不吸烟妇女一般肺部疾病与肺癌发生的关系

为进一步探讨肺结核、慢性支气管炎、肺气肿、哮喘及肺炎等疾病在肺癌发生中的可能作用,对美国密苏里州非吸烟妇女的肺癌进行了一项病例—对照研究。病例组为1981年6月1日至1991年4月1日该州登记在册的白种人非吸烟女性肺癌患者共618例,年龄30～84岁,其中432例(70%)从不吸烟,186例(30%)曾吸烟但已戒烟长达15年以上。在131例年龄低于65岁的病人中有118例持有驾驶执照。对     

吸烟与膀胱癌发病关系的调查分析

我们于1988～1998年对患膀胱癌的住院病人584例与吸烟的关系进行调查分析,现报告如下:1 资料来源与方法 调查组选择1988～1998年膀胱癌住院病例584例,其中男患468例;女患116例,年龄20～60岁以上,平均55.34±8.46岁。分别对不同年龄组、不同性别、病理类型、吸烟人数、吸烟病人的区域分布及吸烟量进行分析。对照组采用对424人健康男性患者家属(年龄25～65岁)随机问卷形式调查其吸烟情况,答卷率100％。2 结果与分析     

被动吸烟与非吸烟妇女的肺癌

目前,对非吸烟妇女肺癌的患病原因尚未完全明确。为评价被动吸烟与非吸烟妇女肺癌的联系,作者进行了此项研究。研究对象为美国密苏里州白人妇女,病例组为618例1988年1月～1991年6月确诊的原发性肺癌病人,平均年龄为71.5岁,其中包括终生非吸烟者432例(70%和戒烟者(停止吸烟15年以上或每年吸烟不超过1包)186例(30%)。另选1402例平均年龄为69.9岁的非肺癌病人作对照。调查时由受试者或其家属填写包括年龄、种族、吸烟状况、居住史、被动吸烟状况、自身及家族健康史、职业及饮食习惯等内容的调查表,然后由调查人员逐项核对。同时对468例(76%)病人作组织学检查。最后根据调查结果用多元logistic回归模型计算比数比(OR)及95%可信区间(CI),确定被动吸1烟与肺癌的关系。结果发现,儿童时期被动吸烟妇女中,患肺癌的危险无明显增加,而终生非吸烟妇女中     

吸烟、被动吸烟与肺癌发病风险的病例对照研究

目的 探讨吸烟、被动吸烟与肺癌的关联.方法 采用病例对照研究设计,面访肺癌新发病例1 303例和按性别、年龄(±2岁)频数匹配的健康对照1 303例.结果 吸烟是男性肺癌的重要危险因素(调整OR=4.974,95％ CI:3.933 ～6.291),随着开始吸烟年龄提前、吸烟年限延长、日吸烟量、吸烟包年以及吸烟深度的增加,患肺癌危险性增高,呈剂量反应关系(Ptrend＜0.001),戒烟≥10年患肺癌的危险性降低45.4％.男性吸烟患肺鳞癌的危险性比患肺腺癌大.被动吸烟是非吸烟者肺癌的危险因素(调整OR=1.912,95％CI:1.486～2.460),工作环境被动吸烟的男性非吸烟者患肺癌的调整OR为2.221(95％CI:1.361 ～3.625),家庭环境被动吸烟的女性非吸烟者患肺癌的调整OR为1.804(95％ CI:1.270～2.562).68.04％男性肺癌的发生可归因于吸烟,26.51％非吸烟者肺癌的发生可归因于被动吸烟.结论 吸烟是肺癌的重要危险因素,工作环境被动吸烟是男性非吸烟者肺癌的主要危险因素,家庭环境被动吸烟是女性肺癌的主要危险因素.戒烟具有重大的公共卫生学意义.     

生活贴士

吸烟的4大危害世界卫生组织发表的研究报告显示,35～69岁这一年龄段死亡者中有30%是死于吸烟所引起的疾病,平均折寿23年!70岁以上年龄段吸烟者,平均折寿8年。妇女吸烟促衰老美国的科学家通过研究发现,吸烟的妇女在年龄相仿的人群中,提前进入绝经期的比例最高;吸烟还是使妇女嘴唇和眼角过早出现皱纹的重要原因。吸烟妇女易致小便失禁     

从来不吸烟的男性肺癌

许多国家的医学者早在20～30年以前就已经查明吸烟对肺癌的发生有着非常重要的作用,这在近年来的研究也得到证实。但是在临床上也见到从来不吸烟的肺癌病人,作者在最近15年期间(1967～1982),详细地研究了吸烟及其强度和肺癌发病率之间的相互关系,并且查明发病率与病人的性别有很大差别:女性肺癌病人(800多例)吸烟与不吸烟的比例为1∶1;而男     

长春市2005例妇女骨密度调查报告

目的:调查长春市2005例妇女骨密度,为长春市女性骨密度正常值提供数据资料,对不同年龄妇女的骨密度变化进行统计分析,获得骨密度峰值(BMDg/cm2),T值百分比及骨质疏松(OP)发病率。方法:采用OsteometerMediTech公司生产的DTX-200骨密度仪对长春市2005例妇女进行骨密度测量,将测量结果按10岁为1年龄段分组,使用SPSS13.0软件进行统计分析。结果:①长春市女性骨密度峰值出现在30岁年龄段,40岁开始缓慢下降,60岁开始明显下降;②50～59岁年龄段骨质疏松发病率为14.74%,60～69岁年龄段发病率为51.25%,70～79岁年龄段发病率为74.42%,80～89岁年龄段发病率为86.11%。结论:女性骨质疏松的发生与绝经关系密切,60岁以后骨质疏松发病率呈递增趋势,不同年龄段骨质疏松发病率差异显著(P<0.01)。     

前列腺癌与生活行为方式病例对照研究

目的探讨前列腺癌与生活行为方式的病因学关系。方法选择在中山大学4所附属医院诊断的前列腺癌患者62例，选择良性前列腺增生、其他疾病患者各62例为对照（1：2配对），匹配条件为年龄组（±5岁）、性别、民族和居住地类型相同。调查以面谈为主，辅以病历记录，采用条件Logistic回归法分析数据。结果以前列腺增生为对照。吸烟量每天20支及以上者患前列腺癌的危险是不吸烟者的2．19（0．87～5．52）倍；年吸烟量达800支以上者患前列腺癌的危险是不吸烟者的2．08（0．81～12．679）倍。以其他病例为对照，日饮酒量超过100g（乙醇）者患前列腺癌的危险是不饮酒者的2．17（0．7～6．63）倍；饮酒年限达40年及以上者患前列腺癌的危险是不饮酒者的3．35（O．89～5．30）倍。体育锻炼频率每周少于5次增加前列腺癌的患病危险，OR〈3次／周=6．68（0．46-97．58），OR3-5次／周=8．48（1．37～52．61）。未发现饮茶与前列腺癌有统计学关联。结论吸烟是前列腺癌的危险因素，饮酒年限长者和缺乏锻炼者易患前列腺癌．     

肺癌介入治疗患者的心理状态及护理体会

现将我院1997年11月至2001年11月收治的60例肺癌患者的护理体会总结如下。 1 临床资料 60例病人中,男48例,女12例,年龄30岁～75岁,平均年龄52岁。原发性中、晚期肺癌45例,转移性肺癌15例。 2 心理特点及护理     

某沿海地区男性公务员吸烟/饮酒与高血压检出情况分析

目的 探讨某地区男性公务员人群吸烟／饮酒不良行为分布情况及其与高血压检出率的关系。方法 利用体检相关数据，采用两样本率卡方检验分析。结果 公务员各年龄段的吸烟率随年龄增加而上升，35～44岁组为最高，饮酒率则推迟10年，45—54岁组最高，此后随年龄递增两者均趋下降。平均烟量(支／d)和酒精量(ml／d)也随年龄增加而分别增加，但分别在45～54岁和55～64岁达最高，65～岁快速下降。各年龄段吸烟与对照组的高血压检出率差异均无显著性；25—34岁和65～岁饮酒与对照组的高血压检出率差异有显著性，其它年龄段显示饮酒高于对照组的趋势，但差异无显著性；饮酒人群的高血压检出率有高于对照组和吸烟组的趋势。结论 经济发达地区公务员嗜烟问题有所改善，与政府干预和个人健康意识加强有关。饮酒问题，以青年和老年期为最突出，其它年龄段可能样本例数少未能呈现，但数据显示嗜酒与高血压检出有密切的关系，值得引起重视。     

Household smoking bans and adolescents' perceived prevalence of smoking and social acceptability of smoking

OBJECTIVES: Household smoking bans might decrease the visibility of cigarette smoking and communicate nonsmoking social norms and parental attitudes to youths, which may serve as mediators to reduce smoking initiation. Whether they have these effects even if parents smoke or do not otherwise communicate strong disapproval of smoking to their children is not clear. We tested these hypotheses in multi-level analyses. METHODS: A telephone survey of a random sample of 3831 Massachusetts adolescents (12-17 years) assessed respondents' perceptions of smoking prevalence and attitudes about the social acceptability of smoking in their community. The association of these outcomes with the presence of a smoking ban in the youths' home was tested in multivariate analyses that adjusted for town-level clustering and individual and environmental characteristics. RESULTS: A household smoking ban was reported by 71% of all youths and 49% of youths who lived with smokers. In multivariate models, youths who had a household smoking ban were more likely to perceive a lower adult smoking prevalence (OR 2.1; 95% CI 1.7-2.5; P < 0.001), greater adult disapproval of adult smoking (OR 2.0; 1.5-2.6; P < 0.001) and of teen smoking (OR 1.5; 95% CI 1.2-1.9; P = 0.001). CONCLUSIONS: Among adolescents, a household smoking ban was associated with a lower perceived prevalence of adult smoking in their communities and more negative attitudes about the social acceptability of smoking, two factors that affect the likelihood of smoking initiation. Household smoking bans had these effects even in the presence of two parental factors known to encourage adolescent smoking initiation (parental smoking and lack of perceived parental disapproval of youth tobacco use). This provides an additional rationale for promoting household smoking bans to parents.     

Household smoking restrictions and adolescent smoking

PURPOSE: To examine the association between household smoking restrictions and adolescent smoking, controlling for parental smoking, peer smoking, and tobacco marketing. DESIGN: Cross-sectional analysis of 1999 data from the Growing Up Today Study, a longitudinal cohort of adolescents. SETTING: Self-report questionnaire. SUBJECTS: 10,593 adolescents aged 12 to 18 years. MEASURES: The dependent variable was established smoking (smoking > or = 100 cigarettes). Variables of interest were household smoking restrictions, parental smoking, peer smoking, and tobacco promotional item (TPI) possession. RESULTS: Four percent of participants reported that their households permitted smoking. Parental smoking, peer smoking, and TPI possession were significantly associated with established smoking In logistic regression models adjusted for age, gender, peer smoking, and TPI possession, adolescent smoking was inversely related to the presence of a restrictive household policy (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.48-0.93); however, when parental smoking was added to this model, the association was attenuated (OR = 0.94, CI = 0.65-1.35). When only one parent in the household smoked, smoking restrictions were more common when this parent was the father. CONCLUSIONS: Although household smoking restrictions offer health benefits, they do not appear to be associated with adolescent smoking after accounting for other factors. Prior studies did not include parental smoking, peer smoking, and marketing influences. This analytic difference may explain apparent contradictions in the literature.     

Meanings of smoking and adolescent smoking across ethnicities.

PURPOSE: To develop insight into population-specific meanings of smoking in our highly multicultural middle schools in order to provide effective and appropriate tools for smoking prevention efforts. METHODS: We used focus group interviews to develop the Meanings of Smoking Index (MSI), a nine-item scale that uses a "mark all that apply" strategy to assess what smoking means to children who have tried smoking as well as to those who are susceptible to smoking. In 24 public and parochial middle schools in the greater Los Angeles area, 2336 7th graders (1483 Latino, 565 Asian/ Pacific Islander and 288 white, 55.2% of the sample was female) completed the MSI as part of a school-based trial of culturally-targeted smoking prevention strategies. Items were rank ordered according to salience (rate of endorsement) and relevance (strength of relationship with lifetime smoking) across the entire sample and separately for Hispanic/Latino, Asian/Asian-American and white respondents. Spearman correlation coefficient was used to compare results between ethnicities. RESULTS: The most frequently endorsed meanings were similar across ethnicities. Magnitude of associations between smoking behaviors and meanings were dissimilar across ethnicities. The meaning with the strongest relationship to lifetime smoking for whites and Latinos was "it helps me study" (OR 3.4 and 2.6 respectively), and for Asians was "don't want to make another smoke alone" (OR 5.4). CONCLUSIONS: We have shown previously that interventions on meanings of eating behaviors changed dietary behaviors in adolescents. The present findings suggest that meanings are powerful determinants of adolescent smoking in culturally diverse populations and could offer powerful intervention tools to prevent adolescent smoking.     

Association of smoking status, cumulative smoking, duration of smoking cessation, age of starting smoking, and depression in Korean adults

ABSTRACT: BACKGROUND: Many previous studies did not sufficiently control for several confounding factors that may affect the association between smoking and depression, such as socioeconomic status. We investigated the association between depression and smoking status, smoking exposure, duration of smoking cessation, and age of starting smoking while controlling for socioeconomic factors. METHODS: This study was based on a community health survey performed in Jeollanam-do, South Korea, between September and November 2009. In total, 20,084 subjects (9,128 males and 10,966 females) were included in the analysis. Information on smoking characteristics, such as smoking status, pack-years of smoking, and age of starting smoking, was collected using a standardized questionnaire. Depression was defined using the Korean CES-D score. RESULTS: The odds ratios (ORs) of depression were 1.35 (0.92-1.98) for former smokers and 1.77 (1.27-2.48) for current-smokers among males, and 2.67 (1.38-5.16) for former smokers and 3.72 (2.11-6.54) for current-smokers among females, after adjusting for other confounding factors. Compared to light smoking, heavy smoking was significantly associated with depression in males [OR = 3.97, 95% confidence interval (CI) = 1.42-11.14], but not in females (OR = 1.24, 95% CI = 0.73-2.09). No significant associations between depression and age of starting smoking and duration of smoking cessation were observed among former smokers. CONCLUSIONS: Our data demonstrate that smoking is strongly associated with depression, particularly among females. These findings suggest that depression prevention may need to be combined with smoking prevention and that different strategies may be needed for males and females.     

Predicting adult smoking: the influence of smoking during adolescence and smoking among friends and family

The aim of the study was to predict smoking from early adolescenceto adulthood by using longitudinal data. The data was gatheredin connection with the North Karelia Youth Project. The projectwas started in 1978 with students in the seventh grade of juniorhigh school (aged 13 years) and finished in 1980 when the studentsreached the ninth grade. The follow-up study included four additionalsurveys over 15 years, the last being in 1993–94. Theresults show that two-thirds of the smokers in the ninth gradeof junior high school (aged 15 years) were still smoking atthe age of 28. About half of the smokers at the age of 28 weresmokers in the ninth grade and the other half had started afterthat. Previous smoking status and smoking by friends were themost important predictors of smoking. The continuity of smokingand non-smoking from adolescence to adulthood supports the importanceof prevention programs in junior high school. On the other hand,about half of the smoking adults had started smoking after that.This indicates that the prevention programs should continueafter junior high school.     

拒烟自我效能在吸烟危害认知对戒烟成功影响的中介效应分析

目的 分析拒烟自我效能在吸烟危害认知对戒烟成功影响的中介效应。方法 采用以社区人群为基础的病例对照研究设计,以642例男性自发性戒烟成功者为病例组,700例男性自发性戒烟失败者为对照组。吸烟危害认知水平由12个评分项目的总分评估,拒烟自我效能由拒烟自我效能问卷评估。总效应被分解为直接效应和间接效应,通过基于KHB法的logistic回归分析探讨各效应。结果 调整潜在混杂因素(包括年龄、开始吸烟年龄、职业、教育水平、婚姻状况)后,拒烟自我效能的中介效应仅占吸烟危害认知对戒烟成功影响总效应的6.03%,吸烟危害认知对戒烟成功影响的直接效应占总效应的93.97%;在3种拒烟自我效能情境(包括积极、消极、习惯情境)下的中介效应占吸烟危害认知对戒烟成功总效应的比例分别为6.80%、3.08%和2.32%。结论 拒烟自我效能在吸烟危害认知对戒烟成功的影响具有部分中介效应。提高吸烟者的危害认知水平可直接促使其戒烟成功,并可通过增大拒烟自我效能促使其成功戒烟。     

Adolescent smoking

Most smokers start experimenting with cigarettes in early adolescence. This paper describes the factors which influence the development of the smoking habit. Methods of intervention, both in and out of the classroom, are discussed. Recommendations for further legislation and increased taxation on tobacco are supported.