Smoking In Smokers Research Articles

The effect of snus on alcohol-related cigarette administration in dependent and non-dependent smokers

IntroductionAlcohol has been found to increase tobacco smoking in both dependent daily smokers (DDS) and nondependent nondaily smokers (NNS), yet little attention has been directed toward examining how different treatments/products modify drinking-related smoking behavior. MethodsThis study examined the acute effects of snus (4mg of nicotine) on alcohol-related smoking responses in 18 DDS and 17 NNS. During each double-blind session, participants were randomly assigned to receive one of the following combinations: alcohol and snus, alcohol and placebo snus, placebo alcohol and snus, or placebo alcohol and placebo snus. Participants consumed their assigned beverage before absorbing their session's product, and after 30min participants could self-administer puffs of their preferred brand of cigarette over a 60-minute period using a progressive ratio task. ResultsAlcohol significantly increased tobacco craving (p<.001) and tended to decrease latency to start smoking (p=.021) but only among NNS. In contrast, snus tended to decrease the number of puffs earned and how hard DDS worked for puffs in both beverage conditions (ps≤.019) but it did not alter the smoking behavior of NNS. Craving was not significantly impacted by snus in either type of smoker. DiscussionThese findings raise the possibility that different processes mediate alcohol and cigarette co-use in NNS and DDS and suggest that snus may be effective in reducing alcohol-related cigarette use in DDS specifically.

Effects of the opioid receptor antagonist naltrexone on smoking and related behaviors in smokers preparing to quit: a randomized controlled trial

To determine if naltrexone affects smoking behaviors in smokers preparing to quit, and whether or not such pre-quit responses predict post-quit date outcomes. Double-blind, placebo-controlled, randomized study. The current study focused on smoking-related outcomes in the pre-quit phase, which was 1 week prior to the quit date, and these findings were linked with reductions in the same outcomes demonstrated in the post-quit phase published previously for this randomized controlled trial (RCT) in mediation analyses. Community sample of adult smokers desiring to quit in Chicago, Illinois, USA. Participants were 315 smokers randomized to naltrexone (n = 161; mean age = 42.58 years; 60% Caucasian) or placebo (n = 154; mean age = 41.32 years; 55% Caucasian). The difference from baseline in the number of cigarettes smoked during the pre-quit phase interval was the primary outcome. Secondary pre-quit outcomes were assessed using Likert scales of subjective responses and consumption of cigarettes, alcohol and food. Number of cigarettes smoked, alcoholic drinks consumed and the Brief Questionnaire of Smoking Urges were assessed in the post-quit phase. Relative to placebo, naltrexone decreased the number of cigarettes smoked (-4.21 versus -2.93, P < 0.05), smoking urge (P = 0.02) and number of alcoholic drinks consumed (P = 0.04). Exploratory mediation analyses linking outcomes of the pre-quit and post-quit phases found that naltrexone's effects on reducing smoking urge, cigarettes smoked and alcoholic drinks consumed in the pre-quit phase demonstrated full mediation of their respective effects during the post-quit phase. Naltrexone taken in the week before a quit attempt reduces cigarette consumption, urges to smoke and alcohol consumption relative to placebo. The size of the effect mediates statistically the size of similar effects after the quit date.

Introduction effects of the Australian plain packaging policy on adult smokers: a cross-sectional study

ObjectiveTo determine whether smokers smoking from packs required under Australia's plain packaging law had different smoking beliefs and quitting thoughts, compared with those still smoking from branded packs.DesignCross-sectional survey during...

Cigarette Smoking Is Associated with Human Semen Quality in Synergy with Functional NRF2 Polymorphisms1

Although cigarette smoking is considered a major risk factor for several human diseases, the effects of smoking on male fertility are controversial. Studies on the consequences of smoking, which also take into account genetic background, may facilitate understanding of the interactions between genes and smoking and their effects on male fertility. In this study, genetic variants of two functional polymorphisms of erythroid 2-related factor 2 (NRF2), mRNA expression levels of the antioxidant gene NRF2, catalase (CAT), superoxide dismutase isoenzyme-2 (SOD2), glutathione S-transferase-M1 (GSTM1), and seminal SOD activities were compared in 314 heavy smokers and 314 matched nonsmokers. The NRF2 rs6721961 TT genotype was found to be associated with low semen quality in heavy smokers (OR [95% CI] = 2.370 [1.106-5.081]). This variant genotype was found more frequently in heavy smokers with low semen quality than in those with high semen quality (P = 0.011). Heavy smokers with this genotype had significantly lower sperm concentrations and sperm counts (P < 0.05) when compared with those without this genotype. Smoking was also significantly associated with decreased seminal SOD activity (P < 0.05) and reduced NRF2 and SOD2 mRNA expression in heavy smokers with this variant genotype. These results were specific to heavy smokers with the NRF2 rs6721961 TT genotypes, but did not apply to nonsmokers or heavy smokers that did not carry this genotype. This study suggests an association between cigarette smoking in heavy smokers with NRF2 rs6721961 TT genotype and a decrease in semen quality.

PRS35 - Beliefs In Effectiveness Of Various Smoking Cessation Interventions Among Jordanian Adult Smokers

Background: Formal smoking cessation interventions including pharmacologic and behavioral interventions have been well known among Chinese smokers, however, the utilization of such interventions is not widely adopted. Lack of belief in the effectiveness of these interventions may be a probable reason. The objective of this study was to identify potential predictors affecting smokers’ beliefs in the effectiveness of smoking cessation interventions among Chinese adult smokers. Methods: A self-reported survey was distributed using convenience sampling among adult smokers over 18 years at two sites in China. Potential predictors, including socio-demographic characteristics, health conditions, and addiction level that affect smokers’ beliefs in the effectiveness of either pharmacologic or behavioral smoking cessation interventions were explored using multivariate logistic regression. Results: A total of 365 smokers were identified and considered as cohort in this analysis. Higher income ($450/ month or more vs. less than $450) (odds ratio (OR): 3.05, 95% confidence interval (CI): 1.38-6.72), studying in private schools (OR: 4.87, 95% CI: 1.06-22.39) and preferring to inhale when smoking (OR: 1.95, 95% CI: 1.07-3.57) were associated with having beliefs in the effectiveness of pharmacological products. Heavy smokers (smoke 20 cigarettes/ day or more vs. less than 20) (OR: 0.36, 95% CI: 0.18-0.71) and age group (≥40 years old vs. 18-40 years old) (OR: 0.36, 95% CI: 0.18-0.72) were negatively associated with having beliefs in the effectiveness of behavioral methods. Conclusions: The rates of believing in the effectiveness of various smoking cessation interventions among Chinese adult smokers ranged from approximately 30% to 60%. The utilization of formal cessation interventions including both pharmacologic and behavior methods can be limited by smokers’ beliefs which should be considered when choosing a smoking cessation intervention.

Evaluation of probable specific immunotoxic effects of cigarette smoking in smokers

Tobacco smoking is one of the most potent and prevalent addictive habits, influencing the behavior of human beings for over four centuries. It is not surprising that immunological studies on the effect of cigarette smoking on the human immune system are rather rare. This cross-sectional, parallel group study was performed at the King Khaled Hospital between May and November 2010. Thirty current smokers (16 males and 14 females), aged 18–41years were included. The level of IFN-γ, IgG and IgM in serum along with the T-lymphocyte subset (CD4+, CD8+ and CD16+) percentage was assessed. Systemic exposure to nicotine was assessed by a radioimmunoassay (RIA) with a double antibody for cotinine. The results revealed a decrease in the total leukocyte count, decrease in the CD4+ levels with a significant decrease of CD4+/CD8+ ratio along with a decrease in natural killer CD16+ level of both groups of cigarette smokers and a significant decrease in the IgG level and increase in the IFN-γ level. The findings suggest that CD4+, CD8+, CD16+, IgG, IgM and IFN-γ are sensitive to the cumulative chronic effect of smoking because they can affect both innate and adaptive immunity and may serve as a potential immuno-biomarker for active smoking. The current review underlines the importance of smoking prevention and eradication not only for its ordinary disorders but also for its autoimmune disorders as well.

Acute effects of cigarette smoking in habitual smokers, a focus on endothelial function

Abstract Background The chronic effect of cigarette (cig.) smoking is well established. The acute effect of smoking abolishes the concept, argued by heavy smokers, to decrease the number of smoked cigarettes instead of quitting. Aim To detect the acute effects of cigarette smoking and the duration of these effects. Patients and methods Thirty four smokers (age 21–35 years) were studied at 3 occasions; 9 h after the last cig. smoking, 5 min after one cig. smoking and 30 min after 3 cig. smoking within 30 min. They were subjected to measurement of both ventricular functions using standard and tissue Doppler imaging (TDI), aortic distensibility, stiffness and endothelial function assessment by endothelium-dependent flow-mediated dilatation (FMD) and maximum vasodilatation. Results After one cigarette smoking, we found a statistically significant effect on blood pressure, Heart Rate, FMD percent, Dilation Ratio, aortic distensibility (P = 0.007), and aortic stiffness index (ASI) (P = 0.01). Furthermore the LV diastolic function was significantly impaired after smoking. Despite disappearance of acute effect of 3 cig. smoking within 30 min on blood pressure, Heart Rate and aortic distensibility, a significant difference was still found as regards FMD percent and dilation ratio denoting the extension of the endothelial dysfunction for more than 30 min after the last cigarette. Conclusion Many acute changes occur following one cigarette smoking even in habitual smokers. Persistence of endothelial dysfunction parameters after smoking indicates the failure of circulation adaptation in response to such offense that might contribute to the precipitation of acute events in vulnerable patients.

Comparison of age at natural menopause in BRCA1/2 mutation carriers with a non–clinic‐based sample of women in northern California

Germline mutations in BRCA1 and BRCA2 (BRCA1/2) are related to an increased lifetime risk of developing breast and ovarian cancer. Although risk-reducing salpingo-oophorectomy reduces the risk of both cancers, loss of fertility is a major concern. A recent study suggested an association between BRCA1 mutation and occult primary ovarian insufficiency. The objective of the current study was to determine whether BRCA1/2 mutation carriers have an earlier onset of natural menopause compared with unaffected women. White carriers of the BRCA1/2 gene (n = 382) were identified within the Breast Cancer Risk Program Registry at the University of California at San Francisco and compared with non-clinic-based white women in northern California (n = 765). The 2 groups were compared with regard to median age at the time of natural menopause before and after adjustment for known risk factors, and the role of smoking within each group was examined using the Kaplan-Meier approach for unadjusted analyses and Cox proportional hazards regression analyses for adjusted analyses. The median age at the time of natural menopause in the BRCA1/2 carriers was significantly younger than among the unaffected sample (50 years vs 53 years; P < .001). The unadjusted hazard ratio for natural menopause when comparing BRCA1/2 carriers with unaffected women was 4.06 (95% confidence interval, 3.03-5.45) and was 3.98 (95% confidence interval, 2.87-5.53) after adjusting for smoking, parity, and oral contraceptive use. For BRCA1/2 carriers who were current heavy smokers (smoking ≥ 20 cigarettes/day), the median age at natural menopause was 46 years versus 49 years for nonsmokers (P = .027). The BRCA1/2 mutation was associated with a significantly earlier age at natural menopause, and heavy smoking compounded this risk. Because the relationship between menopause and the end of natural fertility is considered to be fixed, these findings suggest the risk of earlier infertility among BRCA1/2 carriers.

Bronchiolitis in young female smokers

Smoking is a growing concern among young women. However, the pulmonary effects of smoking in young female smokers in their 20's are unknown. The purpose of this study was to determine whether young female smokers demonstrate smoking-related lung abnormalities such as bronchiolitis in their 20's. We recruited young females (20-30 yr) from Izmir, Turkey; 29 smokers and 31 lifetime non-smokers. They were all asymptomatic. All subjects performed complete lung function measurements and underwent thoracic computed tomography (CT) scanning at suspended full inspiration using a Toshiba "Aquilion" multi-slice CT scanner. The CT images were analyzed using custom software (Emphylx-J) and published equations to calculate total lung volume, mean lung density, lung mass, and the extent of emphysema. CT images were also read semi-quantitatively for respiratory bronchiolitis and emphysema by 2 experienced chest radiologists. When there was substantial difference in scoring, a 3rd (independent) radiologist read the CT scans. Plasma biomarkers of smoking were also measured in these subjects. Although none of the subjects demonstrated emphysema on CT images, 41% of smokers (compared with only 15% of non-smokers) had evidence for respiratory bronchiolitis (with a score of 2 or more; p=0.0301). There was a significant relationship between pack-years of smoking and the severity of respiratory bronchiolitis in smokers. Plasma interleukin (IL)-6 levels were also higher in smokers than in non-smokers (p=0.028). Quantitative analysis for emphysema or airways disease on CT scans did not reveal any significant differences in the two groups with the exception of lung mass, which was higher in the smokers than in non-smokers. Lung function was similar between the two groups. Young female smokers in their 20's and 30's demonstrate CT changes consistent with respiratory bronchiolitis and elevated plasma IL-6 levels. They also have "heavier" lungs compared with lifetime non-smokers. These data indicate that pathologic changes of smoking occur early in young female smokers in the absence of demonstrable airflow limitation or symptoms. Public health efforts to curb smoking in young women are clearly needed to reduce the burden of smoking related lung disease in women.

Clinical relevance of plasma miR-106b levels in patients with chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is characterized by both chronic inflammation in the airway and systemic inflammation; however, the molecular mechanism of COPD has not been fully elucidated. By measuring microRNA (miRNA) expression in the plasma of COPD subjects, we aimed to identify the clinical relevance of plasma miRNA levels in these patients. Blood samples were obtained from COPD patients and age-matched normal controls. We initially produced plasma miRNA expression profiles using TaqMan low-density array screening. For further validation, individual qRT-PCRs were performed in 40COPD patients and 20 healthy subjects. TaqMan low-density array screening showed that 9miRNAs (miR-29b, miR-483-5p, miR-152, miR-629, miR-26b, miR-101, miR-106b, miR-532-5p and miR-133b) were significantly downregulated in the plasma from COPD patients when compared with normal smokers. Among these miRNAs, we focused on miR-106b. A reduction in the plasma miR-106b levels was evident in COPD ex-smokers and COPD current smokers compared with levels in smokers. There was a negative correlation between the plasma miR-106b level and the duration of disease since diagnosis in COPD ex-smokers and the duration of smoking in COPD current smokers. These findings support the concept that progressive reduction in the plasma miR-106b level may reflect persistent and systemic changes even after the discontinuation of smoking in COPD patients. miR-106b may therefore play an important role in the pathogenesis of COPD.

Serum mineral status of long-term cigarette smokers

This study was carried out to investigate comparatively some serum mineral levels of cigarette smokers. A total of 25 nonsmokers (control group) and 50 long-term cigarette smokers (smoking for at least 15years; smoker group) were participated in the study. Subjects were between 25 and 40years old. Control and smoker groups were matched for age, sex and body mass index status. The blood samples were taken from smokers and nonsmokers after 12h of fasting period. The levels of zinc (Zn), copper (Cu), iron (Fe), magnesium (Mg), calcium (Ca), potassium (K), chlorine (Cl), sodium (Na) and phosphorus (P) were measured by autoanalyzer using commercial kits. Student's t test was used to compare the control and smoker groups, and p<0.05 indicated a significant difference. Pearson's correlation coefficient was used to demonstrate the relationship among parameters in smoker and control groups. Although there was no statistical difference (p>0.05) between the groups regarding the levels of K, P, Mg, Na, Cl, Zn, Fe, Ca and Cu, some positive correlations were observed in controls but not in smokers. Therefore, it was concluded that smoking does not affect the serum mineral levels. However, it may negatively affect some important positive correlations among minerals observed in healthy individuals.

Effect of active smoking on glucose tolerance and lipid profile

Background: The acute effects of cigarette smoking in smokers include dyslipidemia and impaired insulin action that leads to abnormal glucose metabolism. Both dyslipidemia and insulin resistance are well-established major risk factor for cardiovascular disease. Aims & Objective: To ascertain the prevalence of several degrees of glucose abnormalities in smokers and to assess the impact of active tobacco smoking on lipids profile in adult male population. Material and methods: A cross-sectional study was conducted with one hundred and fifty two active adult male smokers defined by persons smoking cigarettes over 2 pack years and fifty age and Body Mass Index (BMI) matched healthy control. Smokers were classified into mild to moderate (Group I) and severe (Group II) based on the number of pack years as 2 – 10 and more than 10 respectively. Glucose tolerance was assessed according to American Diabetes Association (ADA) guidelines and standard methods were adopted to check the lipid levels. Data analyses were performed with the SPSS 15.0 statistical software. Results: An abnormal glucose metabolism was diagnosed in 66% (95% confidence interval [CI], 61.4%-71.6%) of the smokers. The mean HOMA-IR (Homeostasis model assessment-insulin resistance) in smokers was 6.8 + 3.1. Decreasing glucose tolerance was associated with insulin resistance i.e. from normal glucose tolerance condition through IGT, IFG to diabetic, the HOMA IR progressively increased (4.9 + 2.1, 6.7 + 4.2, 7.4 + 3.1 and 8.9 + 3.7 respectively). Atherogenic index as indicated by total cholesterol/HDL cholesterol and LDL cholesterol/HDL cholesterol ratio was significantly elevated in both the smoker groups as compared to non-smokers. According to the Adult Treatment Program III criteria, the metabolic syndrome was diagnosed in 44.07% (95% CI, 35.9%-47.3%) of the smokers. In fact only 10 participants (6%, 95% CI, 5.4% - 7.1%) showed good control of cardiovascular risk factors. Conclusion: Abnormalities in lipid profile and glucose tolerance are directly correlated with smoking pack years in this study. Intense education program about adverse health events of smoking should be under taken through all means.

The Effect of Chronic Smoking on the Pupil and Photostress Recovery Time

Purpose: To determine the effect of chronic smoking on the pupil and photostress recovery time. Methods: Macular adaptation to photostress condition, and mesopic and photopic pupillary responses were measured using automated perimetry (Humprey®), and an OPD device (Nidek), respectively. Forty heavy smokers (smoking ≥1 box/day for the past 5 years at least), and 40 age- and sex-matched nonsmokers were enrolled. All the subjects had full vision and no ocular problems. Results: The baseline foveal threshold value (FTV) before photostress was similar in both groups (p = 0.75). Although photostress recovery times (7.1 ± 1.1 and 7.4 ± 1.3 min) were similar in smokers and nonsmokers (p = 0.30), FTV measured at the first minute after photostress was statistically higher in smokers (36.05 ± 0.98 dB) than nonsmokers (34.7 ± 1.03 dB; p = 0.018). Scotopic pupil sizes in smokers (6.73 ± 0.82 mm) and nonsmokers (6.55 ± 0.62 mm) were similar (p = 0.28); however, photopic pupil size in smokers (5.36 ± 0.73 mm) was different from nonsmokers (4.73 ± 0.58 mm; p = 0.001). Conclusions: Chronic smoking may dilate the pupil, and increases macular FTV immediately after photostress.

Increased genetic vulnerability to smoking at CHRNA5 in early-onset smokers.

Recent studies have shown an association between cigarettes per day (CPD) and a nonsynonymous single-nucleotide polymorphism in CHRNA5, rs16969968. To determine whether the association between rs16969968 and smoking is modified by age at onset of regular smoking. Primary data. Available genetic studies containing measures of CPD and the genotype of rs16969968 or its proxy. Uniform statistical analysis scripts were run locally. Starting with 94,050 ever-smokers from 43 studies, we extracted the heavy smokers (CPD >20) and light smokers (CPD ≤10) with age-at-onset information, reducing the sample size to 33,348. Each study was stratified into early-onset smokers (age at onset ≤16 years) and late-onset smokers (age at onset >16 years), and a logistic regression of heavy vs light smoking with the rs16969968 genotype was computed for each stratum. Meta-analysis was performed within each age-at-onset stratum. Individuals with 1 risk allele at rs16969968 who were early-onset smokers were significantly more likely to be heavy smokers in adulthood (odds ratio [OR] = 1.45; 95% CI, 1.36-1.55; n = 13,843) than were carriers of the risk allele who were late-onset smokers (OR = 1.27; 95% CI, 1.21-1.33, n = 19,505) (P = .01). These results highlight an increased genetic vulnerability to smoking in early-onset smokers.

The relationship of dysthymia, minor depression, and gender to changes in smoking for current and former smokers: Longitudinal evaluation in the U.S. population

BackgroundAlthough data clearly link major depression and smoking, little is known about the association between dysthymia and minor depression and smoking behavior. The current study examined changes in smoking over 3years for current and former smokers with and without dysthymia and minor depression. MethodsParticipants who were current or former daily cigarette smokers at Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions and completed the Wave 2 assessment were included in these analyses (n=11,973; 46% female). Analyses examined the main and gender-specific effects of current dysthymia, lifetime dysthymia, and minor depression (a single diagnostic category that denoted current and/or lifetime prevalence) on continued smoking for Wave 1 current daily smokers and continued abstinence for Wave 1 former daily smokers. ResultsWave 1 current daily smokers with current dysthymia (OR=2.13, 95% CI=1.23, 3.70) or minor depression (OR=1.53, 95% CI=1.07, 2.18) were more likely than smokers without the respective diagnosis to report continued smoking at Wave 2. Wave 1 former daily smokers with current dysthymia (OR=0.44, 95% CI=0.20, 0.96) and lifetime dysthymia (OR=0.37, 95% CI=0.15, 0.91) were less likely than those without the diagnosis to remain abstinent from smoking at Wave 2. The gender-by-diagnosis interactions were not significant, suggesting that the impact of dysthymia and minor depression on smoking behavior is similar among men and women. ConclusionsCurrent dysthymia and minor depression are associated with a greater likelihood of continued smoking; current and lifetime dysthymia are associated with a decreased likelihood of continued smoking abstinence.

Young adult perceptions of smoking in outdoor park areas

PurposeSmoking restrictions in recreational settings are established to promote anti-smoking norms and reduce exposure to secondhand smoke. Outdoor smoke-free policies are increasing, yet little is known about the perceptions of such restrictions. MethodsData were collected from a population-based sample of young adults (n=2289) in upper Midwestern United States. Cross-sectional multivariate logistic regression was used to assess predictors of the perceived difficulty to smoke in outdoor park areas. ResultsLiving in an area with a smoke-free park policy was associated with a 1.4 times higher odds of perceiving difficulty to smoke compared to those living in an area without such a policy, after controlling for past month smoking, physical activity, age, and gender. Both smokers and non-smokers living in an area with a smoke-free park policy had higher odds of perceiving difficulty to smoking in park areas (OR=1.6 and 1.3 respectively) compared to smokers and non-smokers living in areas without such policies. ConclusionBanning smoking in park areas was associated with a heightened perception of difficulty in smoking for young adult smokers and non-smokers.

Expectancies regarding the interaction between smoking and substance use in alcohol-dependent smokers in early recovery.

The purpose of this study was to investigate expectancies regarding the interaction between cigarette smoking and use of alcohol among alcohol-dependent smokers in early recovery, using the Nicotine and Other Substances Interaction Expectancies Questionnaire (NOSIE). Participants were 162 veterans, 97% male, with a mean age of 50 years, enrolled in a clinical trial aimed at determining the efficacy of an intensive smoking cessation intervention versus usual care. At baseline, participants were assessed on measures of smoking behavior, abstinence thoughts about alcohol and tobacco use, symptoms of depression, and smoking-substance use interaction expectancies. In addition, biologically verified abstinence from tobacco and alcohol was assessed at 26 weeks. Participants reported that they expected smoking to have less of an impact on substance use than substance use has on smoking (p < .001). Severity of depressive symptoms was significantly associated with the expectancy that smoking provides a way of coping with the urge to use other substances (p < .01). The expectation that smoking increases substance urges/use was predictive of prospectively measured and biologically verified abstinence from smoking at 26 weeks (p < .03). The results add to our knowledge of smoking-substance use interaction expectancies among alcohol-dependent smokers in early recovery and will inform the development of more effective counseling interventions for concurrent alcohol and tobacco use disorders.

Smoking and prostate cancer risk in young men in Appalachian Kentucky.

e12004 Background: Kentucky has the highest smoking rates in the US, with 25.2% of the adult population considered current smokers compared to 18.4% nationwide (CRC, 2011 statistics), as well as high rates of chronic conditions including diabetes, heart disease, and lung cancer. In particular, the Appalachian area of Kentucky appears to have particularly high rates of both smoking and prostate cancer, beyond what is typical for the state as a whole. Recent data on prostate cancer from the Kentucky State Cancer Registry from 2004-2008 showed an incidence rate of 144 vs. 139.8 per 100,000 for "Appalachia" and Kentucky as a state, respectively. The purpose of this study is to investigate the relationship between smoking and risk of prostate cancer in Appalachian Kentucky. Methods: Data were collected on all prostate cancers diagnosed from 1996-2005 in a large hospital serving the Appalachian region. Data were collected without identifiers. Relevant statistics recorded included age at diagnosis, family history, and smoking status (classified as current smoker, non-smoker, or unknown smoking status). Results: A total of 286 patients with diagnosed prostate cancer were collected. The patients ranged from 45 to 94 years of age at diagnosis (Mean = 71, SD = 9.8). Of the 286, 89 (31.1%) had never smoked, and 94 (32.9%) were current or former cigarette smokers (Mean pack years = 25.4). To control for the age-related increase in cancer risk, patients were separated into two age groups: age 65 and younger (n=86, 30.1%), and older than 65 (n=200, 69.9%). The proportion of the younger group who smoked was significantly greater than that of the older group (44.2% vs. 28%, respectively; p= 0.009, Fischer's exact test). Conclusions: These data suggest that smoking in males younger than 65 is positively associated with an increased risk of prostate cancer in Appalachian Kentucky. Further study is needed to elucidate this relationship, as well as to evaluate any association between smoking severity and Gleason score.

The relationship of major depressive disorder and gender to changes in smoking for current and former smokers: longitudinal evaluation in the US population

Although depression and smoking are correlated highly, the relationship of major depressive disorder (MDD) to smoking cessation and relapse remains unclear. This study compared changes in smoking for current and former smokers with and without current and life-time MDD over a 3-year period. Analysis of two waves of longitudinal data from the National Institute on Alcohol Abuse and Alcoholism's National Epidemiologic Survey on Alcohol and Related Conditions (wave 1, 2001-02; wave 2, 2004-05). Data were collected through face-to-face interviews from non-institutionalized United States civilians, aged 18 years and older, in 50 states and the District of Columbia. A total of 11 973 adults (54% male) classified as current or former daily smokers at wave 1 and completed wave 2. Classification as current or former smokers at wave 1 and wave 2. Smoking status remained stable for most participants. Wave 1 current daily smokers with current MDD [odds ratio (OR) = 1.38, 95% confidence interval (CI): 1.03, 1.85] and life-time MDD (OR = 1.52, 95% CI: 1.15, 2.01) were more likely than those without the respective diagnosis to report continued smoking at wave 2. Wave 1 former daily smokers with current MDD (OR = 0.44, 95% CI: 0.26, 0.76) were less likely to report continued abstinence at wave 2. None of the gender × MDD diagnosis interactions were significant. Patterns of results remained similar when analyses were limited to smokers with nicotine dependence. Current and life-time major depressive disorders are associated with a lower likelihood of quitting smoking and current major depressive disorder is associated with greater likelihood of smoking relapse.

Separate and Combined Effects of Very Low Nicotine Cigarettes and Nicotine Replacement in Smokers with Schizophrenia and Controls

The prevalence of smoking among people with schizophrenia in the United States is about 3 times that of the general population. Novel approaches are needed to reduce rates of smoking-related morbidity and mortality among these smokers. This study used a within-subjects design to investigate the separate and combined effects of sensorimotor replacement for smoking (very low nicotine content [VLNC] cigarettes vs. no cigarettes) and transdermal nicotine replacement (42 mg nicotine [NIC] vs. placebo [PLA] patches) in smokers with schizophrenia (SS; n = 30) and control smokers without psychiatric illness (CS; n = 26). Each session contained a 5-hr controlled administration period in which participants underwent the following conditions, in counterbalanced order: VLNC + NIC, VLNC + PLA, no cigarettes + NIC, no cigarettes + PLA, usual-brand cigarettes + no patches. Next, participants completed measures of cigarette craving, nicotine withdrawal, smoking habit withdrawal, and cigarette subjective effects, followed by a 90-min period of ad libitum usual-brand smoking. Smoking VLNC cigarettes during the controlled administration periods reduced cigarette craving, nicotine withdrawal symptoms, habit withdrawal symptoms, and usual-brand smoking in SS and CS relative to the no cigarette conditions. VLNC cigarettes were well accepted by both groups and did not affect psychiatric symptom levels in SS. Transdermal nicotine significantly reduced cigarette craving but did not affect usual-brand smoking. These findings suggest that reducing the nicotine content of cigarettes to nonaddictive levels may be a promising approach for reducing nicotine dependence among people with schizophrenia.