中国农村地区现在吸烟者戒烟意愿及其影响因素研究

目的 了解中国农村地区现在吸烟者戒烟意愿,探索其影响因素,为控烟工作提供参考。方法 本研究数据来源于2018年中国慢性病及危险因素监测,采用多阶段分层整群抽样的方法抽取184 509名≥18岁居民,其中10 241名农村现在吸烟者纳入研究。采用χ²/F检验对戒烟意愿与人口学信息、烟草使用情况、烟草相关危害知识的认知、慢性病患病情况等因素进行单因素分析,多因素分析采用非条件多因素logistic回归分析。结果 3 453名（37.46%）考虑在未来12个月内戒烟。logistic回归分析显示,偶尔吸烟者的戒烟意愿高于每天吸烟者（OR=0.693,95%CI：0.494~0.971）,每天吸烟量<1包者的戒烟意愿高于≥1包者（OR=0.628,95%CI：0.511~0.771）,12个月内有戒烟经历者的戒烟意愿高于12个月内未戒过烟的现在吸烟者（OR=0.438,95%CI：0.357~0.537）,烟草危害认知程度高者戒烟意愿更高（OR=1.056,95%CI：1.028~1.086）,差异均有统计学意义（P<0.05）。结论 中国农村地区现在吸烟者戒烟意愿与吸烟状况、吸烟量、戒烟情况、烟草危害认知有关。建议加强对农村地区的健康教育宣传,提供简短的戒烟干预,提高农村现在吸烟者的戒烟意愿。     

Exposure to psychosocial work strain and changes in smoking behavior during pregnancy – a longitudinal study within the Danish National Birth Cohort

Objective:Knowledge of the relationship between psychosocial strain in the work environment and smoking during pregnancy is scarce. This study aimed to examine the association between psychosocial job strain and change in smoking behavior during pregnancy.Methods:The cohort included 65 645 pregnancies from the Danish National Birth Cohort (1996–2002), where pregnant women were interviewed on job factors and lifestyle during the first and third trimesters. Smoking was categorized into non-, non-daily, and daily smoking at each interview. Psychosocial job strain was categorized into four groups based on the concept of Karasek’s demand–control model: low strain (reference), passive, active and high strain. Associations between psychosocial strain and change in smoking status between the first and second interviews were analyzed by multinomial logistic regression, separately for each smoking category at first interview.Results:Non-smoking women exposed to high strain work were more likely to become daily smokers [adjusted odds ratio (OR_adj) 1.41, (95% confidence interval (CI) 1.08–1.83)] compared to non-smoking women exposed to low strain work. Non-smoking women exposed to passive work were more likely to become both non-daily and daily smokers [OR_adj 1.59 (95% CI 1.21–2.08) and OR_adj 1.32 (95% CI 1.03–1.70), respectively]. Daily smoking women exposed to high strain work were less likely to decrease their smoking [OR_adj 0.57 (95% CI 0.32–0.99)] compared to daily smoking women exposed to low strain work.Conclusions:Psychosocial strain influenced the women’s smoking behavior during pregnancy, especially in job types with low control.     

Variation in smoking-related lung cancer risk factors by cell type among men in Argentina: a case-control study

A high mortality rate for lung cancer (62.7 per 100,000) is found in Rosario, Argentina. To investigate the reasons for this high rate, a case-control study was carried out among 215 male cases with histologically confirmed lung cancer and 433 hospitalized controls for conditions unrelated to tobacco consumption. Odds ratios (OR) of squamous cell (SQ), adenocarcinoma (AD), and small cell (SM) carcinoma of the lung associated with different characteristics of the smoking habit were quantified. Ninety-eight percent of the cases had smoked regularly. Smokers were significantly younger at diagnosis than ex-smokers (P<0.0001), a pattern consistent for all cell types. The ORs for the heaviest cf the lowest consumption categories were 15.3 for SQ, 11.6 for AD, and 11.6 for all lung cancer (P<0.0001). Risks associated with the use of unfiltered cigarettes were three to five times higher than those for filtered cigarettes, depending on cell types. For ex-smokers, risks after 10 years of nonsmoking were about 12 times lower than those of current smokers (P<0.001). To halt further increases in lung cancer, preventive measures in Argentina should be directed primarily towards smoking control.Ms Pezzotto and Drs Bay, Morini, and Poletto are with the Institute of Immunology, School of Medicine, National University of Rosario, Argentina. Dr Mahuad is with Hospital Italiano Rosario, Argentina. Address correspondence to Ms Pezzotto, Inst. Inmunologia, Facultad de Medicina, Santa Fe 3100, 2000 Rosario, Argentina.     

A case-control study of risk factor for renal cell cancer in northern Italy

A hospital-based case-control study of renal cell cancer was conducted in northern Italy betwen 1986 and 1989, with 240 cases of renal cell cancer (150 males and 90 females), and 665 controls (445 males and 220 females) chosen on the basis of age, sex, and area of residence. No associations were found between renal cell cancer and: body mass index (BMI); number of cigarettes smoked; age at starting to smoke; years of smoking; consumption of wine, beer, spirits, coffee, decaffeinated coffee; tea; intake of animal protein, fruits, and vegetables; various resproductive factors; hormonal use; sexual habits; sexually transmitted diseases; or selected occupational exposures. The odds ratio (OR) was above unity in smokers (OR=1.34 for 15 cigarettes/day), but the trends in risk with dose or duration were not statistically significant. Significant positive associations were found between renal cell cancer and sources of fat intake, especially margarine (OR for highest vs lowest intake = 1.71), and oils (OR=1.89) whereas carrot intake showed a negative association (OR=0.62). Also, a history of nephrolithiasis and multiple episodes of cystitis showed weak positive associations (OR=2.00, 95 percent confidence interval (CI) 1.07–3.73; and OR=1.60, 95 percent CI 0.95–2.70, respectively).Address reprint requests to Dr Talamini. The work was conducted with the contribution of the Italian Association for Cancer Research, Milan, Italy and the CNR (Italian National Research Council) Applied Projects Oncology (Contract n. 85.02209.44).Drs Talamini, Barón, Barra, Bidoli, Serraino, and Franceschi are in the Epidemiology Unit, Aviano Cancer Center, Via Pedemontana Occ. 33081 Aviano (PN) Italy. At the time of this work, Dr Barón was a visiting biostatistician from the Department of Preventive Medicine and Biometrics, University of Colorado, Health Science Center, CO, funded by the National Cancer Institute (US) and the Italian National Research Council. Dr Franceschi is also chief of the Hormones and Sexual Factors and Cancer Working Group of the European Organization for Cooperation in Cancer Prevention Studies, Bruxelles, Belgium. Drs La Vecchia and Negri are in the Mario Negri Institute for Pharmacological Research, Milan, Italy. Dr La Vecchia is also in the Institute of Social and preventive Medicine, University of Lausanne, Switzerland.     

吸烟对多环芳烃接触者生物膜损伤指标、染色体畸变和P21蛋白的影响

目的:了解吸烟对多环芳烃接触者生物膜损伤指标、染色体畸变和血清癌基因蛋白P21的影响.方法:对接触多环芳烃化合物的24名焦炉工和27名沥青工中吸烟与不吸烟者的血清谷胱甘肽S-转移酶(GST)、血清脂质结合唾液酸(LSA)、染色体畸变和血清癌基因蛋白P21水平进行研究.结果:吸烟与不吸烟者间GST、LSA、染色体畸变率和血清P21水平各指标差异均无显著性差异(P>0.05).结论:吸烟对多环芳烃接触者沥青工和焦炉工的GST、LSA、染色体畸变率和血清P21水平无明显影响,可能是沥青工、焦炉工接触多环芳烃混合物浓度较高,掩盖了吸烟的作用.     

焦炉工血清ras P21水平和外周血淋巴细胞SCE率检测

目的:为了解接触焦炉逸散物职业性人群遗传效应的改变,从分子水平揭示焦炉逸散物的遗传毒作用.方法:对25名焦炉工和12名正常对照分别检测了血清P21和外周血淋巴细胞姐妹染色单体互换(SCE)率.结果:发现焦炉工P21水平(3 774.2)、SCE率(11.43)明显高于对照组P21水平(1 270.7)和SCE率(6.37);焦炉工中,炉顶工血清P21均值(4 377.5)高于其它工种(3 300.1),炉顶工SCE(13.51)明显高于其它工种(10.07);对焦炉工按是否吸烟进行比较,未发现组间P21和SCE有差异显著性.结论:提示焦炉逸散物具有较强的遗传毒理学效应,可提高机体癌蛋白P21水平和SCE频率.     

Thalidomide-induced neuropathy and genetic differences in drug metabolism

A pharmacogenetic predisposition to thalidomide-induced neuropathy has been investigated. Differences of drug metabolism were examined in 16 patients with severe orogenital ulceration, who were treated with thalidomide (200 mg/day) for 0.3–5.0 years. Eight had evidence of early peripheral neuropathy according to nerve conduction studies. Rates of C-hydroxylation, N-acetylation, and conjugation reactions with sulphate, glucuronide and glycine, were tested with the probe compounds debrisoquine, sulphadimidine, paracetamol and aspirin, respectively. Urinary drug metabolites were analysed by high pressure liquid chromatography. Results were compared with 16 healthy age- and sex-matched volunteers.Of the patients 6.25% and 13.3% of the controls had a poor Debrisoquine Hydroxylator Ratio (DMR); none of the patients with neuropathy had a poor DMR as compared to 12.5% without neuropathy. Of the patients 40.0% and 35.7% of the controls were slow acetylators; 28.6% with neuropathy were slow acetylators as opposed to 50% without neuropathy. Similarly, there were no significant differences in rates of conjugation between groups. All unaffected patients were active smokers, whereas only two of those with neuropathy smoked. Cumulative dose or duration of therapy were unrelated to risk of neuropathy.In conclusion, changes of nerve conductivity are a frequent and unpredictable adverse effect of thalidomide (200 mg/day), although smoking may have a protective action against their development. Nerve conduction studies are required before and during treatment, irrespective of the prescribed dose.     

PSYCHOSOCIAL PROFILE OF PREGNANT ADOLESCENTS IN A LARGE AUSTRALIAN REGIONAL AREA

A psychosocial profile was developed of 122 pregnant adolescents attending a public hospital antenatal clinic in a large regional Australian area. Participants completed the Rosenberg Self-Esteem Scale and the Support Behaviours Inventory and were interviewed to obtain psychosocial and demographic information. Results revealed that those who were most likely to have either or a combination of poor self-esteem, lack of social support, be unemployed or smoke, were more likely to be living alone or with friends, not have a partner or have a partner for a shorter period, have a partner who was older, have previous children, have not planned their pregnancy and have less education. The degree of social support was significantly associated with self-esteem. Over half of the sample smoked, and over half were unemployed. These results underscore the importance of addressing psychosocial factors in the implementation of care for the pregnant adolescent.     

Smoking and Cancer Screening for Women Ages 42–75: Associations in the 1990–1994 National Health Interview Surveys

Background. Previous studies have found an association between current smoking and lower rates of mammography and Pap testing. The objective of this study was to investigate the association of smoking status with breast and cervical cancer screening across the 1990–1994 National Health Interview Surveys (NHIS). The NHIS provides a consistent set of independent and dependent variables across several surveys, with data collected by a similar in-person interview methodology from year to year. This report employs more databases than have been used in other analyses that have examined associations between smoking and cancer screening.Methods. Data were from the health promotion and cancer control supplements to the 1990–1994 NHIS. The target population was women ages 42–75. Associations were examined between smoking status (never, former, <1 pack/day, ≥1 pack/day) and three screening indicators: ever had a mammogram, mammogram in the past 2 years, and Pap test in the past 3 years. Sample sizes ranged from about 3000 to over 10,800 depending on the respective NHIS survey and dependent variable. Data analyses were conducted by bivariate and multiple logistic regression.Results. Women who smoked ≥1 pack of cigarettes per day were significantly less likely to have had mammography screening in all NHIS surveys, compared to women who never smoked. Adjusted odds ratios were 0.63 to 0.74 for ever had a mammogram, and 0.56 to 0.66 for mammography in the past 2 years. Women who smoked ≥1 pack per day also had lower Pap test rates than women who never smoked in 1992–1994 (adjusted odds ratios of 0.51–0.71). Results for lighter smokers were not as consistent. Former smokers often had significantly higher screening rates than never smokers.Conclusions. Research still needs to identify reasons for lower screening among women who smoke. Factors to explore include the social networks of smokers and broader health behavior patterns. Clinicians should consider heavier smoking as a marker for risk of not obtaining screening and make assessment of screening status a priority at each visit.     

Relationship between Cigarette Dose and Perceived Risk of Lung Cancer

BACKGROUND: Most people are aware that smoking cigarettes increases the risk of ill health, in particular of lung cancer. The precise way in which they relate amount of exposure to smoke and level of health risk has not, however, been determined. METHODS: A convenience sample of 155 French adolescents and adults ages 15 to 75 rated the risk of "smoker's cancer"--the popular term for lung cancer--in 24 scenarios depicting eight levels of daily cigarette consumption of three concentrations of nicotine. The data were analyzed according to functional measurement methodology to ascertain the forms of the relationship between exposure and perceived risk. RESULTS: All subjects perceived that the risk of smoker's cancer increased as smoking increased. Yet at high levels of consumption, additional cigarettes were generally judged to result in decreasing increments of risk, regardless of the nicotine content of the cigarettes and the sex and smoking status of the participants. Adolescents, however, were more likely than adults to perceive a linear, rather than a negatively accelerated, relationship. CONCLUSIONS: The actual form of the relationship between the dose of cigarette smoke and risk of lung cancer is either linear or positively accelerated. Public health educators and physicians should be aware that, at least in France, many people, particularly adults, incorrectly perceive this relationship as negatively accelerated.