicted KI scores at baseline. Amongst participants (n = 65) who achieved abstinence for 2 weeks, number of years smoking predicted KI scores (β = 0.38, p = 0.01). At 8 weeks postcessation, CPD significantly predicted of KI scores (β = −0.74), p = 0.04).Conclusions: With abstinence from smoking, the overall severity of menopausal symptoms decreased and shared variance with different smoking-related variables. The temporal and cessation-related symptom course identified in this study will be important in informing cessation interventions with this population of smokers.

Using Diverse Communication Strategies to Re-Engage Relapsed Tobacco Quitline Users in Treatment, New York State, 2014

IntroductionMost smoking cessation programs lack strategies to reach relapsed participants and encourage a new quit attempt. We used a multimodal intervention to encourage past quitline registry participants to recycle into services.MethodsWe invited 3,510 past quitline participants back to quitline services, using messages consecutively delivered through Interactive Voice Response (IVR), followed by postcard and email reminders, 2 Short Messaging Services (SMS) texts, and a final cycle of IVR. The primary study outcome was recycling into a new quitline-assisted quit attempt. We used statistical analyses to assess rates and predictors of recycling (socioeconomic, health- and tobacco-related variables) with study participants and compared the study sample with registry participants not selected for the study (comparison group).ResultsQuitline services were re-initiated by 12.2% of the intervention sample and 1.9% of the comparison group (z = 6.03, P < .001, effect size of 0.44). Most re-enrollments were done via direct IVR-transfer to the quitline. Predictors of re-enrollment were age (odds ratio [OR] = 1.45 for every 10 years of age; 95% confidence interval [CI], 1.34–1.57), number of years smoking (OR = 1.27; 95% CI, 1.18–1.36), and reporting cancer (OR = 2.32; 95% CI, 1.47–3.68) or chronic obstructive pulmonary disease (OR = 1.55; 95% CI, 1.16–2.10). Living with other smokers was correlated with a lower chance of recycling into treatment (OR = 0.72; 95% CI, 0.57–0.91).ConclusionRecycling previous quitline participants using a proactive, IVR-based intervention is effective in reinitiating quitline-assisted quit attempts. Older, long-term smokers reporting chronic conditions are more likely than younger smokers to re-engage in quitline support when these methods are used.

Laryngeal findings and acoustic changes in light cigar smokers.

The aim of this prospective study was to look at the laryngeal findings and acoustic changes in light cigar smokers in comparison to nonsmokers, in the setting of a voice clinic. A total of 22 cigar smokers and 19 nonsmokers used as controls were enrolled in the study. Demographic data included age, number of years smoking, number of cigars per week, history of allergy, and history of reflux. The confounding effects of allergy and reflux were accounted for in the control group. Subjects underwent laryngeal endoscopy and acoustic analysis. On laryngeal endoscopy, the most common laryngeal finding was thick mucus. There was no significant difference in the prevalence of any of the laryngeal findings in cigar smokers vs. In comparison with the control group, both the fundamental frequency and habitual pitch were significantly lower in cigar smokers (p value = 0.034 and 0.004, respectively). We conclude that cigar smokers have lower fundamental frequency and habitual pitch compared to nonsmokers.

Correlates of Converted and Native Nondaily Smoking.

Nondaily smokers represent a growing proportion of current smokers in the United States. However, little is known about which characteristics are important in distinguishing between nondaily smokers who are former daily smokers (converted nondaily) and nondaily smokers who never smoked daily (native nondaily). This study contrasts converted and native nondaily smokers on demographic, psychosocial, tobacco-related characteristics and quit intentions and behaviors in a tri-ethnic sample (Blacks, Whites, and Latinos) of smokers. Smokers were recruited for a web-based survey using an online panel survey company. Participants were 1,201 nondaily smokers (904 converted nondaily smokers and 297 native nondaily smokers). A multivariable logistic regression was conducted to assess the associations between demographic, smoking-related, and psychosocial variables with converted versus native nondaily smoking. Logistic regression indicated that number of years smoking, years as a nondaily smoker, number of days smoked in a month, smoking dependence, identity as a smoker, and number of smoking cessation methods used were correlates of being converted nondaily smokers versus native nondaily smokers. Clinicians and researchers should consider characteristic variations in nondaily smokers when designing and implementing intervention efforts targeting this smoking population.

Adherence to treatment to help quit smoking: effects of task performance and coping with withdrawal symptoms.

BackgroundCurrently the combined cognitive-behavioral and pharmacological treatment is the best option to quit smoking, although success rates remain moderate. This study aimed to identify predictors of continuous abstinence in an assisted smoking cessation program using combined treatment. In particular, we analyzed the effects of socio-demographic, smoking-, and treatment-related variables. In addition, we analyzed the effect of several risk factors on abstinence, and estimated a model of risk for smoking relapse.MethodsParticipants were 125 workers at the University of Granada (50 males), with an average age of 46.91 years (SD = 8.15). They were recruited between 2009 and 2013 at an occupational health clinic providing smoking cessation treatment. Baseline measures included socio-demographic data, preferred brand of cigarettes, number of years smoking, use of alcohol and/or tranquilizers, past attempts to quit, Fargerström Test for Nicotine Dependence, Smoking Processes of Change Scale, and Coping with Withdrawal Symptoms Interview. Participants were invited to a face-to-face assessment of smoking abstinence using self-report and cooximetry hemoglobin measures at 3, 6, and 12 months follow-up. The main outcome was smoking status coded as “relapse” versus “abstinence” at each follow-up. Kaplan-Meier survival analysis was performed to estimate the probability of continued abstinence during 12 months and log-rank tests were used to analyze differences in continued abstinence as a function of socio-demographic, smoking-, and treatment-related variables. Cox regression was used to analyze the simultaneous effect of several risk factors on abstinence.ResultsUsing alcohol and/or tranquilizers was related to shorter abstinence. Physical exercise, the number of treatment sessions, performance of treatment tasks, and coping with withdrawal symptoms were related to prolonged abstinence. In particular, failure to perform the treatment tasks tripled the risk of relapse, while lack of coping doubled it.ConclusionsOur results show that physical exercise, performance of treatment-related tasks, and effective coping with withdrawal symptoms can prolong abstinence from smoking. Programs designed to help quit smoking can benefit from the inclusion of these factors.

Abstract C86: Active smoking and breast cancer risk among Hispanic and non-Hispanic white women from the Breast Cancer Health Disparities Study

Abstract The association between smoking and breast cancer has been extensively evaluated in epidemiological studies. Some, but not all studies found a positive association between smoking and breast cancer risk, especially among women with long smoking duration. Few studies have included Hispanic women. We evaluated the interaction between active smoking exposure and ethnicity using data from the Breast Cancer Health Disparities Study, a consortium of three population-based case-control studies including U.S. non-Hispanic whites (NHW) (1,525 cases; 1,593 controls), U.S. Hispanics/Native Americans (1,265 cases; 1,495 controls), and Mexican women (990 cases; 1,049 controls). Using multivariable logistic regression, odds ratios (ORs) and 95% confidence intervals (CI) were calculated to estimate the risk of breast cancer associated with active smoking exposure and assess differences in associations by ethnicity. We also tested for interaction effects between smoking and ethnicity by menopausal status and by history of alcohol use. Assessment of tobacco usage and active smoking exposures by ethnicity showed that there were significant (p value &amp;lt; 0.001) differences between NHW, Hispanic/Native American, and Mexican women with regard to smoking status, total pack-years, total number of smoking years, and average number of cigarettes/day, with women from Mexico smoking fewer cigarettes than women living in the U.S. Risk was increased only among Mexican women who were former smokers (OR, 1.43; 95% CI 1.04-1.96, p interaction=0.03) or who smoked for more than 30 years (OR, 1.95; 95% 1.13-3.35, p interaction=0.04), compared to never smokers. No significant associations were observed among NHW or Hispanic/Native American women. Among NHW premenopausal women, increased breast cancer risk was associated with smoking 20 cigarettes or more/day (OR, 1.61; 95% CI 1.07-2.41, p interaction=0.02), whereas for NHW postmenopausal women the association with the same risk category was null. Additionally, we observed positive associations with breast cancer risk among postmenopausal women from Mexico who were former smokers (OR, 1.65; 1.09-2.50, p interaction=0.003) or who smoked for more than 30 years (OR, 2.13; 95% CI 1.18-3.86, p interaction=0.04). Lastly, there was a significant positive association found among Mexican women who were former smokers with a history of alcohol use (OR, 2.30, 95% CI 1.01-5.21, p interaction=0.003), while there were no significant associations found among nondrinkers who were Mexican, Hispanic/Native American, or NHW in the same risk category for smoking status. Our data suggest that the association between smoking and breast cancer risk is significant among women from Mexico. Furthermore, menopausal status and history of alcohol use should be examined for their potential modifying effects when evaluating the association between cigarette smoking, ethnicity, and breast cancer risk. Citation Format: Avonne E. Connor, Kathy B. Baumgartner, Richard N. Baumgartner, Christina M. Pinkston, Stephanie D. Boone, Esther M. John, Gabriela Torres- Mejía, Lisa M. Hines, Anna R. Giuliano, Roger K. Wolff, Martha L. Slattery. Active smoking and breast cancer risk among Hispanic and non-Hispanic white women from the Breast Cancer Health Disparities Study. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr C86. doi:10.1158/1538-7755.DISP13-C86

Association between smoking, nicotine dependence, and BDNF Val66Met polymorphism with BDNF concentrations in serum.

Nicotine use is associated with the upregulation of brain-derived neurotrophic factor (BDNF) in serum. An association between smoking and the BDNF Val(66)Met polymorphism has also been found. The aim of this study is to examine the levels of serum BDNF in never-smokers, former smokers, and current smokers-with and without nicotine dependence-and to examine the interaction of the polymorphism and smoking status with serum BDNF. We used baseline serum and gene data of BDNF on 2,088 participants from the Netherlands Study of Depression and Anxiety (NESDA) to investigate smoking-BDNF association while controlling for potential confounding variables. Nicotine dependence was assessed with the Fagerstrom Test for Nicotine Dependence (FTND). Smokers with and without nicotine dependence had higher levels of serum BDNF than former and never-smokers. Nicotine dependence and number of cigarettes smoked per day did not add to the prediction of serum BDNF; however, total number of smoking years was a significant predictor of serum BDNF. There was no association of BDNF Val(66)Met, nor an interaction of this polymorphism and smoking status, with serum BDNF. Current smoking and higher number of smoking years are associated with higher levels of serum BDNF, and this is independent of the BDNF genotype. Nicotine dependence itself is not associated with a further increase or decrease of serum BDNF. Longitudinal investigations that address changes in serum BDNF in incident smokers and/or in quitters may be useful to understand the association of smoking with BDNF.

Alcohol and Smoking Affect Risk of Uncomplicated Colonic Diverticulosis in Japan

Colonic diverticula are located predominantly on the right side in Asia and on the left side in Europe and the United States. Factors associated with uncomplicated colonic diverticulosis and its distribution pattern have been unknown. Our aims are to investigate the prevalence and risk factors for uncomplicated colonic diverticulosis. We conducted a prospective cross-sectional study in adults who underwent colonoscopy. Alcohol, alcohol related flushing, smoking, medications, and comorbidities were assessed by interview on the colonoscopy day. Alcohol consumption was categorized as nondrinker, light (1–180 g/week), moderate (181–360 g/week), and heavy (≥361 g/week). Smoking index was defined as the number of cigarettes per day multiplied by the number of smoking years and categorized as nonsmoker, <400, 400–799, and ≥800. A total of 2,164 consecutive patients were enrolled. Overall, 542 patients (25.1%) had uncomplicated colonic diverticulosis located on the right side (50%), bilaterally (29%), and on the left side (21%). Univariate analysis revealed age, male, smoking index, alcohol consumption, aspirin use, anticoagulants use, corticosteroid use, hypertension, and atherosclerotic disease as factors significantly associated with diverticulosis. Alcohol related flushing was not associated with the disease. Multivariate analysis showed increasing age (P<0.01), increasing alcohol consumption (P<0.01) and smoking (P<0.01), and atherosclerotic disease (P<0.01) as significantly associated factors. Alcohol and smoking were associated with right-sided and bilateral diverticula. In conclusion, one in four Japanese adults have colonic diverticulosis (50% right-sided). Age, alcohol consumption, and smoking were found to be significant risk factors for uncomplicated colonic diverticulosis, particularly right-sided and bilateral.

Unique symptoms at midlife of women with osteoporosis and cardiovascular disease in Taiwan

This study compared symptoms at midlife, menopause attitudes, and depression among three groups of late peri- or postmenopausal women, namely, women with cardiovascular disease (CVD group), women with osteoporosis (Os group), and women in generally good health (Co group). We used a cross-sectional method. Participants were purposively sampled from a medical center and a residential community in southern Taiwan. A total of 500 women between 45 and 60 years of age participated in the study. Four measures were used: a demographics and health habits questionnaire, the Women's Health Initiative Symptom Scale, the Attitudes Towards Menopause Scale, and the Center for Epidemiological Studies-Depression Scale. Significant demographic differences among the groups were found in age, number of children, educational level, family income, employment status, exercise duration per session, smoking status, daily cigarette consumption, and number of years smoking. After significant covariates had been controlled for, the CVD group reported significantly more severe symptoms at midlife than did the Co group; significantly more severe "psychosomatic symptoms" than did the Co group; and significantly more severe "gastrointestinal symptoms and swelling" and "vasomotor symptoms" than did either the Os group or the Co group. The CVD group also reported significantly greater depressive symptoms than did the Os group. This study identified a number of differences in symptoms at midlife and depressive symptoms among the three groups. Results support the importance of providing unique care for peri- and postmenopausal women in different health categories. Findings may help healthcare professionals better appreciate the diversity of menopausal experiences and support the development of appropriate care strategies.