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At least 19 recordsLinked to original sources

Smoking, the oral contraceptive pill, and Crohn's disease.

Both cigarette smoking and the oral contraceptive pill have been implicated as aggravating factors in Crohn's disease. Based upon the recent demonstration of multifocal gastrointestinal infarction in Crohn's disease, a possible pathogenic mechanism for this condition, we propose how smoking and the oral contraceptive pill may potentiate a tendency for focal thrombosis and hence exacerbate the activity of Crohn's disease.

Blood Coagulation

Tranexamic acid in alveolar sockets in the prevention of alveolitis sicca dolorosa.

The effect of trans-4-amino-methyl-cyclohexane acid (AMCA) and a placebo preparation on the development of alveolitis sicca dolorosa (ASD) was investigated in a double-blind designed experiment. The preoperative registrations were age, sex, use of oral contraceptives, menstrual cycle, smoking, degree of impaction and operation time. The study included 120 healthy persons. Each person had bilateral impacted mandibular molars removed surgically at one session. AMCA (160 mg/extraction site) or placebor was applied in each socket after the operation. The postoperative course was evaluated on average 5 days later by the use of 13 different variables describing local and general discomfort. The incidence of ASD was 7.5% in the AMCA side and 5.0% in the placebo side. The result shows that a local inhibition of plasminogen activation by AMCA is insufficient to prevent the development of ASD. The occurrence of ASD and postoperative discomfort was not increased in women operated during the menstrual period. The usage of oral contraceptives is known to be associated with a high frequency of ASD. Women taking oral contraceptives may therefore postpone the operation to the withdrawal period of the pill, to reduce the risk of developing ASD. Postoperative pains and the consumption of analgetics were significantly increased in patients who were habitual smokers.

Adolescent

The effect of smoking and oral contraceptives on the urinary excretion of epinephrine and norepinephrine.

Eight smokers and seven nonsmokers between the ages of 20 and 38 years were studied. None of these patients was pregnant. Three smokers and two nonsmokers were not taking oral contraceptives, as contrasted by three nonsmokers and four smokers taking oral contraceptives. Results approached statistical significance for urinary norepinephrine (p = 0.15) and epinephrine (p = 0.07) when the groups were compared. The values for nonsmoking/noncontraception tended to be low but, unexpectedly, the values for smoking/contraception also were low. When the smoking subjects (six of seven) stopped there was a significant decline in norepinephrine (p = 0.02) and the epinephrine decline approached significance (p = 0.08). The study does not show any synergistic effect of oral contraceptives and smoking but demonstrates that the smoker can diminish stimulation of the adrenal gland (epinephrine) and sympathetic nervous system (norepinephrine) if she will stop smoking.

Adult

Elevations in serum copper, erythrocytic copper, and ceruloplasmin concentrations in smokers.

Previous investigators have reported significant elevations of serum copper and ceruloplasmin levels in lymphoma patients and subjects using estrogen, but have not taken into account the smoking habits of these populations. In order to determine whether smoking had any effect on these variables, the authors examined five groups for serum and erythrocytic copper and ceruloplasmin levels: 40 healthy subjects, 14 users of oral contraceptives, 25 smokers, 14 nonsmoking pretreatment lymphoma patients, and eight treated lymphoma patients. Significant elevations of serum copper and ceruloplasmin in pretreatment lymphoma patients, treated patients, and estrogen users were found, confirming previous reports. In addition, all groups had elevations of erythrocytic copper compared with the healthy subjects. Also, significant elevations of serum copper (P less than .0053) and ceruloplasmin (P less than .0001) were found in smoking relative to nonsmoking subjects. No correlation between duration of smoking and these elevations was found.

Adolescent

Acute metabolic and circulatory effects of cigarette smoking in late pregnancy.

The acute metabolic and circulatory effects of cigarette smoking (two cigarettes of a standard brand) in the last trimester of pregnancy were studied. 12 subjects, all of whom where hospitalized because of pregnancy complications, volunteered to participate in the investigation. A statistically significant immediate increment in the maternal heart rate, systolic and diastolic blood pressure, fetal heart rate, plasma glucose and plasma cyclic AMP was noted. Plasma glycerol, plasma insulin and blood lactate did not change significantly. 30 min after smoking there was a small but significant increase in plasma nonesterified fatty acids, plasma beta-hydroxybutyrate and plasma C-peptide.

Blood Glucose

Cigarette smoking as an etiologic factor in cleft lip and palate.

A case-control study has been made on smoking habits in women who, during 1975, gave birth to infants with closure defects of the central nervous system (ASB) or with cleft lip or cleft palate (CLP). For each case, two control subjects with nonmalformed infants were selected and matched for delivery unit, time of delivery, maternal age, and maternal parity. Smoking habits were routinely included in hospital records at first visit to a maternity health clinic during pregnancy. Data were studied for 66 cases of CLP, 66 cases of ASB, and 261 control subjects. Significantly more women who had infants with CLP smoked than did control women, but women with ASB infants showed a normal smoking pattern. Drug use did not explain the findings. It is suggested that maternal smoking is one of many factors of importance in the etiology of cleft lip and cleft palate in humans.

Birth Weight

Changes in morbidity and mortality during comprehensive community programme to control cardiovascular diseases during 1972-7 in North Karelia.

A comprehensive community programme studying the control of cardiovascular diseases (CVD) was carried out in North Karelia, Finland, between 1972 and 1977. The main objective was to reduce the mortality and morbidity of CVD, particularly in middle-aged men. Changes in the mortality and incidence of CVD were monitored by community-based registers of cases of acute myocardial infarction (AMI) and stroke and data on death certificates. During the programme the total mortality in the area decreased by 5% and the mortality from CVD decreased by 13% among men and 31% among women aged 30-64 years. The incidence of AMI fell by 16% among men and 5% among women, while that of cerebral stroke fell by 38% among men and 50% among women. Changes in mortality in North Karelia were compared with those in a matched control area; the difference between the two areas was not significant. The true effect of the programme cannot be deduced from these results, but mortality from CVD and the incidence of AMI and stroke fell during the five years studied. Thus the changes in mortality and morbidity of CVD accorded with the initial objectives of the programme.

Adult

Premature mortality attributable to smoking and hazardous drinking in Canada.

All causes of death related to the two risk factors, smoking and hazardous drinking, have been reviewed followed by a selection of those causes of death for which the causal role of the risk factor appears to be quasi-certain. For each cause, existing epidemiologic data were reviewed and used to determine the fraction of premature mortality which could be attributed to each factor (called the attributable fraction). This fraction was then multiplied by the corresponding Canadian premature mortality measured in terms of deaths between ages one and 70 and potential years of life lost (PYLL) between ages one and 70, which gives a higher weight to younger deaths. Of the 73,440 deaths between ages one and 70 in Canada in 1974, 12% (or 8718 deaths) were found to be attributable to current smoking and 6% (4716) to hazardous drinking. In terms of PYLL between ages one and 70, hazardous drinking ranks ahead of current smoking with 10% (or 132,044 PYLL) of the total PYLL, whereas current smoking represents 8% (105,085 PYLL) of the total . Regardless of whether premature mortality is expressed in terms of deaths or PYLL, about 18% of Canadian premature mortality is attributable to current smoking and/or drinking (with the range of possible values being 14-22%).

Accidents

Maternal smoking, birth weight, infant death, and the self-selection problem.

Several aspects of the relationship between maternal smoking and birth weights of infants are discussed. No satisfactory explanation for Yerushalmy's results has been given other than that low birth weight appears to relate more to the smoker than to the smoking. Recent studies by Silverman support this position. The possibility that nicotine may induce a physiologic response that serves to alleviate bioenergetic deficiency in some individuals should not be overlooked. In this view, both smoking and low birth weight are symptoms of deficient maternal bioenergetic systems.

Birth Weight

A case-control study of paternal smoking and birth defects.

Although the influence of paternal smoking on birth defects is of great public interest, epidemiological evidence concerning this potential relationship is extremely limited. A stratified random sample of 29 hospitals in the Shanghai Municipality, China, was used to select 1012 birth defects cases and controls. Mothers of the cases and controls were interviewed in the hospitals from October 1986 to September 1987. A modest relationship between paternal smoking and overall birth defects in offspring was identified [odds ratio (OR) = 1.21, 95% confidence interval (CI): 1.01-1.45]. More markedly elevated risks were identified for anencephalus (OR = 2.1), spina bifida (OR = 1.9), pigmentary anomalies of the skin (OR = 3.3) and varus/valgus deformities of the feet (OR = 1.8). Our analysis also shows that paternal smoking is more likely to be associated with multiple rather than isolated malformations. A paternally-mediated effect of smoking on birth defects is suggested and further studies are encouraged.

Adult

Gross differences observed in the placentas of smokers and nonsmokers.

Gross placental characteristics of 7651 smokers and nonsmokers are compared in light of the previous finding that placentas of smokers are heavier for the weight of their fetuses than are those of nonsmokers. Subchorionic fibrin deposits and placental calcification are more prevalent in the placentas of smokers than in those of nonsmokers. While mean placental weights and placental weight distributions for light and heavy smokers combined do not differ from those of nonsmokers, other placental measurements do differ. Smokers have thinner, rounder placentas than nonsmokers and the distance from the edge of rupture of the membranes to the placental margin is reduced among smokers. These findings are discussed in relation to placental changes observed at high altitudes and complications of pregnancy that differ for smokers and nonsmokers.

Birth Weight

The effect of smoking during pregnancy on the incidence of low birth weight among Chinese parturients.

The incidence and effect of smoking in Chinese parturients are not well known. In a retrospective case-controlled study of 213 patients who smoked during pregnancy, it was found that the incidence of low birth-weight was doubled. On average the babies were smaller by 200 g, shorter by 1 cm and the head circumference was smaller by 0.3 cm. These anthropometric deficits may have significant long-term effects. Although the incidence of smoking in Chinese parturients is low (2%), the rising trend in recent years should prompt all physicians to advise expectant mothers to avoid smoking before and during pregnancy.

Adult

Very high collagen increase in placentae of smoking mothers.

In 55 placentae, collected at term from clinically normal pregnancies, hydroxyproline was assayed. Thirty were from mothers who smoke and 25 from nonsmokers. In placentae of smokers, hydroxyproline concentration was 42.77 +/- 8.77 micrograms/mg of tissue and in these of nonsmokers 22.52 +/- 7.46 micrograms/mg. Such high a difference discloses a large increment in placental collagen production in smokers, which may account for some of the noxious effects of tobacco on pregnancy.

Evaluation Studies as Topic

[Health education: prevention of smoking].

With the aim of primary prevention, the Health Education Service of Geneva organizes in all schools since 1970, an information campaign against the dangers of smoking! The objectives of this preventive action are to render the pupils conscient of the dangers of smoking, to draw their attention on the lures of advertisement and to permit them to make a personal opinion on the subject. This information is given in primary and secondary schools by the teachers who receive the necessary audio-visual equipment from the Health Education Service. In the higher degrees, this information is integrated in a regular health teaching program. All future teachers also receive an "anti-smoking" information given by doctors of our Department. We hope that this form of objective and scientific instruction in schools will minimise the effects of publicity, making the young people aware of the risks they encounter.

Adolescent