Smoking Men Research Articles

Preventability of Colorectal Cancer in Saudi Arabia: Fraction of Cases Attributable to Modifiable Risk Factors in 2015-2040.

A rise in colorectal cancer (CRC) burden is expected around the globe. This study aimed to determine the population attributable fractions (PAFs) of CRC cases contributed by modifiable risk factors in Saudi Arabia. The PAF was calculated for modifiable risk factors with strong evidences of a causal association with CRC. CRC incidence was obtained from the National Cancer Registry, relative risks were retrieved from recent meta-analysis studies, and the prevalence of exposure to risk factors was obtained from national surveys. Conventional statistical formulas were used to calculate PAFs from registered CRC cases, stratified by sex. Three scenarios were proposed to make projections and present the expected effects of prevention interventions on the number of CRC cases in Saudi Arabia for 2025–2040. The results showed the largest fraction of attributable CRC cases among men and women was contributed by physical inactivity (16.13% and 16.45%), followed by excess weight (obesity: 9.71% and 6.93%; overweight: 6.05% and 1.9%); and tobacco smoking (current smoker: 3.04% and 0.18%; former smoker: 3.29% and 0.12%). We estimated that the number of projected cases attributable to physical inactivity, smoking, and excess weight in men and women would increase from 807 and 315 in 2025 to 1360 and 556 in 2040, respectively. In conclusion, physical inactivity, being overweight or obese, and tobacco smoking are major lifestyle factors affecting the incidence of CRC in Saudi Arabia. Prevention interventions and public health programs to reduce their prevalence are warranted.

111 Your Penis Wants you to Quit: ED Knowledge and Smoking Cessation Motivation in an Urban Urology Clinic

Tobacco use is the single most preventable cause of morbidity and mortality in the world today.1 Cigarette smoking is associated with elevated rates of cardiovascular disease, GU malignancy and erectile dysfunction2. Erectile dysfunction alone is estimated to affect 34 million men this year. This urban population study assesses knowledge of the association between smoking and erectile dysfunction and examines smoking cessation motivation once subjects learned of the link between smoking and erectile dysfunction. A cross-sectional study of an outpatient clinic comprised of smoking and nonsmoking men (>18), was conducted using a 13-item questionnaire assessing demographic data, relevant smoking history, and participants’ awareness of erectile dysfunction association with smoking. We utilized the International Index of Erectile Dysfunction (IIEF-5) questionnaire to assess the degree of erectile dysfunction, the Fagerstom Test for Nicotine Dependence (FTND) 6 to assess smoking dependence as well as the Readiness to Quit Ladder to assess motivation of quitting both before and after an education statement was provided. The education statement was "Smokers are twice as likely to develop erectile dysfunction (impotence) compared to nonsmokers and quitting smoking has been shown to improve erections.” Statistical analysis was performed utilizing survey responses with significance levels of p < .05.

Patterns of Tobacco Use and its Relation to Oral Precancers and Cancers among Individuals Visiting a Tertiary Hospital in South India

The aim of this study was to evaluate the use of tobacco and its association with oral precancers and cancers. Medical records of 1,007 individuals were assessed for the patterns of tobacco abuse and the presence of tobacco-related oral mucosal alterations. This study comprised 1,007 individuals (M:F: 95.4%:4.6%). In the cohort, 60.1% had smoking habit and 56.1% had smokeless habit. Of the bidi smokers, 18.2% developed carcinoma, 14.3% developed leukoplakia, which is statistically significant (p < 0.001). A logistic regression analysis of the development of oral submucous fibrosis (OSMF) shows that habit of smokeless forms of tobacco has an odds ratio (OR) of 18+ when compared with smoking. Combination of bidi and gutkha had 12.3 times higher risk of developing oral cancer and 4.4 times risk of developing leukoplakia. A total of 33.3% betel quid and gutkha chewers presented with tobacco pouch keratosis, which is statistically significant. Smoked and smokeless forms of tobacco were equally popular among the study population. The packeted form of smokeless tobacco (gutkha) was more prevalent. Oral submucous fibrosis was more common than leukoplakia, and oral cancer developed more frequently in elderly men smoking bidis. This study throws light on the fact that the use of both smoke and smokeless forms of tobacco is still prevalent, and the use of gutkha was most prevalent. These findings will help tobacco cessation and counseling centers to focus their effort in motivating people to stop gutkha chewing habit. This also brings to the forefront the need to create better treatment strategies to manage OSMF.

A Qualitative Study of Factors Influencing the Onset of Hookah Smoking among Iranian Men with Turkmen Ethnicity

IntroductionHookah smoking has grown considerably among Iranian Turkmen in the past two decades. The reasons for this increase in the consumption of hookah are unclear. Therefore, this study was conducted with the aim of determining the factors related to the start of hookah smoking in men with Turkmen ethnicity.MethodsThis qualitative study was conducted between February 2018 and June 2018 in Turkmen cities of Golestan provinces in Iran. The study participants included 26 male Turkmen water pipe smokers with various ages, occupation, and education level. Study data were collected through semi-structured individual interview and the results were analyzed in August 2018 by content analysis. Data management was done by software, MAXQDA version 10.ResultsIn this study, 26 hookah smoker men with the age range of 20–45 years were interviewed. The age of the participants at the time of starting hookah consumption varied from 14 to 25 years. On the basis of qualitative data, the reasons for the start of hookah smoking in male Turkmen were classified into three main categories: (1) individual (curiosity and sense of adulthood, fewer perceived risks compared with other substances and hookah’s sensory attractions); (2) interpersonal (hookah-smoking friends and consumption of hookah by family members); and (3) societal (blaming unemployed people in small neighborhoods, cultural influence, more social acceptance compared with other substances, and easy access to hookah).ConclusionIndividual, interpersonal, and societal factors play important role in the start of hookah smoking among male Turkmens. Developing health policies based on the above factors can be effective in adopting hookah prevention and control strategies. Moreover, future studies could be developed with the goal of discovering ways to solve the problem of unemployment and plan for developing recreational activities in this area to prevent initiation of hookah smoking especially among youth.

Smoking as a risk factor for physical impairment: a systematic review and meta-analysis of 18 cohort studies

Smoking has various negative effects on diseases and disabilities. The authors examined the relationships between smoking and physical impairments in this meta-analysis. Two databases including PubMed, Scopus, and two gray literature databases including Google Scholar and Research Gate were searched systematically using Mesh keywords. After reviewing the studies, 18 Prospective cohort studies were selected based on criteria. Risk Ratio (RR) of physical impairment as outcome of smoking and subgroup analysis based on gender, adjusted quality, geographic location and smoking status were done using random effects. Publication bias was calculated as well. The results showed that the risk of physical impairment in smokers is equal to RR = 1.26 and CI = 1.16–1.36 (P = <001). In women, RR = 1.19 and CI = 0.80–1.75 (P = 0.388); and in men, RR = 1.87 and CI = 1.31–2.68 (P = <001) were achieved. Some evidences of publication bias were found. Smoking increases the risk of physical impairment. Men are at a greater risk of physical impairment; perhaps because the prevalence of smoking in men is higher than women.

Smoking and Alcohol Intake but Not Muscle Strength in Young Men Increase Fracture Risk at Middle Age: A Cohort Study Linked to the Swedish National Patient Registry.

We aimed to determine the relationship between handgrip strength, smoking, and alcohol consumption in young men and fracture risk at middle age. Thus, we carried out a cohort study including young men undergoing conscription examination in Sweden from September 1969 to May 1970 at a typical age of 18 years. Data on muscle strength, height, weight, and lifestyle factors were linked to the National Patient Register 1987-2010. Handgrip strength was considered the main exposure and smoking and alcohol consumption as secondary exposures. Outcomes were all fractures (except face, skull, digits), major osteoporotic fractures (thoracic/lumbar spine, proximal humerus, distal forearm or hip), and major traumatic fractures (shaft of humerus, forearm, femur, or lower leg) based on ICD-9 and -10 codes. We used Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) according to handgrip strength as a continuous variable (per 1 SD), after adjustment for weight, height, parental education, smoking, and alcohol consumption. A total of 40,112 men were included, contributing 892,572 person-years. Overall, 3974 men fractured in middle age with the incidence rate (95% CI) of 44.5 (43.2-45.9) per 1000 person-years. The corresponding rates were12.2 and 5.6 per 1000 person-years for major osteoporotic and traumatic fractures, respectively. Handgrip strength-adjusted HR (95% CI) was 1.01 (0.98-1.05), 0.94 (0.88-1.00), and 0.98 (0.88-1.08) per SD for all, major osteoporotic, and major traumatic fractures, respectively. Adjusted HR (95% CI) for smokers (>21 cigarettes/d) was 1.44 (1.21, 1.71) for all fractures, while the association between alcohol consumption and hazards of fracture was J-shaped. Therefore, young adult handgrip strength was not associated with fracture risk in middle-age men, although smoking and high alcohol consumption did confer an increased risk. © 2019 American Society for Bone and Mineral Research. © 2019 American Society for Bone and Mineral Research.

Smoking, alcohol intake, and frailty in older Korean adult men: cross-sectional study with nationwide data.

Smoking and alcohol intake are major causes of negative health outcomes and may be co-inherited traits. However, little is known about the association of frailty with smoking and alcohol intake in older adults. Community-dwelling older men (N = 1426) aged 70-84years were divided into four groups: 1) non-smoking (< 100 cigarettes in life-time) and non-alcohol intake (< one time/month); 2) smoking (≥ 100 cigarettes) and alcohol intake (≥ one time/month); 3) non-smoking with alcohol intake; and 4) smoking and no alcohol intake. Frailty was assessed with a modified version of the Cardiovascular Health Study (CHS) frailty index, the Korean version of the Fatigue, Resistance, Ambulation, Illness, and Loss of Weight (KFRAIL) index, the Korean Frailty Index (KFI), and the Study of Osteoporotic Fracture (SOF) frailty index. Frailty risks were estimated with multiple logistic regression models after adjusting for age, income, education, residence, marital status, hospitalization, physical activity, comorbidities, and levels of vitamin B12, aspartate aminotransferase, and gamma-glutamyl transferase. Frailty differed according to smoking and alcohol status. Frailty in the smoking and non-alcohol-intake group was significantly higher according to the CHS frailty index (Odds ratio = 1.592; 95% confidence interval [CI] 1.032-2.455), KFRAIL (CI 1.613, 1.037-2.509), and KFI (CI 1.869, 1.115-3.131) compared with the non-smoking and alcohol-intake group. However, there was no increased frailty risk in the other study groups. Frailty prevalence differed depending on smoking status and alcohol intake in older Korean men. Therefore, we should adopt a comprehensive approach to understanding frailty in older adults that considers both smoking and alcohol intake.

Approaches to Tumor Classification in Pulmonary Sarcomatoid Carcinoma.

Pulmonary sarcomatoid carcinoma (PSC) is a heterogeneous category of primary lung cancer accounting from 0.3% to 3% of all primary lung malignancies. According to the most recent 2015 World Health Organization (WHO) classification, PSC includes several different variants of malignant epithelial tumors (carcinomas) histologically mimicking sarcomas showing or entirely lacking a conventional component of non-small cell lung cancer (NSCLC). Thus, this rare subheading of lung neoplasms includes pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, pulmonary blastoma, and carcinosarcoma. A diagnosis of PSC may be suspected on small biopsy or cytology, but commonly requires a surgical resection to reach a conclusive definition. The majority of patients with PSC consists of elderly, smoking men with a large, peripheral mass characterized by well-defined margins. However, presentation with a central, polypoid endobronchial lesion is well-documented, particularly in pleomorphic carcinoma and carcinosarcoma showing a squamous cell carcinoma component. As expected, PSC may pose diagnostic problems and immunohistochemistry is largely used when pathologists deal these tumors in routine practice. Indeed, PSC tends to overexpress molecules associated with the epithelial-to-mesenchymal transition, such as vimentin, but the panel of immunostains also includes epithelial markers (cytokeratins, EMA), TTF-1, p40 and negative markers (e.g., melanocytic, mesothelial and sarcoma-related primary antibodies). Although rare, PSC has increased their interest among oncologist community for different reasons: a. identification of the epithelial-to-mesenchymal phenomenon as a major mechanism of secondary resistance to tyrosine kinase inhibitors; b. over-expression of PD-L1 and effective treatment with immunotherapy; c. identification of c-MET exon 14 skipping mutation representing an effective target to crizotinib and other specific inhibitors. In this review, the feasibility of the diagnosis of PSC, its differential diagnosis and novel molecular findings characterizing this group of lung tumor are discussed.

Subject, Object, Agent, Other: Zoom, PNP and Crystal Methamphetamine

This paper advances the argument that gay men using online meeting spaces to smoke methamphetamine together are re-enacting the HIV/AIDS crisis. Using ethnographic observations of gay men smoking meth through an online meeting software called Zoom, this paper attempts to synthesise pharmaceutical insight with Freudian and Foucauldian theory. The idea of naked bodies presenting themselves before others while administering powerful pharmaceuticals – quarantined and isolated – expresses a recurrence of the HIV/AIDS crisis. The paper argues the crisis instantiated a logic of quarantine and containment which required gay men to insert themselves into an ascetic discourse and conduct, engaging only in isolated sexual practices. Gay populations were to be surveilled by medical institutions. Constant testing and monitoring of behaviour were to be used as a technique to contain the virus. Finally, powerful retroviral medications appeared in the mid-1990s and became the saviour of the AIDS infected populace, freeing queer bodies from the shackles of HIV. All of this creates new techniques for the function of power. Now, in place of quarantine, bodies isolate themselves. In place of surveillance, bodies become spectacles. In place of antiretrovirals, bodies infuse their blood with stimulants.

Aggregation of Asian-American subgroups masks meaningful differences in health and health risks among Asian ethnicities: an electronic health record based cohort study

BackgroundFew large cohort studies have examined the prevalence of diabetes mellitus (DM), hypertension (HTN), coronary artery disease (CAD), obesity, and smoking among middle-aged and older adults in the major Asian-American ethnic groups and Native Hawaiian/Pacific Islanders (PIs). The aim of this study was to evaluate how prevalence of these conditions and risk factors differs across Asian-American and PI ethnic groups and compares with an aggregated All Asian-American racial group.MethodsThis study used a cohort of 1.4 million adults aged 45 to 84 who were Kaiser Permanente Northern California health plan members during 2016. The cohort included approximately 274,910 Asian-Americans (Chinese, Filipino, Japanese, Korean, Southeast Asian, South Asian, other), 8450 PIs, 795,080 non-Hispanic whites, 107,200 blacks, and 210,050 Latinos. We used electronic health record data to produce age-standardized prevalence estimates of DM, HTN, CAD, obesity (using standard and Asian thresholds), and smoking for men and women in all racial/ethnic subgroups and compared these subgroups to an aggregated All Asian-American racial group and to whites, blacks, and Latinos.ResultsWe found large differences in health burden across Asian-American ethnic subgroups. For both sexes, there were 16 and > 22 percentage point differences between the lowest and highest prevalence of DM and HTN, respectively. Obesity prevalence among Asian subgroups (based on an Asian BMI ≥ 27.5 kg/m2 threshold) ranged from 14 to 39% among women and 21 to 45% among men. Prevalence of smoking ranged from 1 to 4% among women and 5 to 14% among men. Across all conditions and risk factors, prevalence estimates for Asian-American and PI ethnic groups significantly differed from those for the All Asian-American group. In general, Filipinos and PIs had greater health burden than All Asians, with prevalence estimates approaching those of blacks.ConclusionsIn a population of middle-aged and older adult Northern California health plan members, we found substantive differences in prevalence of chronic cardiovascular conditions, obesity, and smoking across Asian-American ethnic groups and between Asian-American ethnic groups and an aggregated All Asian racial group. Our study confirms that reporting statistics for an aggregated Asian-American racial group masks meaningful differences in Asian-American ethnic group health.

Connection between smoking and back pain--findings from an Icelandic general population study

The association between pain in general, back pain and smoking was studied in a sample of subjects from the general public (n = 862). The results show that smoking men had pain problems more frequently than women (p &lt; 0.0001). In comparison with non-smokers, smokers were found to have back pains more frequently (p &lt; 0.01). Male smokers were also found to have a higher frequency of intervertebral disc problems than female smokers (p &lt; 0.009). The frequency of disc problems encountered by the smoking subjects indicates a possible connection between smoking and back pain.

Risk of harm from alcohol use and heavy alcohol consumption: Its association with other NCD risk factors in Thailand

While there is an abundance of literature examining the relation between quantity of alcohol consumption and risk factors for non-communicable diseases (NCD), there is less evidence on whether the risk of harm from alcohol use would have a similar relationship with NCD risk factors. The study aims to determine the association between level of harm from alcohol use and NCD risk factors. A cross-sectional survey was conducted among health care workers in Thailand in 2013. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was used to assessed risk of harm from alcohol use. The results suggest that higher risk of harm from alcohol use was associated with two of the eight NCD risk factors among women (higher blood pressure and higher triglyceride level) and five of the eight NCD risk factors among men (smoking, physical inactivity, higher blood pressure, higher blood glucose and higher triglyceride level). For men, assessing risk of harm could be incorporated as part of NCD programs as practitioners do not have to worry about the accuracy of the alcohol quantification and conversion to standard drinks. However, among women, quantifying volume may still be needed.

The prediction of colorectal cancer using anthropometric measures: A Swedish population-based cohort study with 22 years of follow-up.

Obesity is a risk factor for colorectal cancer (CRC). The objective of this article is to investigate whether anthropometric measures reflecting visceral obesity are better predictors of CRC than body mass index (BMI). Data were analysed from the Malmö Diet and Cancer study in Sweden, comprising 16,669 women and 10,805 men (median age 56.6 and 59.1 years) followed for a median 21.5 years. Diagnoses of CRC were identified using Swedish national registers. Cox regression was used to test the associations of BMI, waist circumference (WC), waist-hip ratio, waist-to-height ratio, waist-to-hip-to-height ratio, A Body Shape Index (ABSI) and percentage body fat with the development of CRC adjusted for age, alcohol consumption, smoking, education and physical activity in men and women. None of the measures were significantly associated with an increased risk for CRC in women. WC was the strongest predictor of colon cancer (CC) in men and the only measure that was independent of BMI. ABSI was the only measure significantly associated with the risk of rectal cancer in men. Visceral obesity, best expressed as WC, is a risk factor for CC in men but a poor predictive marker for CRC in women.

Disparities in smoking habits in Hungarian Roma and general populations

Abstract Background Smoking status, dependence and cessation efforts of the disadvantaged Hungarian Roma living in segregated settlements were compared to those of the general population. Methods Data were collected through survey. Each study group consists of 500 randomly drawn subjects, and are representative of the adult (18-64) general and Roma population, living in two counties of North-East Hungary. Questions on smoking from the European Health Interview Survey were used with some modifications. Prevalence data were analysed according to age strata (18-29, 30-44 and 45-64 years) by chi2 test, and were compared to data from 2003 and 2014. Results In Roma the proportion of never smokers is much less compared to the general ones (men:27.27% vs.75%, women:38.6% vs.70.75%, p &amp;lt; 0.05). Less Roma reported never smoking in all age compared to 2014, increasing trend can be found in the general population since 2003. Smoking prevalence is higher in Roma in all ages (72.73% vs.20 83%; 68.42% vs.28.42%; 59.02 vs. 32.26%, p &amp;lt; 0.05, respectively). Interestingly, the prevalence of Roma men smokers is decreasing by age, in the general population the trend is the opposite. Heavy smoker status is the highest in 30-44 age group of both populations. Increasing trend of heavy smoking can be detected in the Roma, but the opposite holds for general population compared to 2014. Half of the Roma smoke within 5 minutes after wakeup (50% vs. 36.92%, p &amp;lt; 0.05), smoke hand-rolled cigarettes (68.91%vs 30.77%, p &amp;lt; 0.05), higher proportion of them tried to quit (34.78% vs. 23.38%, p &amp;lt; 0.05) but smaller proportion of them obtained advise on how to quit (48.53% vs.59.09%, p &amp;lt; 0.05). Initiation starts earlier age among them (men: 15.1 vs.16.6, women: 16.2 vs.18.2, p &amp;lt; 0.05). Conclusions Regular smoking (especially heavy) is much higher in the Roma and decreasing by age compared to the general in all age-groups. The 30-44 age group of Roma mean are exclusively heavy smokers but half of the Roma show effort to quit. Key messages Tailoring cessation programs for Roma men especially those belong to 30-44 age group is a priority to reduce tobacco-related adverse effects. Complex public health programmes that taking into account special socio-cultural environment and lower formal education level of the Roma are needed.

Text Message Support for Smoking Cessation During Ramadan: A Focus Group Study With Somali Immigrant Muslim Men.

Somali Muslim male immigrants in Minnesota have a high prevalence of smoking, estimated at 44%, compared with the average smoking rate for adults in the United States (14%). However, the literature has reported spontaneous reductions of smoking during Ramadan. This study sought to gather the views of Somali Muslim men on how faith impacts their smoking, and determine what messaging to incorporate into a tailored text messages intervention that draws on the Muslim faith beliefs and practices during Ramadan to promote smoking cessation. Thirty-seven Somali adult male smokers were recruited from community settings to participate in one of five focus groups in Minneapolis and Saint Paul, Minnesota. The research study team developed a semi-structured focus group guide that explored: (1) the experience of Muslim immigrants quitting smoking during Ramadan, (2) views on text messaging interventions to reduce smoking focusing on health and faith, and (3) views on the relationship between faith and smoking. A thematic analysis was conducted. Participants reported reductions in smoking during Ramadan, which was mostly achieved without formal treatment (ie, willpower). There was interest in text messaging interventions that incorporated faith and health-related messages, and that would be delivered around the time of Ramadan. Participants described concerns about the adverse health effects of smoking, including the risk of chronic health issues, cancer, and death. Combining faith and health-related text-based messaging, and tailoring interventions around and beyond Ramadan, maybe a valuable approach to help address smoking disparities in the Somali immigrant community. Ramadan offers a unique window of opportunity to intervene upon smoking for Somali Muslim immigrant men, for whom rates of smoking are high. Combining faith and health-related text-based messaging, and tailoring interventions around and beyond Ramadan, maybe a valuable approach to help address these serious smoking disparities.

Cross-sectional associations of food insecurity with smoking cigarettes and heavy alcohol use in a population-based sample of adults

BackgroundSmoking, alcohol abuse and dual substance use represent significant public health problems and are thought to contribute to significant disparities in morbidity and mortality in the United States. Associations of food insecurity with these substances are poorly characterized, particularly concerning heavy alcohol consumption and dual substance use. Additionally, demographic factors may moderate these associations. MethodsIn a cross-sectional, representative sample of Wisconsin adults (n = 1616), logistic regression was used to examine whether food insecurity was associated with cigarette smoking, heavy alcohol use and dual substance use. Interactions of food insecurity with gender, marital status and age group tested moderation by demographic factors. Principal FindingsFood insecurity was associated with cigarette smoking in men and women (odds ratio (OR) = 3.0, 95% confidence interval (CI) = 2.1–4.4); however, only among men was food insecurity associated with heavy alcohol use (OR = 1.5; 95% CI = 1.0–2.2) and dual substance use (OR = 5.2; 95% CI = 1.5–18.6). Marital status and age group did not moderate associations of food insecurity with substance use. ConclusionsFood insecurity and substance use are highly correlated. Heavy alcohol consumption and dual use were positively correlated with food insecurity among men, but not among women. Longitudinal analyses are needed to disentangle temporality and underlying pathways of observed associations. Additionally, future work should determine whether interventions and policies targeting food insecurity can simultaneously reduce cigarette and alcohol use.

Influence of Smoking on Thyroid Function in Japanese Subjects: Longitudinal Study for One Year of On-Off Smoking.

ContextWe previously identified factors affecting thyroid status, including sex, age, and smoking.ObjectiveIn the current study, we increased the number of subjects examined and investigated the effects of these factors, particularly smoking and the thyroid peroxidase antibody (TPO-Ab), in Japanese patients with euthyroxinemia and serum free T4 levels within the normal range.ParticipantsA total of 12,289 subjects who underwent health checkups were analyzed in a cross-sectional and longitudinal study.ResultsThe mean age of subjects was 50 ± 10 years (age range: 21 to 88 years). Serum TSH levels and the prevalence of positivity for TPO-Ab increased with age in Japanese subjects with euthyroxinemia. Mean serum TSH levels were significantly lower in the smoking group than in the nonsmoking group except for women older than 50 years. Serum TSH levels were significantly higher in subjects with positivity for TPO-Ab than in those with negativity at all ages and in both sexes; however, smoking did not affect free T4 levels or positivity for TPO-Ab. Among men, the rate of smokers was significantly higher in patients with subclinical hyperthyroidism (25%) than in those with subclinical hypothyroidism (10%; P < 0.05). Furthermore, the results of the longitudinal study revealed a significant decrease in serum TSH levels 1 year after the start of smoking in men (P < 0.05).ConclusionBecause smoking appeared to lower serum TSH levels in Japanese subjects with euthyroxinemia, their smoking status warrants careful consideration when evaluating subclinical thyroid function.

P6261Aortic stiffness and carotid intima thickness in hypercholesterolemic males with erectile dysfunction: relation to smoking status and statin therapy

Abstract Purpose Aim of the study was to examine possible differentiation of aortic stiffness and carotid atherosclerosis among hypercholesterolemic patients with erectile dysfunction (ED) according to smoking status and statin therapy. Methods We measured carotid intima-media thickness (cIMT) and carotid-femoral pulse wave velocity (cfPWV) in three age-matched groups of ED patients with a moderate cardiovascular risk (SCORE) and low-density lipoprotein cholesterol (LDL-C) level greater than or equal to 100 mg/dL: Smokers not receiving statin therapy (n=106), Smokers actively under statin treatment for at least three months with no dose adjustment for a minimum of six weeks (n=59) and Non-smokers not receiving statin therapy (n=97). The severity of ED was evaluated with measurements of penile peak velocity (PSV) 20 min after the intracavernous injection of prostaglandin E1 (20 μg). Results The groups of untreated smokers and non-smokers had similar mean LDL-C level. The mean LDL-C of patients under statin therapy was lower, however the differences with the level of the untreated patients was not statistically significant. Overall 33 (56%) of the patients under statin therapy reached their LDL-C goal. Body mass index and the prevalence of hypertension were not different between the three groups. The PSV was significantly lower in smokers with or without therapy compared to that of non-smokers, denoting significant influence of smoking status on the smaller in size penile arteries and consequently, a unfavorable effect on erectile function. Figure illustrates the differences in cfPWV (left plot) and cIMT (right plot) mean (±SE) values between the three groups. Smokers not receiving statin therapy had significantly higher cfPWV compared to the other groups while smokers under statin therapy had no different cfPWV than that of non-smokers not receiving therapy. The cIMT values were not different between the three groups. Smoking, statins and vascular changes Conclusions Smokers ED patients receiving statin therapy exhibited similar atherosclerotic burden compared to untreated hypercholesterolemic individuals, however, the cfPWV was significantly lower, possibly because of the known pleiotropic effects of these drugs on the aortic elastic properties. Although the cross-sectional design precludes drawing conclusions of causal relationships, the findings of this study have important clinical implications given the harmful effect of both hypercholesterolemia and smoking in men suffering from ED and the higher risk for future cardiovascular events that ED confers.

Sex-dependent differences in clinical characteristics and in-hospital outcomes in patients with takotsubo syndrome.

Takotsubo syndrome (TTS) is an acute reversible left ventricular dysfunction, which occurs mainly in postmenopausal women. The goal of this study was to compare the course of the disease and prognoses in men and women with TTS in 2 large Polish university hospitals. The analysis included 232 patients (211 women and 21 men) hospitalized at the 1st Chair and Department of Cardiology at the Medical University of Warsaw and at the 1st Department of Cardiology at the Medical University of Gdańsk. Men who developed TTS were more likely to live alone than women. Physical stress triggered TTS more often in men than in women. There were no differences in the prevalence of risk factors and comorbidities, except for a higher prevalence of smoking in men. With regard to the cardiac biomarkers, both admission and peak levels of N‑terminal prohormone of brain natriuretic peptide were higher in women. ST‑segment depression was found more frequently in men than in women (25% vs 6.2%). Despite the same length of hospitalization, ejection fraction at discharge was lower in men than in women (50% vs 60%). In‑hospital outcomes (arrhythmias, mechanical complications, cardiogenic shock, mortality rate) were similar in both groups. β-Adrenolytics and statins were more often prescribed to women than to men (74.5% vs 52.4% and 68.3% vs 38.1%). Moreover, there was a tendency toward more frequent use of P2Y12 inhibitors in men than in women (23.8% vs 10.4%). Differences occurred in the clinical course of TTS between men and women. However, in‑hospital outcomes were similar in both groups.

Cigarette Smoking and the Risk of Cutaneous Melanoma: A Case-Control Study

Objective: Previous studies regarding cigarette smoking causing a lower risk of melanoma are inconclusive. Here, we re-examined melanoma risk in relation to cigarette smoking in a large, case-control study. Methods: In total 1,157 patients with melanoma diagnosed between 2003 and 2011 in the Netherlands and 5,595 controls from the Nijmegen Biomedical Study were included. Information concerning smoking habits and known risk factors for melanoma were obtained through self-administered questionnaires. Logistic regression analyses stratified by gender were performed to study the risk of cigarette smoking on melanoma risk, adjusted for age, marital status, highest level of education, skin type, sun vacation, use of solarium, time spent outdoors, and sun protective measures. Results: Among men, current and former smokers did not have a higher risk of melanoma compared to never smokers: adjusted odds ratio (OR) = 0.56 (95% confidence interval [CI]: 0.40–0.79) and adjusted OR = 0.50 (95% CI: 0.39–0.64), respectively. With an increasing number of years smoked the risk of melanoma decreased: <20 years: OR = 0.61 (95% CI: 0.46–0.80); 21–40 years: OR = 0.50 (95% CI: 0.37–0.68); >40 years: OR = 0.26 (95% CI: 0.15–0.44). No clear trend was found for the number of cigarettes smoked. Results for females were less clear and not statistically significant (current smoker: adjusted OR = 0.96, 95% CI: 0.74–1.26, former smoker: adjusted OR = 0.89, 95% CI: 0.73–1.08). Conclusion: This study shows a strong inverse association between cigarette smoking and melanoma risk in men. Fundamental laboratory research is necessary to investigate the biological relation between smoking cigarettes and melanoma.