Subjective health of male ex-smokers: relationship with time since smoking cessation,intensity and duration of tobacco consumption

BACKGROUND: To examine the relationship of subjective health with time since smoking cessation and amount and duration of tobacco consumption among male ex-smokers. METHODS: Pooled analysis of three household interview surveys conducted in 1993 (n = 8,494), 1995 (n = 2,556), and 1997 (n = 2,624) on samples representative of the noninstitutionalized population aged 16 and over in Spain. RESULTS: After controlling for the main confounders, ex-smokers with smoking burden < or =13 pack-years had a lower frequency of suboptimal health (fair, poor, or very poor) than current smokers (OR, 0.59; 95% Cl, 0.38-0.91) during the first year after cessation; thereafter, it reached a value similar to that of never-smokers 11 years or more after cessation. Among those with burden >13 pack-years, frequency of suboptimal health during the first year after cessation was higher than in current smokers (OR, 1.28; 95% CI, 1.00-1.63). Afterwards, it fell progressively, approaching the value of never-smokers 11 years or more after cessation. Frequency of suboptimal health in ex-smokers increased with duration (years) of smoking (P linear trend = 0.045), but did not vary with the number of cigarettes smoked. CONCLUSIONS: Suboptimal health declined with time since smoking cessation, to reach the frequency of never-smokers. Longer duration of tobacco consumption is associated with worse subjective health.     

Correlates of smoking in pregnant women in six Brazilian cities

OBJECTIVE: To evaluate sociodemographic and lifestyle correlates of smoking in pregnant women sampled from hospitals. METHODS: A cross-sectional study was conducted in 5,539 pregnant women aged 20 or more who sought medical attention in prenatal clinics of affiliate hospitals of the Brazilian National Health System in the cities of Manaus, Fortaleza, Salvador, Rio de Janeiro, S?o Paulo, and Porto Alegre from 1991 to 1995. Interviews were conducted using a standardized questionnaire that covered sociodemographics and smoking habits before and during pregnancy. Current smoking was defined as smoking at least one cigarette/day, former smoking as reporting having smoked at least one cigarette/day but having quit, and never smoking as never having smoked one cigarette/day. RESULTS: Smoking during pregnancy was associated with lower education (OR=2.13; CI 95%: 1.76-2.57) and greater parity (OR=1.84; CI 95%: 1.53-2.21). Positive associations were also found with increased gestational age and alcohol consumption. No significant association was found with skin color or occupation status. A protective effect was observed for women married or living with a partner (OR=0.55 CI 95%: 0.42-0.72). Having Manaus' women as a reference, Porto Alegre's women showed the greatest risk for smoking in pregnancy (OR=5.00; CI 95%: 3.35-7.38), followed by S?o Paulo's (OR=3.42; CI 95%: 2.25-5.20), Rio de Janeiro (OR=2.53; CI 95%: 1.65-3.88) and Fortaleza's (OR=2.56; CI 95%: 1.74-3.78). CONCLUSIONS: The study findings are similar to those described in the literature regarding education, parity, and marital status. However, no association with skin color was seen in the multivariate analysis. Former smokers had sociodemographic characteristics more similar to non-smokers than former smokers.     

Influenza vaccination in old adults in Spain

BACKGROUND: to describe population patterns of influenza vaccination, and to analyse the effect of a set of demographic, socio-economic status, lifestyles, health status, and health services variables, on the likelihood of being vaccinated in the those > or = 65 years. METHODS: Cross-sectional study. From the 1997 National Health Survey those > or = 65 years old were selected. Adjusted odds ratios were calculated through multiple logistic regression models, reporting having an influenza vaccination last season as a dependent variable. RESULTS: A total sample of 1148 was analysed: 51.3% of subjects reported having received a vaccination last year. Adjusted odds ratios showed that the risk of not having been vaccinated was higher for people from 65-69 years (OR: 1.70; 95% CI [1.32-2.19]), women (OR: 1.48; 95% CI [1.14-1.92]), residents in cities of more than 1 million inhabitants (OR: 1.74; 95% CI [1.12-2.70]), smokers (OR: 1.92; 95% CI [1.24-2.96]), having high-risk chronic conditions (OR: 1.41; 95% CI [1.08-1.85]), and for those whose last physician visit was between 2 weeks and 6 months ago (OR: 1.40; 95% CI [1.07-1.85]), and more than 6 months ago (OR: 2.13; 95% CI [1.52-2.98]). CONCLUSION: Influenza vaccination levels are sub-optimal. Factors that have been identified as barriers to receiving this effective intervention are: younger age, female sex, less contact with the health care system, smokers, and not having high-risk chronic conditions. No effect was found for socio-economic status or variables related with health, functional status or other health-related behaviours. This study may contribute to identifying population groups who could be targeted for health promotion interventions aimed to improve their influenza vaccination uptake.     

Cigarette smoking during pregnancy in rural Nepal. Risk factors and effects of beta-carotene and vitamin A supplementation

OBJECTIVE: We examined risk factors of smoking and the association between smoking and pregnancy-related and 6-month infant mortality in rural Nepal, where 30% women reported smoking during pregnancy. DESIGN: Cross-sectional analysis of risk factors associated with smoking status and health consequences of smoking, using prospective data collected as part of a randomized community trial to examine the effect of maternal vitamin A or beta-carotene supplementation on maternal mortality. SETTING: Rural, southeastern plains of Nepal. SUBJECTS AND METHODS: A total of 17 767 women contributed at least one pregnancy during 3.5 y of the study. Data on cigarette or bidi (rolled tobacco) smoking were collected using a 7-day recall, twice during pregnancy. Associations between smoking status and maternal diet, morbidity profile, household socioeconomic status and serum concentration of retinol, carotenoids and tocopherols were examined. Further, relative risk (RR) and 95% confidence intervals (CI) were calculated to estimate supplement effects on pregnancy-related mortality, stratified by smoking status during pregnancy. RESULTS: Smokers were more likely to be older, illiterate and poor compared to nonsmokers. Fruit and vegetable consumption among smokers and nonsmokers did not vary. However, smokers were more likely to consume meat/fish/eggs and less likely to consume milk than nonsmokers. They were also more likely to report symptoms of vaginal bleeding, edema, severe headache and convulsions during pregnancy relative to nonsmokers. Mortality per 100,000 pregnancies appeared to be higher among smokers than nonsmokers in the placebo group (915 vs 584, RR=1.57, 95% CI: 0.80-3.08). beta-Carotene supplementation reduced pregnancy-related mortality both among smokers (RR=0.31 95% CI: 0.11-0.89) and nonsmokers (RR=0.41, 95% CI: 0.19-0.89). Similar results obtained with vitamin A supplementation were not statistically significant. Infant mortality up to 6 months was approximately 30% higher among smokers compared to nonsmokers in the placebo group both before and after adjusting for confounding factors. Neither supplement given to women reduced infant mortality. CONCLUSIONS: Cigarette smoking during pregnancy is associated with an increased risk of maternal and infant mortality in rural Nepal. beta-Carotene and to some extent vitamin A may reduce the risk of pregnancy-related mortality, but not infant mortality, among both smokers and nonsmokers.     

Smoking behaviors and regular source of health care among African Americans

OBJECTIVES: The purpose of the study was to determine associations between having a regular source of health care, advice from a physician to quit smoking, and smoking-related behaviors among African American smokers. METHODS: A secondary analysis was conducted on data obtained from an intervention study with a posttest assessment of the effectiveness of smoking status as a vital sign. The setting was an adult walk-in clinic at a large inner-city hospital and 879 African American adult current smokers were examined. RESULTS: Among African American smokers, there was an association between having a regular source of health care and planning to quit smoking within the next 30 days (OR = 1.46; 95% CI: 1.04-2.05), receiving physician advice to quit (OR = 1.46; 95% CI: 1.02-2.10), and smoking < or =10 cigarettes a day (OR = 1.42; 95% CI: 1.00-2.03). CONCLUSIONS: African American current smokers with a regular source of health care were further along the quitting process than those without a regular source of health care. Our findings indicate a potential benefit of complementing programs that increase physician cessation advice rates with policies that increase rates of health insurance and the likelihood that individuals have a regular source of health care.     

Self-reported body mass index and health-related quality of life: findings from the Behavioral Risk Factor Surveillance System

OBJECTIVE: To examine the relationship between self-reported body mass index (BMI) and health-related quality of life in the general adult population in the United STATES: RESEARCH METHODS AND PROCEDURES: Using data from 109,076 respondents in the 1996 Behavioral Risk Factor Surveillance System, we examined how self-reported BMI is associated with five health-related quality of life measures developed by the Centers for Disease Control and Prevention for population health surveillance. RESULTS: After adjusting for age, gender, race or ethnicity, educational attainment, employment status, smoking status, and physical activity status, participants with a self-reported BMI of <18.5 kg/m(2) and participants with a self-reported BMI of > or =30 kg/m(2) reported impaired quality of life. Compared with persons with a self-reported BMI of 18.5 to <25 kg/m(2), odds ratios (ORs) of poor or fair self-rated health increased among persons with self-reported BMIs of <18.5 (1.57, 95% confidence interval [CI]: 1.31 to 1.89), 25 to <30 kg/m(2) (1.12, 95% CI: 1.04 to 1.20), 30 to <35 kg/m(2) (1.65, 95% CI: 1.50 to 1.81), 35 to <40 kg/m(2) (2.58, 95% CI: 2.21 to 3.00), and > or =40 kg/m(2) (3.23, 95% CI: 2.63 to 3.95); ORs for reporting > or =14 days of poor physical health during the previous 30 days were 1.44 (95% CI: 1.21 to 1.72), 1.04 (95% CI: 0.96 to 1.14), 1.32 (95% CI: 1.19 to 1.47), 1.80 (95% CI: 1.52 to 2.13), and 2.37 (95% CI: 1.90 to 2.94), respectively; ORs for having > or =14 days of poor mental health during the previous 30 days were 1.18 (95% CI: 0.97 to 1.42), 1.02 (95% CI: 0.95 to 1.11), 1.22 (95% CI: 1.10 to 1.36), 1.68 (95% CI: 1.42 to 1.98), and 1.66 (95% CI: 1.32 to 2.09), respectively. DISCUSSION: In the largest study to date, low and increased self-reported BMI significantly impaired health-related quality of life. Particularly, deviations from normal BMI affected physical functioning more strongly than mental functioning.     

Factors associated with smoking progression among Spanish adolescents

Smoking onset takes place in the early years of adolescence, and can be seen as a progression through stages of preparation, trying, experimentation, regular smoking and nicotine dependence or addiction. The objective of this study is to identify 1-year predictors of smoking consolidation among occasional smokers (experimenters) and of cessation among all smokers. A questionnaire developed to monitor trends in smoking and other health-related behaviors was administered in the spring of 1992 and again 1 year later (1993). The survey was carried out in six large, private schools in Barcelona and Raimat, in the Lleida province, in Catalonia (Spain). In total, 1460 schoolchildren aged 12-19 responded to both the baseline and follow-up questionnaires; 1236 questionnaires (84.7%) were matched through a personal code and were used for the longitudinal study. At the baseline survey 28% of the schoolchildren were regular smokers and 17.1 % were occasional smokers, with no differences by gender. At the follow-up survey, progression from occasional to regular smoking was observed in 42% of the girls and 22.7% of the boys. Other predictors of consolidation included drinking alcohol (OR = 3.1; 95% CI = 1.1-10.1) and reporting the intention to smoke in the future (OR = 2.5; 95% CI = 1.3-4.9). Among all the smokers at the baseline, predictors of cessation were smoking occasionally (versus regularly) (OR = 4.9; 95% CI = 2.8-8.6), negative attitudes regarding smoking (OR = 3.3; 95% CI = 1.9-5.4), reporting no intention to smoke in the future (OR = 2.2; 95% CI = 1.3-3.8), gender (OR for boys = 2.1; 95% CI = 1.2-3.6), receiving weekly pocket less than 1000 ptas (OR = 1.7; 95% CI = 1.1-5.3) and age (OR for being 15 and younger = 1.6; 95% CI = 1.1-4.9). We conclude that consolidation of smoking is twice as likely among girls than among boys. Intention to smoke seems to be a good predictor of future behavior, while attitudes may predict cessation, but not consolidation. Available pocket money seems to be a strong risk factor for smoking at this age.     

Getting focused: missed opportunities for smoking interventions for pregnant women receiving Medicaid

BACKGROUND: The prevalence of smoking, and cessation and relapse rates for pregnant women have health and financial implications. Our objectives were to describe smoking among pregnant smokers receiving Medicaid including characteristics associated with reporting discussion of smoking with providers and the association between those discussions with quitting and maintenance. METHODS: Analysis of Pregnancy Risk Assessment Monitoring System (PRAMS) data from 15 states for 20,287 women with Medicaid for prenatal care during 1998-2000. RESULTS: Thirty-four percent of women smoked before pregnancy (N = 7,686). Most smokers (93%) and nonsmokers (88%) reported discussions about smoking during prenatal care. Women were less likely to have discussed smoking if they were lighter smokers (OR = 1.47; CI = 1.03, 2.12), or reported a previous low-birthweight infant (OR = 1.72; CI = 1.03-2.86). Women reporting discussions (compared to those not) were less likely to quit (ARR = 0.70: CI = 0.59-0.91). Quitters reporting discussions (compared to those not) were no more likely to maintain cessation (ARR = 0.89; CI = 0.7, 1.21). CONCLUSIONS: Smoking cessation interventions can be improved for pregnant women receiving Medicaid, especially if focused to address individual needs of light smokers, those with previous low-birthweight infants, or those who find it most difficult to quit.     

Household smoking bans: which households have them and do they work?

BACKGROUND: This study characterized Oregon households according to type and degree of restrictions on smoking and explored whether smoking restrictions are associated with decreased environmental tobacco smoke (ETS) exposure. METHODS: A population-based, random-digit-dialed cross-sectional telephone survey of 6,199 adult Oregonians was performed in 1997 to provide baseline data on tobacco use in Oregon. RESULTS: Seventy percent of Oregon households were composed of nonsmokers only, and 85% of those had a full ban on smoking inside the home. Of the households containing one or more smokers, 38% had a full household ban on smoking. Among respondents with a full ban in place, 99% of nonsmoker-only households reported that no one smoked in the home in the previous month, compared with 91% of households with at least one smoker. In both nonsmoker-only households and those with at least one smoker, full bans were strongly associated with awareness of the harm of ETS (OR = 12.8, 95% CI 7.3-22.3, and OR = 6.6, 95% CI 3.6-12.3, respectively). The presence of children in the household was also closely associated with full bans in the two types of households (OR = 4.6, 95% CI 2.8-7.6, and OR = 3.0, 95% CI 2.1-4.4, respectively). Nevertheless, 50% of households with children and a smoker present did not have a full ban in place. CONCLUSIONS: While the prevalence of household smoking restrictions is high in Oregon, there remains room for improvement, since 50% of households with a smoker and a child present do not have a full ban on indoor smoking. Public health messages that focus on household smoking restrictions may help protect nonsmokers from exposure to ETS.     

Association of occupational stress and social support with health-related behaviors among chinese offshore oil workers

To explore the relationship of occupational stress and social support with health-related behaviors of smoking, alcohol usage and physical inactivity, a cross-sectional survey was conducted among 561 offshore oil installation workers of a Chinese state-owned oil company. They were investigated with a self-administered questionnaire about socio-demographic characteristics, occupational stress, social support and health-related behaviors. Logistic regression analysis was used to study the association between occupational stress, social support and health-related behaviors and adjusted for age, educational level, marital status, duration of offshore work and job title. Of 561 workers, 218 (38.9%) were current smokers, 124 (22.1%) current drinkers, and 354 (63.1%) physically inactive in their leisure time. Further multivariate logistic regression analysis indicated that: (1) Current smoking was significantly negatively related with perceived stress from "Safety" (OR=0.74; 95% CI=0.58-0.94) and lack of supervisors' instrumental support (OR=0.34; 95% CI=0.18-0.65); (2) Current drinking was significantly positively related to perceived stress from "Interface between job and family/social life" (OR=1.32; 95% CI=1.02-1.70) and "Organizational structure" (OR=1.35; 95% CI=1.06-1.74), but was significantly negatively related to poor emotional support from friends (OR=0.54; 95% CI=0.62-0.96); (3) Physical inactivity after work was significantly positively associated with perceived stress from "Safety" (OR=1.44; 95% CI=1.16-1.79) and lack of instrumental support from both supervisors (OR=1.74; 95% CI=1.16-2.65) and friends (OR=1.68; 95% CI=1.06-2.42). The findings suggest that psychosocial factors of occupational stress and social support at offshore oil work might affect workers' health-related behaviors in different ways.     

Cigarette smoking and sick leave in an industrial population in Shanghai, China.

A study of cigarette smoking and sick leave was conducted at a large petrochemical complex in Shanghai, China in 1988. Among a random sample of 1856 men the smoking prevalence was 80% with the highest rate (84%) occurring in the age group 25-34 years. Only 53% of smokers and 76% of nonsmokers said they believed smoking was harmful to health and knowledge of which diseases were associated with smoking was poor. Retrospective data were also collected on sick leave in 1986 and 1987. In 1986 13% of men took sick leave and in 1987 12%; the mean duration of sick leave was 3 days per year. In 1986 the odds ratios (OR) for taking sick leave were 2.37 for heavy smokers and 1.45 for light smokers compared to unity for nonsmokers; the corresponding OR for 1987 were 1.70 and 1.28 for heavy and light smokers compared with nonsmokers. Smoking was positively associated with sick leave even after adjustment for age, consumption of alcohol and exposure to chemicals; OR = 1.56 (95% confidence interval (Cl): 1.06-2.31) in 1986 and OR = 1.32 (95% Cl: 0.90-1.95) in 1987. Demonstration of this association even in a young population with low sick leave rates illustrates yet again the adverse effects of smoking on health and the urgent need to reduce the very high prevalence of smoking in China.     

Cigarette smoking behavior among US Latino men and women from different countries of origin

OBJECTIVES: This study sought to compare smoking behavior among Latino men and women from different countries of origin. METHODS: A telephone-administered survey was conducted in 8 cities with Latino men and women of different national origin living in census tracts with at least 70% Latino individuals. RESULTS: A total of 8882 participants completed the survey; 53% were women. The average age of respondents was 44 years; 63% were foreign-born, and 59% preferred Spanish for the interview. Current smoking was more prevalent among men (25.0%, 95% confidence interval [CI] = 23.7, 26.3) than among women (12.1%, 95% CI = 11.1, 13.0). Smoking rates were not significantly different by national origin among men, but Puerto Rican women had higher rates of smoking than other women. Central American men and women had the lowest smoking rates. Foreign-born respondents were less likely to be smokers (odds ratio [OR] = 0.77, 95% CI = 0.66, 0.90) than US-born respondents, and respondents with 12 years or less of education had an increased odds of smoking (OR = 1.17, 95% CI = 1.01, 1.35). High ac culturation was associated with more smoking in women (OR = 1.12, 95% CI = 1.00-1.25) and less smoking in men (OR = 0.86, 95% CI = 0.78-0.95). Puerto Rican and Cuban respondents were more likely to be current smokers and to smoke more than 20 cigarettes per day. CONCLUSIONS: Older, US-born, and more-educated respondents were less likely to be current smokers. Respondents of Puerto Rican and Cuban origin were more likely to smoke. Acculturation has divergent effects on smoking behavior by sex.     

Black–white differences in health-related quality of life among older adults

Very little information exists on racial differences in quality of life among older adults. In this paper, we examine black–white differences in health-related quality of life (HRQOL) and identify factors that may account for these differences. The participants were 5,986 community-dwelling persons age 65+ (62% black at baseline) from the Chicago Health and Aging Project. Poor HRQOL was defined as having 14 or more self-reported physically or mentally unhealthy days over the past 30 days. A higher proportion of blacks (11.0%) than whites (9.7%) reported poor HRQOL. After adjusting for age and sex, blacks had increased odds of reporting poor HRQOL compared with whites (odds ratio [OR] = 1.72; 95% CI: 1.50–1.98). The black–white differences in HRQOL tended to increase with age (p < 0.05) and were greater among females (p < 0.05). Lifetime socioeconomic status, summary measures of medical conditions, and cognitive function accounted for most of the black–white difference (OR = 1.06; 95% CI: 0.89–1.27). Our results suggest that racial differences in HRQOL are associated with the combined effects of social disadvantage, poor physical health, and lower cognitive function.     

Nondaily smokers should be asked and advised to quit

BACKGROUND: Nondaily smokers are a growing subpopulation of smokers. Current cessation guidelines were developed for daily smokers, and how clinicians might help nondaily smokers is not clear. METHODS: Analyzing the 2000 National Health Interview Survey in 2004, we compared characteristics of nondaily smokers with never smokers and daily smokers. We used multivariate logistic regression to compare predictors of wanting to quit in 6 months between nondaily and daily smokers. RESULTS: About one in five current smokers was a nondaily smoker. Nondaily smokers reported better health than daily smokers, but had some health status indicators suggesting worse health than never smokers. Nondaily smokers were more likely to want to quit (odds ratio [OR]=1.31, 95% confidence interval [CI]=1.10-1.56) than daily smokers, but were less likely to report a physician having asked about tobacco use (41% vs 50%, p<0.0001) or advised quitting (31% vs 41%, p<0.0001). In both nondaily and daily smokers, physician advice (nondaily OR=1.50, 95% CI=1.03-2.2; daily OR=1.58, 95% CI=1.32-1.89), and the belief that secondhand smoke harms others (nondaily OR=1.48, 95% CI=1.04-2.1; daily OR=1.80, 95% CI=1.56-2.1), predicted wanting to quit. Higher-educated nondaily smokers were less likely to want to quit (OR=0.54, 95% CI=0.32-0.91), unlike in daily smokers (OR=1.48, 95% CI=1.15-1.89). Latino nondaily smokers were less likely (OR=0.43, 95% CI=0.30-0.64) than whites, and African-American daily smokers were more likely (OR=1.27, 95% CI=1.04-1.55) than whites, to want to quit. CONCLUSIONS: While daily smokers may seem a higher cessation priority, nondaily smokers may be more likely to quit with brief interventions. Cessation messages should address health risks of any smoking, ethnic differences, smoke-free messages, and situational triggers.     

Associations of cigarette smoking and alcohol consumption with advanced or multiple colorectal adenoma risks: a colonoscopy-based case-control study in Korea

The associations between alcohol consumption and cigarette smoking habits and the risk for colorectal adenomatous polyps according to the detailed clinical information about polyps were assessed in a large colonoscopy-based study. The study enrolled participants who visited the National Cancer Center of the Republic of Korea for cancer screening between April 2007 and April 2009. In 1,242 newly diagnosed colorectal adenoma patients and 3,019 polyp-free controls, past smokers (odds ratio (OR) = 1.31, 95% confidence interval (CI): 1.04, 1.65) and current smokers (OR = 1.70, 95% CI: 1.37, 2.11) had increased risks for adenomas compared with nonsmokers. Cigarette smoking conferred an even higher risk for advanced adenomas and 3 or more adenomas than for low-risk adenomas or a single adenoma. Dose-response relations were observed among the daily number of cigarettes smoked, the duration of smoking, the pack-years of smoking, and the risk for adenomas. A longer duration of alcohol consumption was associated with a higher risk for advanced adenomas (for >28 years of consumption: OR = 2.0, 95% CI: 1.10, 3.64) and 3 or more adenomas (OR = 2.19, 95% CI: 1.27, 3.76). In conclusion, cigarette smoking and alcohol consumption play roles in colorectal carcinogenesis, and the association differs by the clinical features of the adenomas.     

吸烟对不同收入人群慢性病患病的影响

目的探讨吸烟对不同经济状况人群的健康影响。方法采用多阶段分层整群随机抽样的方法，在全国共抽取95个县、950个村(居委会)，每个样本村(居委会)随机抽取60户家庭，全国共抽取55200户家庭中15～65岁男性5．93万人。结果研究发现在控制年龄、经济状况、文化程度、就业状况、工作岗位的情况下，不论农村、城镇，与从不吸烟的人相比，有吸烟史的人群慢性病患病率均高(农村OR=1．185，95％CI：1．121～1．253；城镇OR=1．083，95％CI：1．010～1．161)；吸烟对农村男性患慢性病的影响(戒烟OR=2．764，95％CI：2．471～3．092)要大于城镇的相应人群(戒烟OR=2．112，95％CI：1．844～2．419)；另外发现吸烟对低收入人口患慢性病的影响(城镇OR=2．076，95％CI：1．551～2．780；农村OR=2．903，95％CI：2．248～3．749)大于对高收入人口的影响(城镇OR=1．785，95％CI：1．285～2．479；农村OR=2．466，95％CI：1．941～3．134)。结论吸烟对收入低下的人群健康损害更大，应该引起重视。     

脂氧酶12 -183G＞A变异影响非小细胞肺癌发病风险

摘要:目的　探讨位于脂氧酶12（LOX12）基因启动子区-183G＞A单核苷酸多态与非小细胞肺癌发病风险之间的关系。方法　选取非小细胞肺癌患者956例及健康对照994例,利用PCR-限制性片段长度多态性方法进行基因分型,以多变量Logistic回归分析比值比（OR）及其95%可信区间（95%CI）。结果　LOX12 -183GG、GA、AA各基因型频率在病例组分别是20.8%、53.6%、25.6%,在正常对照组分别为26.8%、52.2%、21.0%。与-183GG基因型相比,AA基因型明显增加非小细胞肺癌的发病风险,其OR（95%CI）为1.53（1.17～2.00）;而GA基因型并不增加非小细胞肺癌发病风险,其OR（95%CI）值为1.23（0.98～1.55）。吸烟分层分析显示,以携带-183GG基因型的不吸烟者为参照,携带-183AA基因型的重度吸烟者发生非小细胞肺癌的风险为9.12（95% CI:5.07～16.41,P＜0.001）,大于不吸烟但携带-183AA 基因型者的OR值（OR＝2.03,95% CI:1.34～3.09,P＝0.001）与重度吸烟但携带-183GG基因型OR值（OR＝6.84,95%CI:3.81～12.31,P＜0.001）之和。结论　LOX12 基因启动子区-183G＞A单核苷酸多态可与吸烟交互作用共同增加非小细胞肺癌发病风险。     

Relationship between cigarette smoking and oral health status]

The purpose of the study was to examine the relationship between the smoking habit and oral health status, while adjusting for age and some aspects of dental health behavior. The data used were based on a cross-sectional study on dental checkup in the worksite, which included a self-reported questionnaire and oral examination by a dentist. The oral health status variables were CPITN scores, missing teeth/filled teeth/decayed teeth, and self-reported gum bleeding. In addition, the subjects reported in a questionnaire concerning their smoking habit and dental health behavior. Of a total of 7,713 of workers, 5,232 (67.8%) participated in the dental checkup of the worksite. From the population, only the data for 3,303 men were analyzed. We used multiple logistic regression to calculate the odds ratio (OR) for each oral health status according to the smoking habit. Current smokers, compared to subjects who had never smoked, had a higher risk of periodontal disease (OR = 2.3; 95% CI: 1.9-2.7), missing teeth (OR = 1.6; 95% CI: 1.3-1.9) and decayed teeth (OR = 1.5; 95% CI: 1.3-1.8), but they had a reduced risk of gum bleeding (OR = 0.7; 95% CI: 0.6-0.8). Dose response relationships between smoking and these variables were also observed. The results indicated that cigarette smoking was associated with oral health status independent of some aspects of dental health behavior.     

Insulation,asbestos, smoking habits,and lung cancer cell types

The association between occupational exposure to asbestos and histological type of lung cancer was analyzed in a multicenter hospital-based case-control study (2,871 male cases and 5,240 male controls) conducted from 1981-1991. Twenty-two percent of cases and 18% of controls were employed in asbestos-related occupations for at least 1 year. Most of these asbestos jobs were in the construction field. The odds ratio (OR) among current smokers was 1.0 [95% confidence intervals (CI) 0.9 to 1.3]; for ex-smokers, the OR was 1.4 (95% CI 1.1 to 1.6). In contrast, 10% of cases and 5% of controls self-reported that they were chronically exposed to asbestos for at least 1 year. Self-reported asbestos exposure was significantly related to all lung cancer cell types among smokers and ex-smokers, although a trend in the ORs with duration of self-reported exposure was not found for current smokers. Among 48 cases and 52 controls reporting distinct exposure to building insulation, the OR was 2.2 (95% CI 1.2 to 4.3) for current smokers, and 1.8 (95% CI 0.9 to 3.6) for ex-smokers, compared to subjects who were not exposed to building insulation and asbestos. A nonsignificant association with self-reported exposure to asbestos was observed for a small number of never smokers (eight of 83 nonsmoking cases, OR = 2.0, 95% CI 0.9 to 4.6). When examining these results and their causal implications, possible misclassification and reporting biases need to be considered.     

Metabolic syndrome and health-related quality of life among U.S. adults

PURPOSE: Little is known about the association between health-related quality of life and the metabolic syndrome. The objective of this study was to compare health-related quality of life in adults with and without the metabolic syndrome. METHODS: We performed a cross-sectional analysis of 1859 men and women aged > or =20 years from the National Health and Nutrition Examination Survey 2001-2002. Health-related quality of life was assessed with the Centers for Disease Control and Prevention HRQOL-4 tool. RESULTS: A larger percentage of participants with the metabolic syndrome had fair or poor health (difference = 11.3%, p = 0.002), > or =14 physically unhealthy days (difference = 5.0%) (p = 0.129), > or =14 mentally unhealthy days (difference = 7.4%) (p = 0.010), and > or =14 activity-limitation days (difference = 5.8%) (p = 0.024) during the past 30 days than participants without the metabolic syndrome. After adjusting for age, sex, ethnicity, educational status, and smoking status, participants with the metabolic syndrome were more likely to have fair or poor health (odds ratio [OR], 1.94; 95% confidence interval [CI], 1.21-3.13), > or =14 mentally unhealthy days (OR, 1.97; 95% CI, 1.28-3.02), and > or =14 activity limitation days (OR, 3.20; 95% CI, 1.46-7.02) than those without the metabolic syndrome. CONCLUSIONS: U.S. adults with the metabolic syndrome experience worse health-related quality of life than adults without this syndrome.