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PubMed1977

Smoking habits and changes in smoking habits as they relate to chronic conditions and respiratory symptoms.

The relation of smoking to chronic lung disease has been documented in several studies. Several conclusions have been drawn about the type of smoking associated withdisease, including inhalation, filter tip use, and reduction in smoking. These factors were examined in a community epidemiologic study of chronic obstructive lung diseases. It was found that the community population exhibited greater filter tip use and higher rates of exsmoking than often seen elsewhere. Smoking habits and the changes in smoking habits over time were related to physician-diagnosed emphysema and/or chronic bronchitis, but not asthma. Some relation was seen also with present heart trouble. There was dose-relationship to pack-years of smoking in both present and ex-smokers. There were more ex-smokers among males. Most male ex-smokers quit due to symptoms. Ex-smokers were found to have high rates of diagnosed disease but reduced rates of symptoms. The incidence of diagnosed disease was found to be associated with smoking, both in intensity and duration. Changes in smoking over time were found to be correlated with symptomatology.

Adolescent↗
PubMed1990

[Smoking behavior of primary-care clinic patients].

Smoking habits in 1027 patients over the age of 18 in our 2 primary care clinics were surveyed by means of questionnaires which were filled out by 92% of the total population surveyed. 31% of the men and 20% of the women smoked, while 22.9% and 9.5%, respectively, were ex-smokers. The proportion of smokers decreased with increasing age. There was a greater proportion of smokers and of heavy smokers in the Tel Mond clinic in which the patients were of Afro-Asian origin and of lower socio-economic status. In the Herut clinic, in which the patients were of European origin and higher socio-economic status, there were fewer smokers and they had started smoking at an older age. 41% of all smokers expressed a desire to stop smoking. 60.7% of those who had stopped smoking had done so because of some illness or symptom. Very few said they had stopped because of medical advice (1.8%) or anti-smoking propaganda in the media (0.6%). Despite the general reduction in smoking since previous studies, there is need for much more intervention by family physicians.

Adult↗
PubMed1998

Spinal bone density in women using depot medroxyprogesterone contraception.

OBJECTIVE: To determine factors possibly associated with reduced bone density in women using the injectable contraceptive depot medroxyprogesterone acetate. METHODS: In a cross-sectional study, bone mineral density of the lumbar spine was measured by dual energy x-ray absorptiometry in 200 current users of depot medroxyprogesterone acetate who had used this method of contraception for 2-26 years and compared with 350 control subjects. Bone density results are expressed as standard deviation scores (z score). RESULTS: The bone density was significantly lower in depot medroxyprogesterone acetate users (mean z score: -0.65, 95% confidence intervals [CI] -0.80, -0.49, P < .001). Bone density was significantly reduced in nonsmokers and smokers, and there was no significant difference in mean z score between smokers and nonsmokers (mean -0.75 versus -0.58, P=.30). Women who had started depot medroxyprogesterone acetate after the age of 20 years and who had used it for 15 or fewer years had a significantly higher bone density than the remainder of the cohort (mean -0.45 [95% CI -0.62, -0.27] versus -1.02 [95% CI -1.32, -0.73], P < .005). Bone density in depot medroxyprogesterone acetate users was not related to current age, parity, body mass index, calcium intake, or exercise. CONCLUSION: Depot medroxyprogesterone acetate use is associated with a significant reduction in bone density, and although a high proportion of depot medroxyprogesterone users do smoke, the reduction in bone density cannot be explained by smoking. Women who use it for a long time and those who start it before peak bone mass is attained may be at highest risk.

Adolescent↗
PubMed1992

Phase-out filter perforation: effects on human tobacco smoke exposure.

Phase-Out is a mechanical device that dilutes the cigarette smoke stream by mechanically perforating cigarette filters. Machine testing of Phase-Out-treated cigarettes suggested that smoke exposure reductions of 90-95% could be achieved with the device. This study evaluated exposure to carbon monoxide (CO) and nicotine when humans (N = 10) smoked Phase-Out-treated cigarettes under controlled laboratory conditions. Using boost (i.e., change from baseline) measures of constituent exposure, reductions ranging from 30-80% were seen for both nicotine and carbon monoxide. Orderly graded reductions in constituent exposure were observed for both nicotine and carbon monoxide as the number of filter perforations increased from zero to six holes, with no further reduction at the eight-hole condition. Percentage reductions in constituent exposure generally corresponded well to those anticipated from machine testing, indicating that the controlled smoking technology was valid and that the Phase-Out device operated as expected in a human smoking assay. The utility of partial constituent-level reductions is discussed both with regard to lowered health risks of smoking and ease of quitting when partial reduction is used as a gradual weaning preparation for quit attempts.

Adult↗
PubMed1997

Short-term economic and health benefits of smoking cessation: myocardial infarction and stroke.

BACKGROUND: Most analyses of the economic benefits of smoking cessation consider long-term effects, which are often not of interest to public and private policy makers. These analyses fail to account for the time course of the short-run cost savings from the rapid decline in risk of acute myocardial infarction (AMI) and stroke. METHODS AND RESULTS: We estimate the time course of the fall in risk of AMI and stroke after smoking cessation and simulate the impact of a 1% absolute reduction in smoking prevalence on the number of and short-term direct medical costs associated with the prevented AMIs and strokes. In the first year, there would be 924+/-679 (mean+/-SD) fewer hospitalizations for AMI and 538+/-508 for stroke, resulting in an immediate savings of $44+/-26 million. A 7-year program that reduced smoking prevalence by 1% per year would result in a total of 63,840+/-15,521 fewer hospitalizations for AMI and 34,261+/-9133 fewer for stroke, resulting in a total savings of $3.20+/-0.59 billion in costs, and would prevent approximately 13,100 deaths resulting from AMI that occur before people reach the hospital. Creating a new nonsmoker reduces anticipated medical costs associated with AMI and stroke by $47 in the first year and by $853 during the next 7 years (discounting 2.5% per year). CONCLUSIONS: Although primary prevention of smoking among teenagers is important, reducing adult smoking pays more immediate dividends, both in terms of health improvements and cost savings.

Adult↗
PubMed1987

Flotation rest as a smoking intervention.

The present study is an attempt to produce smoking cessation or reduction in persons who smoke cigarettes heavily but are motivated to stop. It makes use of the floating environment as an intervention, coupled with messages designed to shape attitudinal change. Subjects were followed up for twelve months post-intervention. Reduction at 12 month follow-up compares favorably with other interventional techniques, and floats of longer duration appear to be a more effective intervention than shorter floats. Messages did not add to effects found. Control subjects reduced their smoking more than the experimental subjects, suggesting that the procedures used on them were actually more effective interventions.

Adult↗
PubMed2006

Men's constructions of smoking in the context of women's tobacco reduction during pregnancy and postpartum.

Men's smoking is largely under-examined despite research that has consistently linked partner smoking to pregnant women's smoking and smoking relapse in the postpartum. An on-going qualitative study involving 31 couples in Canada exploring the influence of couple interactions on women's tobacco reduction provided the opportunity to examine men's smoking in the context of women's tobacco reduction or cessation during pregnancy and postpartum. Individual open-ended interviews with 20 men who smoked were conducted at 0-6 weeks following the birth of their infants and again at 16-24 weeks postpartum. Constant comparative methods were used along with social constructivist perspectives of fatherhood and gender to guide data analysis and enhance theoretical sensitivity. Four themes emerged in men's accounts of their tobacco use: (1) expressing masculinity through smoking, (2) reconciling smoking as a family man, (3) losing the freedom to smoke, and (4) resisting a smoke-less life. Men's reliance on and commitment to dominant ideals of masculinity seemed to preclude them from viewing their partner's tobacco reduction or cessation for pregnancy as an opportunity for cessation. Expectant and new fathers who smoke, however, may be optimally targeted for cessation interventions because it is a time when men experience discomfort with their smoking and when discontinuities in everyday life associated with the transition to fatherhood and presence of a new baby provide opportunities for establishing new routines. Implications for gender-sensitive smoking cessation interventions are discussed.

Adult↗
PubMed1993

Women's smoking: government targets and social trends.

Hilary Graham reviews the government's targets for a reduction in smoking prevalence among women in the light of the changing patterns of women's smoking. She argues that the targets can not be met unless both policy-makers and health professionals give greater attention to the links between women's smoking and the circumstances of women's lives.

Adolescent↗
PubMed1996

Significant reduction of UVB caused by smoke from biomass burning in Brazil.

Solar UVB radiation, total ozone and the aerosol optical thickness (AOT) of the atmosphere were measured at various sites in Brazil during season of 1995. Smoke from biomass burning caused very significant AOT and up to an 81% reduction in UVB at Cuiabá, hundreds of kilometers from the most widespread burning. Little or no smoke was apparent upwind of the major burning regions at and near Manaus, and UVB was close to the expected values. There is an increased incidence of respiratory, cardiopulmonary and other diseases associated with severe air pollution, but the responsible biological mechanisms are unknown. The bactericidal effects of solar UVB are well known, and significantly reduced UVB resulting from severe air pollution in regions where UVB levels are ordinarily high might enhance the survivability of pathogenic organisms in air and water and on surfaces exposed to sunlight.

Air Pollutants↗
PubMed2002

Epidemiologic trends in esophageal and gastric cancer in the United States.

Use of tobacco, moderate to heavy alcohol ingestion, infrequent consumption of raw fruits and vegetables, and low income accounted for more [figure: see text] than 98% of the SCE rates among both African American and white men and for 99% of the excess incidence among African Americans compared to whites in a case-control study in three areas of the United States [14]. Thus, it is likely that declines in the prevalence of smoking and drinking, especially among men, and increased intake of fresh fruits and vegetables may have contributed to the downward incidence and mortality rate trends reported for SCE. In addition, it seems plausible that obesity, GERD, and possibly reductions in H. pylori prevalence have contributed to the upward trends in ACE rates. Reductions in smoking, improved diet, and reductions in H. pylori prevalence probably have contributed to the consistent reductions observed for NGA. Contributing factors are less clear for the rising incidence rates of GCA during the 1970s and 1980s. These incidence rates have not continued to rise in recent years.

Adenocarcinoma↗
PubMed2004

Cigarette smoking: Evidence to guide measurement.

Smoking cessation programs measure outcomes in terms of abstinence from or reduction in smoking. These outcomes can be measured through self-report by the smoker, through measurement with a biological marker of smoking, or through a combination of both. Consideration of the relative advantages of self-report and biomarker approaches is important in the selection of measurement strategies to evaluate outcomes in smoking cessation interventions. In this article both ways of measuring smoking behavior, self-report and biomarkers of carbon monoxide, cotinine, nicotine, thiocyanate, and alkaloids of nicotine, are explored. Measurement approaches are discussed in light of research evidence and their physiologic bases.

Adolescent↗
PubMed1992

Nocturnal penile tumescence in cigarette smokers with erectile dysfunction.

We examined the relationship between cigarette smoking and erectile physiology in 314 men with erectile dysfunction. All of the men studied were currently cigarette smokers. Evaluations included interviews, physical examinations, and polysomnographic assessment of sleep-related erections. Penile rigidity during nocturnal erection inversely correlated with the number of cigarettes smoked per day. Smoking was also associated with indices of impairment on autonomic function tests and some measures of penile blood pressure. The group of men who smoked the most (more than 40 cigarettes per day) had the fewest minutes of nocturnal tumescence and detumesced fastest. These data are discussed with respect to the results of studies performed in dogs that demonstrated smoking-related reduction in arterial flow and venous restriction. Our findings suggest that smoking may further compromise penile physiology in men experiencing difficulty in maintaining erections long enough for satisfactory intercourse.

Adult↗
PubMed2006

Retail tobacco outlet density and youth cigarette smoking: a propensity-modeling approach.

OBJECTIVES: We examined whether retail tobacco outlet density was related to youth cigarette smoking after control for a diverse range of neighborhood characteristics. METHODS: Data were gathered from 2116 respondents (aged 11 to 23 years) residing in 178 census tracts in Chicago, Ill. Propensity score stratification methods for continuous exposures were used to adjust for potentially confounding neighborhood characteristics, thus strengthening causal inferences. RESULTS: Retail tobacco outlets were disproportionately located in neighborhoods characterized by social and economic disadvantage. In a model that excluded neighborhood confounders, a marginally significant effect was found. Youths in areas at the highest 75th percentile in retail tobacco outlet density were 13% more likely (odds ratio [OR]=1.13; 95% confidence interval [CI]=0.99, 1.28) to have smoked in the past month compared with those living at the lowest 25th percentile. However, the relation became stronger and significant (OR=0.21; 95% CI=1.04, 1.41) after introduction of tract-level confounders and was statistically significant in the propensity score-adjusted model (OR = 1.20; 95% CI = 1.001, 1.44). Results did not differ significantly between minors and those legally permitted to smoke. CONCLUSIONS: Reductions in retail tobacco outlet density may reduce rates of youth smoking.

Adolescent↗
PubMed1980

Smokers' response to shortened cigarettes: dose reduction without dilution of tobacco smoke.

This study was designed to examine the response of smokers to shortening their usual brand of cigarettes. The shortening reduces the dose of smoke available from each cigarette without affecting concentration and therefore differs from dose reduction by dilution, which occurs when smokers switch to cigarettes with lower tar and nicotine deliveries. Measures of smoking behavior (e.g., cigarette consumption, puff rate), mouth-level nicotine intake (calculated from butt content), and intake to the lungs (plasma nicotine and COHb) were made in 10 smokers after 48 hr ad libitum smoking of full, three-quarter, and half-length cigarettes in a Latin square design. Mouth-level smoke intake was maintained on shortened cigarettes due to a combination of 2 types of compensatory maneuver: (1) by increasing the intensity of puffing and thereby extracting proportionately more of the smoke available from each cigarette and (2) by smoking more cigarettes. The amount of smoke inhaled, on the other hand, was only partially maintained (58% compensation). This was achieved by increase in cigarette consumption alone. There was achieved by increase in cigarette consumption alone. There was no evidence of any compensatory increase in the amount of smoke inhaled from each cigarette. Increase in consumption was thus the only maneuver that contributed to maintaining smoke intake at lung level; mouth-level intake was regulated by increasing intake per cigarette as well as consumption.

Adult↗
PubMed2002

Tax, price and cigarette smoking: evidence from the tobacco documents and implications for tobacco company marketing strategies.

OBJECTIVE: To examine tobacco company documents to determine what the companies knew about the impact of cigarette prices on smoking among youth, young adults, and adults, and to evaluate how this understanding affected their pricing and price related marketing strategies. METHODS: Data for this study come from tobacco industry documents contained in the Youth and Marketing database created by the Roswell Park Cancer Institute and available through http:// roswell.tobaccodocuments.org, supplemented with documents obtained from http://www.tobaccodocuments.org. RESULTS: Tobacco company documents provide clear evidence on the impact of cigarette prices on cigarette smoking, describing how tax related and other price increases lead to significant reductions in smoking, particularly among young persons. This information was very important in developing the industry's pricing strategies, including the development of lower price branded generics and the pass through of cigarette excise tax increases, and in developing a variety of price related marketing efforts, including multi-pack discounts, couponing, and others. CONCLUSIONS: Pricing and price related promotions are among the most important marketing tools employed by tobacco companies. Future tobacco control efforts that aim to raise prices and limit price related marketing efforts are likely to be important in achieving reductions in tobacco use and the public health toll caused by tobacco.

Adolescent↗
PubMed1976

Effect of nicotine chewing gum on smoking behaviour and as an aid to cigarette withdrawal.

In a double-blind, placebo-controlled, crossover trial the effect of 2-mg nicotine chewing gum was studied in 43 smokers when they were smoking as inclined and when they were trying to stop smoking. Although 70% of the smokers stopped smoking during treatment, only 23% were still abstinent after one year. The effect of the nicotine, though significant, was small compared with the overall reduction in smoking. When the subjects were smoking as inclined cigarette consumption was reduced by an average of 37% on the nicotine gum compared with 31% on placebo gum, while avergage carboxyhaemoglobin (COHb) levels were reduced by 26% and 15% on the active and placebo gums respectively. When subjects tried to stop smoking there was a further considerable reduction in cigarette consumption, but no longer any difference between the two gums. Nevertheless, average COHb was still lower on the active gum. Plasma nicotine levels on the nicotine gum averaged only 10-7 ng/ml compared with 27-4 ng/ml after smoking. Better results could be expected with 4-mg nicotine gums.

Adult↗
PubMed1984

Intercensal trends in cigarette smoking in New Zealand 1: age, sex and ethnic status.

The 1981 New Zealand census has shown that since 1976 the proportion of cigarette smokers has fallen from 40% to 35% in men and from 32% to 29% in women. In men, there has been a reduction in smoking in every age group, but in women smoking has increased in those aged 20-24 and 70-74 years. More girls aged 15-19 years are smokers than boys. Maori rates of smoking are much higher than other ethnic groups but since 1976 there has been a considerable reduction in the proportion of Maori men and women who smoke. The important exception is that smoking by Maori women aged 20-24 years has increased to very high levels (70%). Almost half the men and a third of the women who smoke consume 20 or more cigarettes a day. The average number of cigarettes smoked per day has fallen since the 1976 census to 18 for men and 14 for women. From 1976 to 1981, the prevalence of smoking in New Zealand has shown a considerable reduction in non-Maori and Maori men and women of most ages, except for younger women.

Adolescent↗