Do sports clubs promote snuff use? Trends among Finnish boys between 1981 and 1991

Adolescent snuff use was rare in Finland but increased in the1980s. ‘Snuffing’ was most frequent in urban regionsand among the physically active. Physical activity has, however,been found to promote a healthy lifestyle. We analysed the relationshipbetween snuff use and physical activity, especially that organizedby sports clubs, during a 10 year period. Boys between 16 and18 years old were studied in a biannual Adolescent Health andLifestyle Survey in 1981–1983 (N = 3667, response rate76%), 1987 (N = 3175, 73%) and 1991 (N = 2936, 65%) by mailedquestionnaires. Snuff use was related only to physical activityorganized by sports clubs and only in the most urbanized area.Smoking was less frequent among the participants of sports clubactivities than the non-participants. In sports clubs, snuffusers drank and smoked more frequently than non-users. Of tobaccousers, snuff use was five times more common among participantsof sports club activities than non-participants. Snuff use haspartly substituted for cigarette smoking in the sports clubsof the most urbanized area. During the study period the socialenvironment of the sports clubs has persistently encouragedthe adoption of habitual snuff use.     

Snuff use and smoking in U.S. men: implications for harm reduction

BACKGROUND: Encouraging smokers to switch to snuff may have unintended public health implications. This study examined the associations between snuff use and smoking in a representative sample of U.S. men. METHODS: Subjects were males aged >or=18 years in the National Health Interview Survey (N=13,865). The data analysis was conducted between August 2001 and April 2002. Multiple logistic regression modeling was used to examine the association between using snuff and quitting smoking. RESULTS: In 1998, 26.4% of U.S. men smoked, 3.6% used snuff, and 1.1% used both products. Adjusting for age and race/ethnicity, current smoking was most prevalent among males who used snuff on some days (38.9%) and lowest among those who used snuff every day (19.2%). Daily snuff users were significantly more likely than never-users to have quit smoking in the preceding 12 months (odds ratio [OR]=4.23; 95% confidence interval [CI]=2.16-8.28). However, U.S. men were more likely to be former snuff users who currently smoked (2.5%) than to be former smokers who currently used snuff (1.0%). Occasional snuff users (some day users) were more likely than never users to have tried to quit smoking in the preceding year (OR=1.69; 95% CI=1.04-2.76) but tended to be less likely to succeed (OR=0.50; 95% CI=0.19-1.33). CONCLUSIONS: Some men may use snuff to quit smoking, but U.S. men more commonly switch from snuff use to smoking. Some smokers may use snuff to supplement their nicotine intake, and smokers who also use snuff are more likely than nonusers to try to quit smoking but tend to have less success.     

Prediction intervals for overdispersed binomial data with application to historical controls

Bioassays are highly standardized trials for assessing the impact of a chemical compound on a model organism. In that context, it is standard to compare several treatment groups with an untreated control. If the same type of bioassay is carried out several times, the amount of information about the historical controls rises with every new study. This information can be applied to predict the outcome of one future control using a prediction interval. Since the observations are counts of success out of a given sample size, like mortality or histopathological findings, the data can be assumed to be binomial but may exhibit overdispersion caused by the variability between historical studies. We describe two approaches that account for overdispersion: asymptotic prediction intervals using the quasi-binomial assumption and prediction intervals based on the quantiles of the beta-binomial distribution. Both interval types were α-calibrated using bootstrap methods. For an assessment of the intervals coverage probabilities, a simulation study based on various numbers of historical studies and sample sizes as well as different binomial proportions and varying levels of overdispersion was run. It could be shown that α-calibration can improve the coverage probabilities of both interval types. The coverage probability of the calibrated intervals, calculated based on at least 10 historical studies, was satisfactory close to the nominal 95%. In a last step, the intervals were computed based on a real data set from the NTP homepage, using historical controls from bioassays with the mice strain B6C3F1.     

Handling of cytostatic drugs and urine mutagenesis

Summary As part of a French national epidemiologic study on human reproduction among hospital personnel, we investigated urine mutagenicity of nurses and personnel from oncology units exposed to cytostatic drugs. During a first series of experiments, urine mutagenicity of 47 subjects working in six oncology units was investigated in the Marseille regional's hospital. A control group of 37 individuals working in one cardiology clinic was also included. Urinary mutagens were extracted on XAD-2 resin and tested by two bacterial mutagenicity tests: the Ames test with tester strains Salmonella typhimurium TA 97, TA 98, TA 100 and TA 102 with or without metabolic activation (S9 MIX) and the SOS Chromotest with tester strain Escherichia coli PQ 37-S9 MIX. Bactericidal activity towards the tester strains was found in 40% of the urine samples (36/90). During a second series of experiments, urine mutagenicity of 17 office clerks was also investigated. Toxicity was found in six of the 21 urine samples. No significant difference of toxicity distribution and no relationship between toxicity and cigarette smoking were found. Qualitative analysis of the data showed no significant difference among the exposed groups and the control group (Chi 2 = 0.529, df = 2) with tester strain TA 98 + S9 MIX. Cigarette smoking was found to be the main factor of increased urinary mutagenicity (Chi 2 = 0.529, df = 1). Quantitative analysis of the data showed that mutagenic potencies varied from 0.332 ±0.539 revertants/mg creatinine to 7.226 ± 6.743 revertants/mg creatinine with TA 98 + S9 MIX. A relationship between the number of cigarettes smoked and mutagenic potency was found (Spearman rank coefficient r _s = 0.412, P < 0.05). One urine sample was found to be mutagenic with tester strain TA 102 and PQ 37.     

Multiethnic polygenic risk scores improve risk prediction in diverse populations

Methods for genetic risk prediction have been widely investigated in recent years. However, most available training data involves European samples, and it is currently unclear how to accurately predict disease risk in other populations. Previous studies have used either training data from European samples in large sample size or training data from the target population in small sample size, but not both. Here, we introduce a multiethnic polygenic risk score that combines training data from European samples and training data from the target population. We applied this approach to predict type 2 diabetes (T2D) in a Latino cohort using both publicly available European summary statistics in large sample size (N_eff = 40k) and Latino training data in small sample size (N_eff = 8k). Here, we attained a >70% relative improvement in prediction accuracy (from R² = 0.027 to 0.047) compared to methods that use only one source of training data, consistent with large relative improvements in simulations. We observed a systematically lower load of T2D risk alleles in Latino individuals with more European ancestry, which could be explained by polygenic selection in ancestral European and/or Native American populations. We predict T2D in a South Asian UK Biobank cohort using European (N_eff = 40k) and South Asian (N_eff = 16k) training data and attained a >70% relative improvement in prediction accuracy, and application to predict height in an African UK Biobank cohort using European (N = 113k) and African (N = 2k) training data attained a 30% relative improvement. Our work reduces the gap in polygenic risk prediction accuracy between European and non‐European target populations.     

Role of tobacco use in the etiology of acoustic neuroma

Two previous studies suggest that cigarette smoking reduces acoustic neuroma risk; however, an association between use of snuff tobacco and acoustic neuroma has not been investigated previously. The authors conducted a case-control study in Sweden from 2002 to 2007, in which 451 cases and 710 population-based controls completed questionnaires. Cases and controls were matched on gender, region, and age within 5 years. The authors estimated odds ratios using conditional logistic regression analyses, adjusted for education and tobacco use (snuff use in the smoking analysis and smoking in the snuff analysis). The risk of acoustic neuroma was greatly reduced in male current smokers (odds ratio (OR) = 0.41, 95% confidence interval (CI): 0.23, 0.74) and moderately reduced in female current smokers (OR = 0.70, 95% CI: 0.40, 1.23). In contrast, current snuff use among males was not associated with risk of acoustic neuroma (OR = 0.94, 95% CI: 0.57, 1.55). The authors' findings are consistent with previous reports of lower acoustic neuroma risk among current cigarette smokers than among never smokers. The absence of an association between snuff use and acoustic neuroma suggests that some constituent of tobacco smoke other than nicotine may confer protection against acoustic neuroma.     

Impact of sample collection participation on the validity of estimated measures of association in the National Birth Defects Prevention Study when assessing gene‐environment interactions

To better understand the impact that nonresponse for specimen collection has on the validity of estimates of association, we examined associations between self‐reported maternal periconceptional smoking, folic acid use, or pregestational diabetes mellitus and six birth defects among families who did and did not submit buccal cell samples for DNA following a telephone interview as part of the National Birth Defects Prevention Study (NBDPS). Analyses included control families with live born infants who had no birth defects (N = 9,465), families of infants with anorectal atresia or stenosis (N = 873), limb reduction defects (N = 1,037), gastroschisis (N = 1,090), neural tube defects (N = 1,764), orofacial clefts (N = 3,836), or septal heart defects (N = 4,157). Estimated dates of delivery were between 1997 and 2009. For each exposure and birth defect, odds ratios and 95% confidence intervals were calculated using logistic regression stratified by race‐ethnicity and sample collection status. Tests for interaction were applied to identify potential differences between estimated measures of association based on sample collection status. Significant differences in estimated measures of association were observed in only four of 48 analyses with sufficient sample sizes. Despite lower than desired participation rates in buccal cell sample collection, this validation provides some reassurance that the estimates obtained for sample collectors and noncollectors are comparable. These findings support the validity of observed associations in gene‐environment interaction studies for the selected exposures and birth defects among NBDPS participants who submitted DNA samples.     

Household smoking behaviours and exposure to environmental tobacco smoke among infants: are current strategies effectively protecting our young?

Objective: To determine the prevalence of infant exposure to environmental tobacco smoke (ETS) among infants attending child health clinics in regional NSW; the association between such exposure and household smoking behaviours; and the factors associated with smoking restrictions in households with infants. Methods: Parents completed a computer‐based questionnaire and infant urine samples were collected. Information was obtained regarding the smoking behaviours of household members and samples were analysed for cotinine. Results: Twenty seven per cent of infants had detectable levels of cotinine. Infant ETS exposure was significantly associated with the smoking status of household members, absence of complete smoking bans in smoking households and having more than one smoker in the home. Smoking households were significantly less likely to have a complete smoking ban in place. Conclusions: This study suggests that a significant proportion of the population group most vulnerable to ETS were exposed. Implications: Future efforts to reduce children's exposure to ETS need to target cessation by smoking parents, and smoking bans in households of infants where parents are smokers if desired reductions in childhood ETS‐related illness are to be realised.     

Proactive outreach smoking cessation program for Chinese employees in China

We evaluated the first workplace intervention to help smokers quit in Hong Kong. Smoking employees (N = 642) received a 26-page self-help booklet and 15 fix SMS within 3 months and chose to receive cognitive behavioral workshop (N = 76), or face-to-face counseling (N = 11), or group health talk (N = 516), or telephone counseling (N = 39). Twenty participants were interviewed individually for their opinions about the interventions. By intention-to-treat, the overall self-reported past 7-day point prevalence quit rate was 31.0% and 32.9%, and reduction rate was 15.0% and 13.2% at 6 and 12-months, respectively. More than 20% of the unmotivated smokers at baseline (N = 399) quit in this program. Proactive outreach workplace smoking cessation programs with diverse intensity but without medications, chosen by smokers and supported by employers without further incentives, were feasible in busy working environment in Hong Kong.     

The sociodemographic pattern of tobacco cessation in the 1980s: results from a panel study of living condition surveys in Sweden.

STUDY OBJECTIVES: To analyse the factors that determined whether or not people were successful in quitting tobacco during the 1980s in Sweden. DESIGN: A logistic regression model was used for the analyses and included: education, marital status, socioeconomic group, social network, physical activities, cigarette consumption, and years spent smoking as independent variables. Men and women were analysed separately for smoking. A specific univariate analysis was also performed for men who used snuff. SETTING: Sweden. PARTICIPANTS: A panel of 5104 randomised people aged 16-84 years was interviewed in 1980-81 and followed up in 1988-89 in the survey of living conditions undertaken by Statistics Sweden. The participation rate was 86%. The panel included 1546 men and women who were daily smokers. There were 418 daily users of snuff among the men, and 129 men both smoked and used snuff. MAIN RESULTS: Together 26% of women and 23% of men had quit smoking. Five percent in both groups were new smokers. Among men, 26% had quit using snuff and 5% had begun smoking. New snuff users among men were 5%. In the multivariate analysis, unmarried men kept smoking at significantly higher rates (OR 2.1; 95% CI 1.2,3.6), as did those men who smoked 11-20 cigarettes/day (OR 2.2; 95% CI 1.5, 3.4), or more than 20 cigarettes/day (OR 2.8; 95% CI 1.4,5.7). Among women, smoking 11-20 cigarettes/day was also a significant factor (OR 3.3; 95% CI 2.1,5.0). Men and women aged 25-44 were significantly more likely to continue smoking (OR = 2.1; 95% CI 1.1,3.7, and 2.2; 95% CI 1.2,4.4) as were those who had smoked for 20 years or more (OR 4.7; 95% CI 2.0,10.8 and OR 2.5; 95% CI 1.1,5.5, respectively). For women, low education (up to grade 9) was also a significant factor (OR = 2.5; 95% CI 1.2,5.1). Among men who had quit using snuff we did not find any values of significance. CONCLUSIONS: One in four smokers had quit during the 1980s and a few started smoking (5%). Some men quit smoking and started using snuff instead. For both sexes, the daily consumption of cigarettes, years spent smoking, and age were the most important determinants of successful quitting. In men, being married/ cohabiting was an important factor as was higher education in women.