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Biological effects of cigarette smoke, wood smoke, and the smoke from plastics: the use of electron spin resonance.

This review compares and contrasts the chemistry of cigarette smoke, wood smoke, and the smoke from plastics and building materials that is inhaled by persons trapped in fires. Cigarette smoke produces cancer, emphysema, and other diseases after a delay of years. Acute exposure to smoke in a fire can produce a loss of lung function and death after a delay of days or weeks. Tobacco smoke and the smoke inhaled in a burning building have some similarities from a chemical viewpoint. For example, both contain high concentrations of CO and other combustion products. In addition, both contain high concentrations of free radicals, and our laboratory has studied these free radicals, largely by electron spin resonance (ESR) methods, for about 15 years. This article reviews what is known about the radicals present in these different types of smokes and soots and tars and summarizes the evidence that suggests these radicals could be involved in cigarette-induced pathology and smoke-inhalation deaths. The combustion of all organic materials produces radicals, but (with the exception of the smoke from perfluoropolymers) the radicals that are detected by ESR methods (and thus the radicals that would reach the lungs) are not those that arise in the combustion process. Rather they arise from chemical reactions that occur in the smoke itself. Thus, a knowledge of the chemistry of the smoke is necessary to understand the nature of the radicals formed. Even materials as similar as cigarettes and wood (cellulose) produce smoke that contains radicals with very different lifetimes and chemical characteristics, and mechanistic rationales for this are discussed. Cigarette tar contains a semiquinone radical that is infinitely stable and can be directly observed by ESR. Aqueous extracts of cigarette tar, which contain this radical, reduce oxygen to superoxide and thus produce both hydrogen peroxide and the hydroxyl radical. These solutions both oxidize alpha-1-proteinase inhibitor (a1PI) and nick DNA. Because of the potential role of radicals in smoke-inhalation injury, we suggest that antioxidant therapy (such as use of an inhaler for persons brought out of a burning building) might prove efficacious.

DNA Damage

Smoking control and smoking rate: implications for worksite smoking cessation.

Amount of control of smoking at three comparable chemical plants was associated with smoking rates. Using a self-report survey, smoking rates were assessed at the three plants. Company authorities were asked about smoking control policy and the extent to which smoking was controlled at each of the three plants was observed. A judgment was made that one plant had a very strict smoking control policy while the other two had moderate policies of control. Smoking rate was then compared for each of the three companies. The company with the strongest smoking control policy had a significantly lower mean rate of smoking than the other two companies. Smoking control may serve to facilitate cessation on the worksite.

Chemical Industry

Inhalation experiments with 14C-labelled cigarette smoke. II. The distribution of cigarette smoke particles in the hamster respiratory tract after exposure in two different smoking systems.

Male and female Syrian golden hamsters were exposed to the smoke of [14C]dotriacontane-16,17 ([14C]DOT)-labelled cigarettes in 2 different exposure systems. These 2 systems differed in terms of the smoke concentration drawn into the exposure chamber. To compare the effectiveness of the exposure systems, the inhaled dose of 14C-labelled cigarette smoke was determined in the different parts of the hamster respiratory tract by liquid scintillation counting. About 6 times more smoke particles were deposited in the respiratory tract after exposure to high smoke concentration with intermittent puffs of fresh air (closed system) than after exposure to smoke diluted with air (open system). About 80% of the diluted smoke reached the bronchi and lung compared to approximately 60% of the concentrated smoke. The remainder of the dose was trapped in the upper respiratory tract, mainly by the nose and larynx. Additionally, in the open system the total dose of inhaled smoke was dependent upon the position in the exposure chamber. The results are discussed with respect to the use of the exposure systems for chronic cigarette smoke inhalation studies in experimental respiratory tract carcinogenesis.

Animals

Exposure to smoking-relevant cues: effects on desire to smoke and topographical components of smoking behavior.

The effects of exposure to two classes of smoking-relevant cues (environmental; negative affect) on desire to smoke and smoking topography were evaluated. Sixty chronic smokers were randomly assigned to one of six groups in a two-way ANOVA design in which the salience of environmental cues and presence of negative affective cues were manipulated. This was followed by a 20-minute interval during which ad libitum smoking was videotaped in an unobtrusive manner. Results indicated that the experimental manipulations differentially influenced ratings of desire and topographical components of smoking behavior. Implications are raised regarding the role of cue reactivity in the maintenance of smoking behavior.

Adolescent

[Smoking--II. Duration of smoking and factors affecting smoking as a social phenomenon].

According to the poll of 5,555 individuals (91% of the expected number) over 40 years of age, selected from electoral registers in all three districts of the community of Mali Idjos in 1987, the average duration of smoking among active smokers increases with age, divergently with regard to sex. The age of smokers at the time they started smoking increases with age groups, from 22.2 to 33.2 in males and from 28.1 to 49 in females. The onset of smoking in the oldest male group in this rural area occurred in the first years after the war (first land confiscation) while in the group from 70 to 74 years of age it occurred in the years of compulsory crop-purchase system. Agglomeration in the onset of smoking in two male age groups (60-64, 65-69) occurred at the time of the second land confiscation. The onset of smoking among females from all age groups, from 45 years on occurred in the first decade of the sexual revolution (1961-1971). The prevalence of smoking in the studied population was different in previous decades as well. It changes according to social factors: from political and economic changes among males to the changes in women's social status among females.

Adult

[Smoking--I. Smoking habits, number of cigarettes smoked].

A multiphase, oncologic, population screening was carried out in 5.555 residents (91% of the expected number) over 40 years of age, from three districts of the community of Mali Idos. The poll showed that 83.1% of males and 21.9% of females are familiar with smoking (ex-smokers or active smokers); 45.7% of males and 11.6% of females are active and 37.4% of males and 10.3% of females are exsmokers; 314 residents--11% of males and 1.3% of females smoke more than one pack of cigarettes daily; some of them smoke more than 60, 80, even 100 cigarettes daily. In two age groups (40-44, 45-49) 100% of male respondents is familiar with smoking; in the group over 75 years of age this percent is reduced to one third (21.8%). We can conclude that the distribution of smoking in this population differed in the middle and in the second half of the century.

Adult

Fantasy in individuals who smoke, stopped smoking, and never smoked.

The present study advanced the hypothesis that individuals who smoke tend to fantasize more than those who have stopped smoking or never smoked. Ninety males and 90 females, with each sex divided into three categories (smokers, stopped smokers, and never smoked) were used. Results of the study supported the hypothesis when applied to male smokers, but not to female smokers. While male smokers tended to fantasize most, the opposite was found for the female smoker, who fantasized least. This was also true in the specific area of achievement.

Achievement

Response of rat lung to inhaled vapour phase constituents (VP) of tobacco smoke alone or in conjunction with smoke condensate or fractions of smoke condensate given by intratracheal instillation.

In a controlled experiment, 6 groups of SPF rats were given cigarette smoke condensate (SWS) in solid form without a vehicle once fortnightly by intratracheal instillation, at 3 dose levels with or without additional exposure to the vapour phase of smoke (VP) from 10 plain cigarettes each week. Treatment continued for life. Six other groups were similarly treated with one of 3 fractions of condensate with or without VP. Exposure to VP was associated with a significant reduction in body weight, but not signficantly with the incidence or severity of any observed pathological change in the lungs. A significant dose-related assoication was seen between SWS or its fractions and the incidence and degree of chronic respiratory disease (CRD), cuboidal or columnar metaplasia (CCM) and squamous metaplasia of alveolar epithelium (Sq.M) produced. No neoplasms, however, were elicited. A significant correlation was found between the degrees of CCM and of Sq.M produced in the 24 groups exposed to SWS or fractions. The results are discussed in the light of studies in which rats were exposed to tobacco smoke by inhalation and of studies in which the same condensate and fractions were applied to mouse skin.

Animals

Investigations of cigarette smoke dosages in inhalation experiments with Syrian hamsters. II. Uptake of cigarette smoke by the animals; comparisons of the influence of the gas phase and the whole smoke of different cigarettes.

An increased CO2 content (CO2 enrichment) in the smoke-air mixture was measured in an inhalation chamber containing Syrian hamsters. Since these additional CO2 concentrations originated from the animals' expiratory air, the level of CO2 (CO2 enrichment) was considered a function of the respiratory capacity. Results obtained with this method of characterizing the respiratory behavior of hamsters in inhalation experiments led us to conclude that the vapor phase of cigarettes reduced respiration up to 45% and the whole smoke, up to 60%. Qualitative and quantitative differences in the composition of the vapor phase and particulate phase as offered in animal inhalation experiments for comparing different cigarettes did not induce measurable differences in the respiratory behavior. Therefore, such inhalation experiments were found to be suitable for comparing the relative effects of different cigarette types. Estimations on the inhaled amounts of TPM led to results that were similar to those obtained in experiments with radioactively labeled smoke.

Animals

Long-term smoking intervention at the worksite: effects of quit-smoking groups and an "enriched milieu" on smoking cessation in adult white-collar employees.

Maximizing the potential of worksites for smoking intervention remains elusive. We hypothesized that long-term effectiveness of group intervention would be enhanced when offered within an "enriched milieu" (full program) compared with relative isolation (group only). The data failed to support the hypothesis. Although sustained abstinence rates were higher at full-program sites (50%) than at group-only sites (44%), the difference did not achieve statistical significance. Initial (35% vs. 47%) and 12-month (18% vs. 22%) quit rates at full-program and group-only sites also failed to demonstrate the "benefit" of the "enriched milieu."

Adult

Smoking habits in early pregnancy and attitudes towards smoking cessation among pregnant women and their partners.

One-hundred and eighty-seven general practitioners in western Norway recorded smoking habits among 2379 women, consulting for their first regular medical check-up in pregnancy. Forty-six per cent had been daily smokers the last 3 months before pregnancy. Thirty-nine per cent were still smoking at the time of their first check-up. Sixteen per cent of the daily smokers stopped smoking spontaneously during the first few weeks of pregnancy. Fifty-seven per cent of women younger than 20 and 28% of women 30 years and older, did smoke at the first check-up. Single women smoked more often than women living with a partner (58% versus 38%). Smoking habits were not associated with number of previous pregnancies. At the first check-up, 530 pregnant women, still smoking daily, 18-34 years of age, living with a partner, accepted to participate in a smoking intervention study. They filled in a questionnaire about their smoking habits, the smoking habits of their partners and their attitudes towards smoking cessation. Sixty-five per cent reported a reduction in their use of cigarettes after becoming pregnant. The mean reduction in the number of cigarettes smoked daily was 4.0 (31%). Most of the respondents expressed a strong motivation to quit or reduce their smoking habits during their pregnancy. Seventy-two per cent of the partners were daily smokers. Reduction in the consumption of cigarettes, negative attitudes towards smoking and determination to stop smoking was significantly higher among women who were encouraged by their partners to stop smoking and in those who perceived that their partners were willing to reduce their consumption.

Adolescent

Depressive Symptoms and Smoking Cessation Among Adolescents and Young Adults Who Smoke: A Prospective Cohort Study.

PURPOSE: This study examined the bidirectional prospective associations between depressive symptoms and smoking cessation among adolescent and young adults who smoke. METHODS: Data on 1,151 participants aged &#x2264;25 years who smoke and receive peer-led quitline counseling in Hong Kong (2016-2022) were analyzed. Exposures included baseline depressive symptoms and smoking cessation (self-reported 7-day abstinence) at 1, 3, and 6 months; Outcome measures included smoking cessation at 1, 3, and 6 months and depressive symptoms at 6 months. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, with a score &#x2265;16 indicating at risk for depression. RESULTS: More severe baseline depressive symptoms were associated with lower odds of smoking cessation at 1, 3, and 6 months, which reversely was associated with lower depressive symptoms at 6 months (all p < .05). Similarly, being at risk for depression at baseline was associated with lower odds of smoking cessation at 1 (adjusted odds ratio [aOR] .66, 95% confidential interval [CI] .47-.93) and 3 months (aOR .71, 95% CI .52-.97). Conversely, smoking cessation at 1 (aOR .40, 95% CI .23-.69), 3 (aOR .58, 95% CI .37-.92), and 6 months (aOR .44, 95% CI .29-.69) was associated with lower odds of at risk for depression at 6 months. DISCUSSION: More severe depressive symptoms were prospectively associated with lower odds of smoking cessation, while smoking cessation was associated with lower depressive symptoms and risk for depression. Integrated interventions simultaneously addressing psychological needs and smoking are warranted, when delivered in smoking cessation programs or embedded within mental health services for youth who smoke.

Humans

The effect of the teachers smoking behavior on their involvement in smoking education in the schools.

The smoking behavior and attitudes of public school teachers were studied to determine if the teachers' smoking behavior is related to their attitudes and behavior regarding students' smoking practice and smoking education in schools. The Northampton, Massachusetts, School System was studied, where 162 of the 194 teachers randomly selected from various schools in the district completed the close-ended questionnaires administered and collected by the researcher. The study yielded a return rate of 83 percent. The results of the study showed that the general climate in school is one conducive to the establishment of a comprehensive smoking education program. It also indicates that the teachers' attitudes and behavior towards smoking education were closely related to their smoking behavior. The ex-smokers were the most active group in attempting to initiate student smoking behavior change, while the smoking teachers were the least active in this respect. Furthermore, pre-service and in-service teacher training programs in relation to smoking education were shown to be extremely sparse and ineffective in the past. This study suggests the need to strengthen pre-service and in-service teacher training programs in smoking education and to make smoking cessation programs available to those teacher who want to stop smoking.

Attitude to Health

Cigarette smoke exposure and development of infants throughout the first year of life: influence of passive smoking and nursing on cotinine levels in breast milk and infant's urine.

The effects of smoke exposure via mothers' milk and/or via passive smoking during the first year of life were investigated in a prospective longitudinal matched-pair study. The somatic and mental development of 69 infants whose mothers smoked more than five cigarettes per day throughout pregnancy and continued smoking after childbirth were compared with 69 children of non-smoking mothers. At birth, mean body weight of neonates from smoking mothers was significantly lower than the weight of neonates from non-smoking mothers. This weight difference between the two groups was no longer significant in infants at 12 months of age. With the methods employed by the authors, neither psychomotor nor mental development was affected by smoke exposure during pregnancy and early infancy. Infections of the lower respiratory tract were more frequent in the children of smoking mothers. These mothers weaned their babies earlier than non-smokers, but the different feeding behaviour did not influence any of the clinical parameters that were investigated in this study. In order to evaluate the extent of smoke exposure, cotinine was measured in children's urine and in breast milk once a month throughout the first year of life. Cotinine in the urine was significantly dependent on feeding behaviour: infants breast fed showed concentrations 10-fold higher than those who were bottle fed. Cotinine excretion in urine of infants from smoking mothers, who were not breast fed (nicotine exposure via passive smoking only) was even higher than that of adult passive smokers. If infants from smoking mothers were breast fed, their urinary cotinine excretion was in the range of adult smokers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

No-smoking laws in the United States. An analysis of state and city actions to limit smoking in public places and workplaces.

OBJECTIVE: To assess the prevalence, content, and growth of state and city laws restricting smoking in public places and workplaces in the United States and to identify factors associated with their passage. DESIGN: A mailed survey of city clerks in US cities with a population of 25,000 or greater (N = 980) and review of existing data sources confirmed the status of smoking restrictions in 902 (92%) of the cities in the sample. State laws were identified by contacting each state's Legislative Reference Bureau (100% response). Content of laws was coded using previously developed categories. MAIN OUTCOME MEASURES: Prevalence, comprehensiveness, and cumulative incidence of no-smoking laws in states and in cities with a population of 25,000 or greater. RESULTS: By July 1989, 44 states and 500 (51%) of the cities in our sample had adopted some smoking restriction, but content varied widely. While 42% of cities limited smoking in government buildings, 27% in public places, 24% in restaurants, and 18% in private workplaces, only 17% of cities and 20% of states had comprehensive laws restricting smoking in all four of these sites. The number of city no-smoking laws increased tenfold from 1980 to 1989. City no-smoking laws were independently associated with population size, geography, state tobacco production, and adult smoking prevalence. Laws were more common in larger cities, Western cities, and states with fewer adult smokers. Laws were less common in tobacco-producing states and in the South. CONCLUSIONS: No-smoking laws are more widespread than previously appreciated, especially at the local level, reflecting a rapid pace of city government action in the 1980s. Nonetheless, comprehensive laws, which are most likely to provide meaningful protection from environmental tobacco smoke exposure, remain uncommon and represent a major gap in smoking control policy. Laws are most needed in smaller and non-Western cities and in states that produce tobacco and have a higher proportion of smokers.

Humans

[Standardization of definitions concerning smoking behavior among Japanese adolescents--results from the Japan Adolescent Smoking Survey (JASS)].

The aim of the Japan Adolescent Smoking Survey (JASS) is to standardize the definitions of smoking behavior among Japanese adolescents together with measurement methods and questionnaires concerned. A study of 9921 school children aged 9 to 18 years in 17 elementary schools, 16 junior high schools and 18 senior high schools in 9 prefectures, was conducted between June and July of 1989, to determine the relationship between actual smoking behavior during the past month or year and the "self-referent label" concerning their smoking status. The main results were as follows: 1) The percentage of those who smoked at least one cigarette during the past month showed a high degree of similarity to the percentage of those who referred to themselves as "regular smokers" or "occasional smokers". 2) Less than 10% of students who identified themselves as "never smokers" or "ex-smokers" smoked at least one cigarette during the past month, while more than 80% of students who referred to themselves as "regular smokers" or "occasional smokers" smoked during the past month. 3) On the whole, those who smoked 20 or more cigarettes during the past month referred to themselves as "regular smokers"; those who smoked between 2 and 19 cigarettes as "occasional smokers"; those who smoked 1 cigarette as "ex-smokers"; those who did not smoke during the past month as "never smokers". 4) The definition where students who smoked one cigarette during the past month are classified as a category of smoker, displayed a high level of sensitivity and specificity for all school-level groups and for both sexes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Cigarette smoking among school children in Singapore. Part III--Knowledge and attitudes towards smoking.

In the third article in this series which mainly assesses the knowledge of school children on the harmful effects of smoking, findings showed that the majority (90%) of school children surveyed were aware of the harmful effects. Current smokers appeared to be the least knowledgeable (69.4%) whilst non-smokers (89.3%) and experimenters (93.7%) were the most knowledgeable. Lung cancer (49%), smoking is bad for health (25%), smoking is bad for passive smokers (7%) and for heart disease (6%) were the most common responses given by the children on the specific ill effects caused by smoking. Smokers and non-smokers alike agreed that smoking is addictive, the proportions agreeing, once again, being lowest among smokers and highest among non-smokers. This trend was also observed when respondents were asked for their attitudes towards smoking--whether cigarette smoking was harmful and whether smoking made a person popular. The majority of respondents felt that a boy or girl who smoked "looked bad"--39% thought so of boys, while a higher proportion (55%), had the same impression of girls. The main reasons for giving up smoking given by ex-smokers were its harmful effects on health (49%), there being no more "kick" to it (16%), peer pressure (13%) and the disapproval of parents and teachers (13%). Among current smokers, at least half stated that they would like to stop smoking. Most of them had tried to kick the habit before but failed in their attempts. Finally, among the non-smokers, only 0.4% of boys and 0.1% of girls indicated that they might smoke in the future.

Adolescent

DNA content of cultured mammalian cells exposed to smoke and smoke fractions from cigarettes containing tobacco or NSM, a tobacco substitute.

The effects of smoke and smoke fractions from tobacco and a substitute smoking material (NSM) on the DNA content of mammaliam cells in culture were measured. Tobacco smoke caused significant (P less than 0.001) changes in the DNA content of all the mammalian cells exposed compared with controls. NSM smoke did not have a significant effect on the DNA content of the exposed cells (P less than 0.95). Smoke from blends of NSM and tobacco caused changes in DNA content in proportion to the amount of tobacco in the mixtures. Condensate from cigarettes containing tobacco or blends of tobacco and NSM caused significant (P less than 0.001) changes in DNA content of mammalian cell populations in culture, whereas equal weights of condensate from NSM alone or NSM containing nicotine did not cause significant changes (P less than 0.05). NSM produces 28% of the weight of condensate per cigarette in comparison with tabacco and would, therefore, be expected to be far less biologically active than tobacco. Filtered smoke from cigarettes containing tobacco caused significant (P less than 0.001) changes in the DNA content of mammalian cells in culture. These changes were quantitatively similar to those caused by whole smoke suggesting that the gas phase of cigarette smoke is biologically more reactive than the particulate phase. The filtered smoke from the substitute smoking material NSM did not cause significant (P less than 0.95) changes in DNA content of cultured mammalian cells. Filtered smoke from blends of NSM and tobacco caused changes in DNA content in proportion to the amount of tobacco in the mixture.

Animals