Smoking Tobacco Products Research Articles

Hookah smoking, nass chewing, and oesophageal squamous cell carcinoma in Kashmir, India

Background:Although cigarette smoking is an established risk factor for oesophageal squamous cell carcinoma (ESCC), there is little information about the association between other smoking and smokeless tobacco products, including hookah and nass, and ESCC risk. We conducted a case–control study in Kashmir Valley, India, where hookah smoking, nass chewing, and ESCC are common, to investigate the association of hookah smoking, nass use, and several other habits with ESCC.Methods:We recruited 702 histologically confirmed ESCC cases and 1663 hospital-based controls, individually matched to the cases for age, sex, and district of residence from September 2008 to January 2012. Conditional logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs).Results:Ever-hookah smoking (OR=1.85; 95% CI, 1.41–2.44) and nass chewing (OR=2.88; 95% CI, 2.06–4.04) were associated with ESCC risk. These associations were consistent across different measures of use, including intensity, duration, and cumulative amount of use, and after excluding ever users of the other product and cigarette smokers. Our results also suggest an increased risk of ESCC associated with ever-gutka chewing and -bidi smoking. However, the latter associations were based on small number of participants.Conclusion:This study shows that hookah and nass use are associated with ESCC risk. As prevalence of hookah use seems to be increasing among young people worldwide, these results may have relevance not only for the regions in which hookah use has been a traditional habit, but also for other regions, including western countries.

Targeting cessation: Understanding barriers and motivations to quitting among urban adult daily tobacco smokers

IntroductionMany people continue to smoke tobacco products despite known negative health consequences, including increased risk of chronic disease and death. Disparities exist in rates of smoking and chronic disease, underscoring the importance of understanding the barriers and motivations to smoking cessation among vulnerable populations, such as socioeconomically disadvantaged people of color. MethodsThis study uses data from a cross-sectional randomized household survey conducted in six low-income neighborhoods in New Haven, Connecticut, USA (N=1205). The objectives were to examine barriers and motivations to quitting smoking among daily tobacco smokers (31.6% of respondents) and sociodemographic differences in endorsement of barriers and motivations. ResultsThe two most common barriers to quitting were perceiving it to be too difficult and not wanting to quit. Financial costs, social support, and social influence were themes endorsed highly across both barriers and motivations to quitting. Sociodemographic differences were found, such as women and Black participants being more likely to be interested in a free quitline or quit website; women and Latinos being more likely to be afraid of gaining weight; and women, participants with less education, and older participants being more likely to be concerned about the cost of cessation products. ConclusionsUnderstanding barriers and motivations to quitting among disadvantaged populations is crucial. Financial issues, social support, and social norms should be targeted in promoting cessation among disadvantaged, urban populations. Programs, interventions, and policies can also use research about specific barriers and motivations for sociodemographic sub-groups to be tailored, targeted, and more effective.

An improved high performance liquid chromatography-fluorescence detection method for the analysis of major phenolic compounds in cigarette smoke and smokeless tobacco products

An improved HPLC method has been developed for the determination of major phenolic compounds in cigarette smoke. A novel reversed phase column with a pentafluorophenylpropyl (PFP) ligand in the stationary phase was chosen to separate the positional isomers (p-, m-, and o-cresols). Methanol instead of acetonitrile was used as the organic mobile phase component to improve the separation of the isomers and cope with the crisis of global acetonitrile shortage in 2009. A shorter analytical column with smaller particle size was used to further increase separation efficiency and reduces solvent consumption. These improvements have led to a new HPLC method that is simpler and faster than the GC–MS method and more sensitive, selective and efficient than the widely used traditional HPLC method. The limit of detection (LOD) and limit of quantification (LOQ) of this method are at the ng/mL level for most of the phenols with good linearity (R2≥0.999) and precision (RSD<15%). The method has been validated using reference tobacco products. The mainstream and sidestream cigarette smoke yields of phenolic compounds obtained by this method are comparable to those obtained by traditional HPLC method with the advantage that p-, m-, and o-cresols can be determined and reported separately by the new method. The method can also be applied for analysis of phenols in smokeless tobacco product.

Association of tobacco products use and diabetes mellitus-results of a national survey among adults in saudi arabia.

To compare the tobacco products use patterns of known diabetics and non diabetics. A community-based cross-sectional study using STEPwise approach among adults using a multistage, stratified, cluster random sample. Data was collected using a questionnaire which included sociodemographics; tobacco products use habits, history of diabetes, biochemical and anthropometric measurements. Of the total of 4654 subjects who participated in the study, 1016 (21.8%) were ever smoked tobacco products users and 65 (1.4%) were ever smokeless tobacco products users. Known Diabetes prevalence was 15.3% (712 known diabetics). There were no significant differences in diabetic status and smokeless tobacco products use for both ever and current use. For smoked products diabetics are fewer in current smokers and more in ex smokers. Diabetics started smoking significantly older, smoked for longer duration and higher intensity than non diabetics. Diabetes appears to be associated with smoked but not smokeless tobacco products use.

How smoking became history: looking back to 2012

Geneva, 21 March 2032: As we all know, the work of tobacco control today is focused on reducing the prevalence and harm from non-smoked tobacco products, caring for ex-smokers with...

Tobacco Use Patterns

Tobacco Use Patterns

Effects of passive smoking on children health

Effects of passive smoking on children health Sara Khalid Salih and Bashir Ibrahim Mukhtar moking is the single greatest avoidable cause of disease and death. According to the World Health Organization (WHO), 1.1 billion people worldwide regularly smoke tobacco products and smoking accounts for 10,000 deaths per day due to the effect of smoke on the body. Nonsmokers are at risk because of inhalation of passive smoke, also known as environmental tobacco smoke (ETS). Exposure to passive smoking (ETS) is harmful to the health of the general population and particularly hazardous to children. Passive smoking exposure causes disease and premature death in children and in adults who do not smoke. Researchers found significant dose-dependent associations between passive smoking and chronic obstructive pulmonary disease, stroke, ischemic heart disease, and all forms of cancer, and all respiratory and circulatory diseases. The home is the place where children are most exposed to second hand smoke; where they spend much of their early life in the presence of their parents. Every day more than 15 million children are exposed to smoke in their homes. Children are especially sensitive to the effects, due to the fact that their bodies are still growing and developing and they breathe faster than adults and therefore may inhale more smoke. Children who live in homes where parents smoke have high levels (more than five times) of cotinine (a biological marker of secondhand smoke exposure) than children who have nonsmoking parents. Also children with childhood ETS exposure were more likely to become smokers in adolescent or in adulthood.

Nicotine, Carbon Monoxide, and Carcinogen Exposure after a Single Use of a Water Pipe

Smoking tobacco preparations in a water pipe (hookah) is widespread in many places of the world, including the United States, where it is especially popular among young people. Many perceive water pipe smoking to be less hazardous than cigarette smoking. We studied systemic absorption of nicotine, carbon monoxide, and carcinogens from one water pipe smoking session. Sixteen subjects smoked a water pipe on a clinical research ward. Expired carbon monoxide and carboxyhemoglobin were measured, plasma samples were analyzed for nicotine concentrations, and urine samples were analyzed for the tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and polycyclic aromatic hydrocarbon (PAH) metabolite biomarker concentrations. We found substantial increases in plasma nicotine concentrations, comparable to cigarette smoking, and increases in carbon monoxide levels that are much higher than those typically observed from cigarette smoking, as previously published. Urinary excretion of NNAL and PAH biomarkers increased significantly following water pipe smoking. Absorption of nicotine in amounts comparable to cigarette smoking indicates a potential for addiction, and absorption of significant amounts of carcinogens raise concerns of cancer risk in people who smoke tobacco products in water pipes. Our data contribute to an understanding of the health impact of water pipe use.

Commentary on Etter &amp; Bullen (2011): Could E-cigs become the ultimate nicotine maintenance device?

Commentary on Etter &amp; Bullen (2011): Could E-cigs become the ultimate nicotine maintenance device?

EFFECTS OF PRENATAL AND POSTNATAL TOBACCO SMOKE EXPOSURE ON THE DEVELOPMENT OF ASTHMA AND WHEEZING: A POPULATION-BASED SIX-YEAR COHORT STUDY

Background: Exposure to tobacco smoke products has been associated with many harmful effects in children. Previous studies have suggested that maternal smoking during pregnancy has stronger impact ...

International Olympic Committee consensus statement on the health and fitness of young people through physical activity and sport

Lung cancer is the most frequent malignant neoplasm in most countries, and the main cancer-related cause of mortality worldwide in both sexes combined. The geographic and temporal patterns of lung...

It’s time to rethink mite allergen avoidance

The role of allergen exposure in the etiology of allergic sensitization and asthma is complex. Advice on strategies to avoid domestic allergens remains contentious because trials of interventions aimed to prevent asthma or reduce symptoms have often failed to demonstrate benefits. Asthma management guidelines differ widely in their recommendations, while Web-based information often claims benefits associated with products. In this rostrum we argue that although many factors have a role in both the etiology and the exacerbation of asthma, allergen exposure probably remains an important contributor to the manifestations of the disease. Currently, there is no evidence-based framework for effective domestic allergen avoidance interventions to reduce chronic aeroallergen exposure. The development of an effective approach to allergen avoidance requires a better understanding of (a) the physical nature of chronic aeroallergen exposure and methods for measuring and reducing this, (b) the interaction between allergen exposure and innate immune modulators at different disease stages, and (c) markers enabling the identification of individuals who would benefit from this. The strategic risk of overemphasizing other novel mechanisms and approaches to asthma management is that we will prematurely abandon and fail to improve an existing approach that could have a significant impact on the development, progression, and symptoms of the disease.

What You Need to Know If You Have Coronary Artery Disease

If your doctor has told you that you have coronary artery disease, or if your doctor has told you that you are at increased risk for developing atherosclerosis (commonly called hardening of the arteries), then this Patient Page is for you. Why does atherosclerosis develop in the first place? This disease is often the result of many factors. The 5 most important risk factors are (1) tobacco smoking, (2) diabetes mellitus, (3) a familial tendency to develop this condition, (4) high blood pressure, and (5) an abnormally high cholesterol level in the blood. Other problems that contribute to the development of atherosclerosis include a sedentary lifestyle, obesity, and psychological stress. Atherosclerosis can lead to anginal complications (chest discomfort), heart attack, stroke, or peripheral vascular disease. Doctors are frequently asked, “I understand that I have hardening of the arteries. What can I do to slow the progression of this disease or even reverse this unhealthy process?” Answers to this question are listed below and inTable 1.1,2 View this table: Table 1. Recommended Lifestyle Changes for Patients With Atherosclerosis Including Heart Attacks 1. You must stop smoking tobacco products. Tobacco smoke and especially cigarette smoke are poisonous. Chemicals in this smoke damage the arteries that carry blood to all organs. Patients who continue to smoke after they have already developed atherosclerosis are at great …

Cigar and pipe smoking, smokeless tobacco use and pancreatic cancer: an analysis from the International Pancreatic Cancer Case-Control Consortium (PanC4)

BackgroundCigarette smoking is the best-characterized risk factor for pancreatic cancer. However, data are limited for other tobacco smoking products and smokeless tobacco. Materials and methodsWe conducted a pooled analysis of cigar and pipe smoking and smokeless tobacco use and risk of pancreatic cancer using data from 11 case–control studies (6056 cases and 11338 controls) within the International Pancreatic Cancer Case-Control Consortium (PanC4). Pooled odds ratios (OR) and the corresponding 95% confidence intervals (CI) were estimated by unconditional multiple logistic regression models adjusted for study center and selected covariates. ResultsCompared with never tobacco users, the OR for cigar-only smokers was 1.6 (95% CI: 1.2–2.3), i.e. comparable to that of cigarette-only smokers (OR 1.5; 95% CI 1.4–1.6). The OR was 1.1 (95% CI 0.69–1.6) for pipe-only smokers. There was some evidence of increasing risk with increasing amount of cigar smoked per day (OR 1.82 for ≥ 10 grams of tobacco), although not with duration. The OR for ever smokeless tobacco users as compared with never tobacco users was 0.98 (95% CI 0.75–1.3). ConclusionThis collaborative analysis provides evidence that cigar smoking is associated with an excess risk of pancreatic cancer, while no significant association emerged for pipe smoking and smokeless tobacco use.

13C2]- Acetaldehyde Promotes Unequivocal Formation of 1,N2-Propano-2′-deoxyguanosine in Human Cells

Acetaldehyde is an environmentally widespread genotoxic aldehyde present in tobacco smoke, vehicle exhaust and several food products. Endogenously, acetaldehyde is produced by the metabolic oxidation of ethanol by hepatic NAD-dependent alcohol dehydrogenase and during threonine catabolism. The formation of DNA adducts has been regarded as a critical factor in the mechanisms of acetaldehyde mutagenicity and carcinogenesis. Acetaldehyde reacts with 2'-deoxyguanosine in DNA to form primarily N(2)-ethylidene-2'-deoxyguanosine. The subsequent reaction of N(2)-ethylidenedGuo with another molecule of acetaldehyde gives rise to 1,N(2)-propano-2'-deoxyguanosine (1,N(2)-propanodGuo), an adduct also found as a product of the crotonaldehyde reaction with dGuo. However, adducts resulting from the reaction of more than one molecule of acetaldehyde in vivo are still controversial. In this study, the unequivocal formation of 1,N(2)-propanodGuo by acetaldehyde was assessed in human cells via treatment with [(13)C(2)]-acetaldehyde. Detection of labeled 1,N(2)-propanodGuo was performed by HPLC/MS/MS. Upon acetaldehyde exposure (703 μM), increased levels of both 1,N(2)-etheno-2'-deoxyguanosine (1,N(2)-εdGuo), which is produced from α,β-unsaturated aldehydes formed during the lipid peroxidation process, and 1,N(2)-propanodGuo were observed. The unequivocal formation of 1,N(2)-propanodGuo in cells exposed to this aldehyde can be used to elucidate the mechanisms associated with acetaldehyde exposure and cancer risk.

Prevalence of Tobacco Use and Physical Activity among Adult Sierra Leonean Population

The current burden of non-communicable diseases (NCDs) and their risk factors such as tobacco use and physical inactivity remain largely unknown in Sierra Leone. Thus, this study was conducted to document the prevalence of tobacco use and physical activity among the adult Sierra Leonean population with a specific objective of determining the sex and age prevalence. A cross sectional population based survey utilising the multi-stage cluster sampling strategy was used. A total of 5,483 individuals aged 25-64 years of both sexes were recruited into the survey. The World Health Organisation (WHO) STEPwise approach to surveillance instrument was adapted and questionnaire was administered to one individual in selected household. The data was analysed and graphed using Epi-Info software version 3.4.3 and graph pad prism version 5.1 respectively. The analyses showed that 34% of the respondents use tobacco products with 26% engaged in smoking tobacco products and 8% were smokeless tobacco users at the time of this study. The average age of commencing tobacco smoking was 21 years; with 92% and 96% of the male and female daily smokers smoking at least six manufactured tobacco respectively. Seventy four percent (74%) and 69% of the non-smoking respondents were exposed to environmental tobacco smoke (ETS) at home and workplace respectively. The study further revealed that 15%, 23% and 87% of the total respondents reported no work-, transport- or recreational- related physical activity respectively; and were therefore classified as physically inactive. The lowest level of physical activity was reported in the recreation domain. Even those who reported moderate physical activity at work or from travel, their median metabolic equivalent (MET) was not sufficient to achieve a level of physical activity that is beneficial to their health. In conclusion, a significant proportion of the population is exposed either directly or indirectly to tobacco smoke, and a large proportion of the adult population is physically inactivity. Thus, NCD prevention policy addressing lifestyle changes such as no smoking should not be limited to work places but should be population based. Keywords: Non-communicable diseases, Physical activity, Risk factors, Sierra Leone, Tobacco

Cigarette Smoke, Bacteria, Mold, Microbial Toxins, and Chronic Lung Inflammation

Chronic inflammation associated with cigarette smoke fosters malignant transformation and tumor cell proliferation and promotes certain nonneoplastic pulmonary diseases. The question arises as to whether chronic inflammation and/or colonization of the airway can be attributed, at least in part, to tobacco-associated microbes (bacteria, fungi, and spores) and/or microbial toxins (endotoxins and mycotoxins) in tobacco. To address this question, a literature search of documents in various databases was performed. The databases included PubMed, Legacy Tobacco Documents Library, and US Patents. This investigation documents that tobacco companies have identified and quantified bacteria, fungi, and microbial toxins at harvest, throughout fermentation, and during storage. Also characterized was the microbial flora of diverse smoking and smokeless tobacco articles. Evidence-based health concerns expressed in investigations of microbes and microbial toxins in cigarettes, cigarette smoke, and smokeless tobacco products are reasonable; they warrant review by regulatory authorities and, if necessary, additional investigation to address scientific gaps.

Prenatal IV nicotine exposure produces a sex difference in sensorimotor gating of the auditory startle reflex in adult rats

Maternal smoking during pregnancy is associated with auditory processing deficits in children; these effects have been confirmed with animal models of continuous high-dose prenatal nicotine exposure. The present experiments utilized a novel, low-dose, intermittent, intravenous (IV) gestational nicotine exposure model to investigate potential deficits on the preattentive process of sensorimotor gating, as indexed by prepulse inhibition (PPI), in preweanling and adult rat offspring. Pregnant dams received bolus IV injections of nicotine (0.05mg/kg/injection) 3×/day on gestational days 8–21. Auditory and tactile stimulus modalities were probed with tone and air puff prepulse stimuli, respectively. These prepulse stimuli preceded a 100dB(A) startle tone by six different interstimulus intervals (ISIs; 0, 8, 40, 80, 120, 4000ms) to define a curve of response inhibition. The magnitude of PPI increased with age, from 59 to 81% inhibition. Preweanlings (PNDs 14 and 18) and adults (PND 75) gestationally exposed to nicotine exhibited altered startle responding relative to controls, but the nature of the deficit became more localized at later ages. The entire curve of response inhibition in preweanlings exposed to prenatal nicotine (PND 14) was shifted up relative to controls, and notably, did not interact with prepulse stimulus modality, suggesting a generalized increased sensorimotor responsiveness as a function of prenatal nicotine. At PND 18, a shift in the response curve across all ISIs was again noted, but varied as a function of prepulse stimulus modality; the increased sensorimotor responsiveness was specific to the auditory, but not tactile, sensory modality. In adulthood, male and female animals prenatally exposed to nicotine were differentially sensitive to modulation by the ISIs, relative to control male and female animals. Specifically, despite robust PPI, adult females exposed to gestational nicotine were relatively insensitive to changes in ISI from 8 to 120ms; in contrast, the robust PPI of nicotine-exposed males demonstrated a clear focal point of inhibition at 40ms. These findings indicate that a low, daily dosing of IV prenatal nicotine produces long-lasting alterations in auditory PPI. An important implication of this research is that “chipping” with smoked-tobacco products during pregnancy may produce enduring changes in sensorimotor processing.

Smoking in the Workplace in South Africa: Law and Practice Relating to the Rights and Obligations of Employers and Employees

South Africans have a high prevalence of smoking. The preamble to the Tobacco Products Control Act, which regulates the production, marketing, advertising, selling and smoking of tobacco products in public places, acknowledges that tobacco use ‘is extremely injurious to the health of smokers, non-smokers and other users of tobacco products’; ‘has caused widespread addiction in society’; and ‘warrants, in the public interest, a restrictive legislation’. One of the objectives of the Tobacco Products Control Act is to regulate the circumstances in which tobacco products can be used in public places, including workplaces. The Act makes smoking in a public place an offence and obliges employers who still allow smoking in the workplace to provide designated smoking areas. However, the Act also empowers employers to ban smoking totally at workplaces. This paper highlights the provisions and regulations relating to smoking in workplaces and discusses the reported cases in which the various bargaining council arbitrators have dealt with the issue of employers’ and employees’ rights in cases relating to smoking at workplaces.

The role of parents, friends and teachers in adolescents' cigarette smoking and tombak dipping in Sudan

ObjectiveTo assess the influence of smoking and tombak (local smokeless tobacco) dipping by parents, teachers and friends on cigarette smoking and tombak dipping by school-going Sudanese adolescents.MethodsThis was a school-based...