Cigarette smoking among gay and bisexual men

OBJECTIVES: This study measured the prevalence of cigarette smoking among gay men and identified associations with smoking. METHODS: Household-based (n = 696) and bar-based (n = 1897) sampling procedures yielded 2593 gay male participants from Portland, Ore, and Tucson, Ariz, in the spring of 1992. RESULTS: Forty-eight percent of the combined sample reported current smoking, a rate far above prevalence estimates for men in Arizona (z = 14.11, P < .001) or Oregon (z = 24.24, P < .001). Significant associations with smoking included heavy drinking, frequent gay bar attendance, greater AIDS-related losses, HIV seropositivity, lower health rating than members of same age cohort, lower educational attainment, and lower income. CONCLUSIONS: Rates of cigarette smoking are very high among gay men. Tobacco prevention and cessation campaigns should be designed to reach the gay male community.     

Cigarette smoking and stages of change among men and women in Kiev,Ukraine

BACKGROUND: Assisting current smokers to progress towards stopping smoking entails identifying their readiness to stop and understanding the factors that may influence their readiness. Relations were established between certain predictor variables (intensity of smoking, age at initiation, duration of smoking, and gender) and stages of readiness to change smoking behaviour in Kiev, Ukraine. METHODS: Analysis was based on a convenient sample of 536 current smokers who completed a stages-of-change questionnaire in a public square in the centre of Kiev's business district, between 22 and 25 July 2000. Frequency distributions, odds ratios, the Kolmogorov-Smirnov test and the Wilcoxon rank-sum test were used to summarize and describe the data. Tests of significance were based on the 0.05 level. RESULTS: The majority of participants (56.1%) were categorized as precontemplative. Less than 20% of the subjects were prepared for action to change smoking behaviour. Later age at smoking initiation was associated with fewer cigarettes smoked per day. Females were more likely then males to seriously consider cutting down the number of cigarettes they smoked. However, males were more likely to have intentionally quit smoking for at least one day within the past year. CONCLUSION: Information on stages of readiness to stop smoking provided by this study may be useful for improving the effectiveness of smoking cessation programmes in Kiev.     

Cigarette smoking and risk of type 2 diabetes mellitus among middle-aged and elderly Japanese men and women

For examination of sex- and age-specific relations between smoking and risk of type 2 diabetes mellitus, 39,528 nondiabetic men and 88,613 nondiabetic women aged 40-79 years who underwent health checkups in Ibaraki-ken, Japan, in 1993 were followed through 2002. Risk ratios for diabetes according to smoking habits were calculated using a Cox proportional hazards model. Compared with never smokers, the risk ratio for diabetes among current smokers, after adjustment for age, systolic blood pressure, antihypertensive mediation use, alcohol intake, parental history of diabetes, body mass index, fasting status, blood glucose concentration, total and high density lipoprotein cholesterol levels, and log-transformed triglyceride level, was 1.27 (95% confidence interval (CI): 1.16, 1.38) in men and 1.39 (95% CI: 1.20, 1.61) in women. The excess risk was more pronounced among men with a parental history of diabetes than among men without one. The excess risk among current smokers was observed in both age subgroups (40-59 and 60-79 years). Respective multivariate risk ratios for the age subgroups were 1.37 (95% CI: 1.18, 1.60) and 1.20 (95% CI: 1.08, 1.34) in men and 1.45 (95% CI: 1.18, 1.79) and 1.34 (95% CI: 1.09, 1.66) in women. Smoking was independently associated with increased risk of type 2 diabetes among both middle-aged and elderly men and women.     

Cigarette smoking and bone mineral density in older men and women.

OBJECTIVES. The association between cigarette smoking and bone mineral density was examined prospectively in a population-based study of older Caucasian men and women. METHODS. Smoking patterns were determined at a 1972-1974 baseline evaluation and, again, 16 years later when 544 men and 822 women had bone mineral density measurements taken. RESULTS. Men and women who were cigarette smokers at baseline demonstrated significantly reduced bone mineral density of the hip compared with nonsmokers. Baseline smoking was not associated with significantly lower bone density at non-hip sites. Women demonstrated a significant dose-response relationship between baseline smoking status at all hip sites measured. Both sexes exhibited significant dose-response relationships between hip bone mineral density and change in smoking status between baseline and follow-up, demonstrating that smoking cessation in later life was beneficial in halting bone density loss associated with smoking. CONCLUSIONS. Smoking was positively and significantly associated with decreased hip bone mineral density in old age. Bone loss associated with smoking would be expected to predict an increased risk of hip fracture in those who do not succumb earlier to another complication of tobacco use.     

Cigarette smoking, menstrual symptoms and miscarriage among young women

OBJECTIVE: To examine associations between cigarette smoking and menstrual symptoms and miscarriage among young women. METHOD: The study sample consists of 14,779 women aged 18-23 years who participated in the mailed baseline survey for the Australian Longitudinal Study on Women's Health, conducted in 1996. The main outcome measures are self reported menstrual symptoms and miscarriages. RESULTS: Current smokers and ex-smokers had an increased risk of menstrual symptoms and miscarriages compared with women who had never smoked, with the highest risk occurring in heavy smokers (adjusted odds ratios for those smoking > or = 20 cigarettes per day: premenstrual tension 1.5 (95% confidence interval 1.3 to 1.7), irregular periods 1.5 (1.3 to 1.8), heavy periods 1.6 (1.4 to 1.9), severe period pain 1.5 (1.4 to 1.7), one or more miscarriages 2.0 (1.5 to 2.8). The odds ratios generally increased with numbers of cigarettes smoked and a younger age of starting to smoke. CONCLUSION: This study suggests that young women who smoke are at higher risk of a range of menstrual problems and miscarriage than those who have never smoked. The immediacy of this risk (in contrast to the longer term risks of chronic disease) can be used to improve the relevance of anti-smoking campaigns targeted to young women.     

Cigarette smoking gives more respiratory symptoms among women than among men. The Nord-Trondelag Health Study (HUNT)

STUDY OBJECTIVE: Studies have indicated that women are more vulnerable to the effect of tobacco smoking compared with men. The aim of this study was to explore the prevalence of reported respiratory symptoms and diseases according to smoking burden, age and sex. DESIGN: Questionnaire in a cross sectional population based study. SETTING: The BONT (Bronchial obstruction in Nord-Trondelag) study is part of a comprehensive health survey of all inhabitants aged above 19 years in the county of Nord-Trondelag, Norway, which was carried out from 1995 to 1997. PARTICIPANTS: A total of 65 717 subjects, 71.3% of the total population aged 20-100, answered the main questionnaire. MAIN RESULTS: In all, 12.7% men and 12.1% women reported episodes of wheezing or breathlessness during the past 12 months, 8.8% men and 8.4% women reported that they had or had had asthma, 7.5% men and 8.2% women had ever used asthma medication, and 4.0% men and 3.0% women reported chronic bronchitis. Thirty per cent of men and 31% of women were smokers, and average pack years of smoking were 15.9 and 10.3, respectively. Among previous and current smokers, significant more women reported episodes of wheezing or breathlessness, current asthma and persistent coughing compared with men with the same smoke burden (pack years) and daily number of cigarettes. CONCLUSION: The prevalence of reported asthma and use of asthma medication was higher than reported in previous Scandinavian studies. Respiratory symptoms increased by smoking burden. Comparing the prevalence of symptoms and current asthma among women and men with the same smoke burden or daily cigarette consumption, women seemed to be more susceptible to the effect of tobacco smoking than men.     

Cigarette smoking and erectile dysfunction among Chinese men without clinical vascular disease

The authors examined the association between cigarette smoking and risk of erectile dysfunction among 7,684 Chinese men aged 35-74 years without clinical vascular disease. Cigarette smoking and erectile dysfunction were assessed by questionnaire. Vascular risk factors were measured according to standard methods. After adjustment for age, education, alcohol consumption, physical inactivity, diabetes, hypertension, overweight, and hypercholesterolemia, the odds ratio of erectile dysfunction was 1.41 (95% confidence interval (CI): 1.09, 1.81) for cigarette smokers compared with never smokers. There was a statistically significant dose-response relation between cigarette smoking and risk of erectile dysfunction (p(trend) = 0.005). Multivariate-adjusted odds ratios of erectile dysfunction were 1.27 (95% CI: 0.91, 1.77), 1.45 (95% CI: 1.08, 1.95), and 1.65 (95% CI: 1.08, 2.50) for those who smoked 1-10, 11-20, and more than 20 cigarettes per day, respectively, compared with never smokers. The association was stronger in participants with diabetes (odds ratio = 3.29, 95% CI: 1.49, 7.27) than in participants without diabetes (odds ratio = 1.33, 95% CI: 1.03, 1.73). If the association is causal, an estimated 22.7% of erectile dysfunction cases (11.8 million cases) among Chinese men are attributable to cigarette smoking. This 2000-2001 study of Chinese men documented an independent and dose-response relation between cigarette smoking and risk of erectile dysfunction.     

美沙酮维持治疗患者吸烟行为及影响因素分析

目的 了解美沙酮维持治疗(MMT)门诊患者吸烟行为特征及相关因素.方法 564例MMT门诊患者完成吸烟行为筛查后分为吸烟组和非吸烟组,从社区选取102名频数匹配(性别、年龄±3岁和文化程度)的一般吸烟者作为社区吸烟组;研究对象自评完成一般情况问卷、尼古丁依赖检测量表(FTND)和Russell吸烟原因问卷并进行统计分析.结果 MMT门诊患者吸烟行为检出率为92.9%(90.8%～95.0%);吸烟组、社区吸烟组(FTND)得分分别为(5.99±2.41)、(4.40±2.50)分,吸烟组高于社区吸烟组,差异有统计学意义(P<0.001);吸烟行为的发生与个体户/临时工(OR=20.8)、无业/失业(OR=16.2)、再婚(OR=2.31)和MMT时间长(OR=1.18)有关.结论 MMT门诊患者具有较高的烟草依赖倾向,吸烟行为具有成瘾、依赖特征;其发生与社会人口学因素及MMT有关.     

Cigarette smoking and serum sex hormones in men

The relation between cigarette smoking and serum sex hormone concentrations was examined in two samples of the Multiple Risk Factor Intervention Trial (MRFIT) population. One sample consisted of 121 men at the Pittsburgh, Pennsylvania MRFIT center who were followed longitudinally for four years. The other sample was drawn from the entire MRFIT cohort and consisted of 163 MRFIT participants who subsequently developed coronary heart disease and 163 matched controls. The results indicated a positive correlation between cigarette smoking and serum total androstenedione concentration. The association was independent of age, relative weight, alcohol drinking, blood pressure, and high density lipoprotein (HDL) cholesterol. Serum total and free testosterone concentrations were positively correlated with cigarette smoking among the longitudinal sample and the controls, but not for the baseline sera from the coronary heart disease cases. This positive correlation was also independent of age, relative weight, alcohol drinking, blood pressure, and HDL cholesterol. There was no association between either serum estradiol or estrone concentrations and cigarette smoking in this population. These observations may have important implications for epidemiologic studies of diseases with significant smoking relations.     

The effect of cigarette taxes on smoking among men and women

The literature contains numerous studies that estimate the effect of cigarette taxes on smoking across various population groups. Although the conclusions are split, most US studies find that men are more responsive to cigarette taxes than women. This paper shows that these results are due to the failure to control for state-specific gender gaps in smoking rates that are correlated with cigarette taxes. When gender-specific state fixed effects are included to control for these gaps, the results indicate that women are nearly twice as responsive to cigarette taxes as are men. Since the econometric specification controls for variation in the tax response by household income, it is unlikely to be responsible for the difference.     

Cigarette smoking and fat distribution in 21,828 British men and women: a population-based study

OBJECTIVE: To examine the relationship between cigarette smoking habits and fat distribution in a population-based cohort of men and women. RESEARCH METHODS AND PROCEDURES: We analyzed cross-sectional data from 21,828 men and women who were 45 to 79 years of age, residents in Norfolk, United Kingdom, and were recruited between 1993 and 1997. Cigarette smoking habits and other lifestyle factors were assessed using self-reported questionnaires. Anthropometric measures were obtained during a health examination. RESULTS: Waist-hip ratio was highest among current smokers and least among never smokers after adjusting for age, BMI, alcohol intake, total energy intake, physical activity, and education. Higher waist-hip ratio was directly associated with higher smoking pack-years in current and former smokers and inversely with duration since quitting smoking in former smokers. Adjusting for age, BMI, and other covariates, current smokers had higher waist circumference but lower hip circumference compared with former or never smokers. DISCUSSION: Cigarette smoking habits seem to influence fat distribution patterns. Although smokers have lower mean BMI compared with nonsmokers, they have a more metabolically adverse fat distribution profile, with higher central adiposity. The explanation for this association may help elucidate the mechanisms underlying the adverse health consequences of cigarette smoking and abdominal obesity.     

Cigarette smoking behavior among Rhode Island physicians, 1963-83.

A survey of practicing physicians in Rhode Island revealed a cigarette smoking rate of only 8.3 per cent in 1983. This represents a continuation of the consistent decrease seen in the percentage of physician smokers in each such survey since 1963. Under age 30, the rate was only 4.5 per cent. An exponential model suggests that the overall rate for Rhode Island physicians will be below 3 per cent by the year 2000.     

Cigarette smoking and increased endogenous estrogen levels in men

In a population-based study of 590 Rancho Bernardo, California men aged 30-79 years without a history of cardiovascular disease, and who were first surveyed in 1972-1974, current cigarette smokers had significantly higher mean endogenous androstenedione, estrone, and estradiol levels compared to nonsmokers. In the cigarette smokers, a dose-response relationship was apparent for these hormones with mean levels increasing with increasing reported cigarette consumption. These differences persisted after adjusting for age and body mass index, and were not accounted for by either caffeine or alcohol intake, or exercise habit. In a further 89 men with a history of cardiovascular disease, hormone levels were not significantly related to smoking habit. The higher endogenous estrogen levels in cigarette smokers may confound the interpretation of studies reporting higher estrogen levels in male myocardial infarction survivors compared to controls.     

Cigarette smoking status and recurrent subjective health complaints among US school‐aged adolescents

Background Subjective health complaints are common among adolescents. There is evidence that girls are more likely to register complaints than boys. This study examines gender differences in the relationship between daily smoking and recurrent subjective health complaints in school‐aged adolescents in the USA. Methods A cross‐sectional design with a multistage probability sample was used to survey 13 339 middle and high school students (grades 6 through 10) with the US 2001–2002 Health Behavior in School‐Aged Children Survey. Results Recurrent subjective health complaints were higher for adolescents who smoke daily and experiment with cigarettes than for those who never smoke. In logistic regression analyses, the odds of daily smoking increased twofold for both boys and girls who report recurrent irritability/bad temper. For girls, the odds of daily smoking were higher among those who reported recurrent headache, stomachache and backache compared with never smokers. For boys only recurrent backache and feeling dizzy were associated with increased odds of daily smoking. Conclusions The relationship between recurrent subjective health complaints and daily smoking provides new insights into both conditions for school‐aged adolescents. Findings from this study suggest different patterns of association between daily smoking and recurrent subjective health complaints occur for girls and boys. Further studies are needed to explore causes and treatment of daily smoking and recurrent health complaints among school‐aged children.     

Cigarette smoking and completed suicide among middle-aged men: a population-based cohort study in Japan

PURPOSE: To clarify whether cigarette smoking was associated with completed suicide in a cohort of middle-aged Japanese men. METHODS: A total of 45,209 out of 57,714 men, aged 40 to 69 years, in nine public health centers across Japan responded to a self-administered questionnaire that included questions regarding their smoking history. The questionnaire was distributed in 1990 (Cohort I) and in 1993 and 1994 (Cohort II). By the end of 2000, 173 suicides were identified by death certificates. RESULTS: After adjusting for potential confounders, current smokers had a marginally higher risk of suicide than never smokers. Current smokers with more than 60 pack-years of cigarette smoking had a more than two-fold higher risk of suicide than never smokers (pooled multivariate relative risk=2.1; 95% confidence interval, 1.1, 4.0), but a significant dose-response relationship between pack-years of smoking and suicide was not found. The risk of suicide increased significantly with increasing numbers of cigarettes smoked per day (p for trend=0.036). Smoking status, duration of quitting, duration of smoking, and age at the start of smoking were not significantly associated with suicide risk. CONCLUSION: Our results suggest that heavy smoking, particularly a large number of cigarettes per day at baseline was associated with an increased risk of suicide independent of several potential confounders.     

Cigarette smoking and testosterone in men and women: A systematic review and meta-analysis of observational studies

Recently Health Canada and the Food and Drug Administration warned about the cardiovascular risk of testosterone, making environmental drivers of testosterone potential prevention targets. Cotinine, a tobacco metabolite, inhibits testosterone breakdown. We assessed the association of smoking with testosterone in a systematic review and meta-analysis, searching PubMed and Web of Science through March 2015 using (“testosterone” or “androgen” or “sex hormone”) and (“smoking” or “cigarette”). Two reviewers independently searched, selected, assessed quality and abstracted with differences resolved by consensus or reference to a third reviewer. The initial search yielded 2881 studies; 28 met the selection criteria. In 22 studies of 13,317 men, mean age 18–61 years, smokers had higher mean testosterone than non-smokers (1.53 nmol/L, 95% confidence interval (CI) 1.11 to 1.96) using a random effects model with inverse variance weighting. In 6 studies of 6089 women, mean age 28–62 years, smoking was not clearly associated with testosterone (0.11 nmol/L, 95% CI − 0.08 to 0.30). Fixed effects models provided similar results, but suggested a positive association in women. Whether products which raise cotinine, such as e-cigarettes or nicotine replacement, also raise testosterone, should be investigated, to inform any regulatory action for e-cigarettes, which emit nicotine into the surrounding air, with relevance for both active and passive smokers.     

Cancer mortality among US men and women with asthma and hay fever

The relation between self-reported physician-diagnosed asthma and/or hay fever and cancer mortality was explored in a prospective cohort study of 1,102,247 US men and women who were cancer-free at baseline. During 18 years of follow-up, from 1982 to 2000, there were 81,114 cancer deaths. Cox proportional hazards models were used to obtain adjusted relative risks for all cancer mortality and for cancer mortality at 12 sites associated with allergy indicators. There were significant inverse associations between a history of both asthma and hay fever and overall cancer mortality (relative risk (RR) = 0.88, 95% confidence interval (CI): 0.83, 0.93) and colorectal cancer mortality (RR = 0.76, 95% CI: 0.64, 0.91) in comparison with persons with neither of these allergic conditions. A history of hay fever only was associated with a significantly lowered risk of pancreatic cancer mortality, and a history of asthma only was associated with a significantly lowered risk of leukemia mortality. In never smokers, these associations persisted but were no longer significant. Results for mortality from cancer at other sites were less consistent. Collectively, these results suggest an inverse association between a history of allergy and cancer mortality; however, the strength of evidence for this association is limited.     

Vitamin supplement use and fatal non-Hodgkin's lymphoma among US men and women

The authors evaluated the association between use of individual supplements of vitamins A, C, and E only and multivitamins and fatal non-Hodgkin's lymphoma in a large prospective mortality study of US men and women. During 14 years of follow-up (1982-1996), 1,571 non-Hodgkin's lymphoma deaths among 508,351 men and 1,398 non-Hodgkin's lymphoma deaths among 676,306 women were documented. Long-term regular use of individual supplements of vitamins A, C, and E only and multivitamins was unrelated to fatal non-Hodgkin's lymphoma among either men or women. The multivariate relative risks for men who used supplements for 10 or more years were 1.03 (95% confidence interval (CI): 0.54, 2.00) for vitamin A supplements, 1.04 (95% CI: 0.78, 1.39) for vitamin C supplements, 1.06 (95% CI: 0.74, 1.51) for vitamin E supplements, and 1.14 (95% CI: 0.92, 1.40) for multivitamins. The multivariate relative risks for women who used supplements for 10 or more years were 1.40 (95% CI: 0.77, 2.54) for vitamin A supplements, 1.19 (95% CI: 0.89, 1.60) for vitamin C supplements, 1.27 (95% CI: 0.87, 1.84) for vitamin E supplements, and 1.21 (95% CI: 0.98, 1.50) for multivitamins. All associations became weaker when vitamin supplements were mutually adjusted. These findings do not support an important relation between long-term regular use of individual supplements of vitamins A, C, and E only and multivitamins and fatal non-Hodgkin's lymphoma.     

Smoking cessation and risk of cataract extraction among US women and men.

Although the observational evidence linking cigarette smoking with risk of senile cataract is well-established, it is unclear whether any benefit is obtained from quitting smoking. Therefore, in this study, the authors examined the association between time since quitting smoking and incidence of cataract extraction in women and men enrolled in the Nurses' Health Study and the Health Professionals Follow-up Study, respectively. There were 4,281 incident physician-confirmed cases of cataract and 1,038,493 accumulated person-years of follow-up. Compared with current smokers, former smokers who had quit smoking 25 or more years previously had a 20% lower risk of cataract extraction after adjustment for age, average number of cigarettes smoked per day, and other potential risk factors (relative risk (RR) = 0.80, 95% confidence interval (CI): 0.71, 0.91). However, risk among past smokers did not decrease to the level seen among never smokers (for never smokers, RR = 0.64, 95% CI: 0.52, 0.79). The observed relation was similar when data were examined by cataract subtype (>25 years since quitting vs. current smoking: primarily nuclear cataract, RR = 0.82, 95% CI: 0.68, 0.97; primarily posterior subcapsular cataract, RR = 0.90, 95% CI: 0.71, 1.13). These findings suggest that any healing from damage due to cigarette smoking occurs at a very modest pace, and they emphasize the importance of never starting to smoke or quitting early in life.     

Cigarette smoking, alcohol consumption, and screening mammography among women ages 50 and older

BACKGROUND: The associations among cigarette smoking and alcohol consumption with recent screening mammograms were evaluated among women ages 50 years and older. METHODS: The sample included 946 white and African-American women ages 50 years and older from the 1995 Maryland Behavioral Risk Factor Survey. Bivariate and logistic regression analyses were performed to evaluate the associations between current cigarette smoking and alcohol consumption in the past month (none, 1-7 drinks, >7 drinks) with obtaining a screening mammogram in the past 2 years (recent mammogram), controlling for sociodemographic and health variables. RESULTS: Seventy-eight percent of respondents had recent mammograms, 15% smoked cigarettes, 18% reported 1-7 drinks, and 12% reported >7 drinks in the past month. Smokers had lower mammography rates than nonsmokers (odds ratio (OR) = 0.47, 95% confidence interval (CI) = 0.30-0.75). Women who drank alcoholic beverages had higher mammography rates than nondrinkers (OR = 1.37, 95% CI = 1.03-1.83). Smokers had the lowest mammography rates, regardless of their consumption of alcohol. An interaction was observed among white but not African-American women: nonsmokers who consumed moderate amounts of alcohol (1-7 drinks) had the highest mammography rates in this subgroup. CONCLUSIONS: To reduce breast cancer mortality, it is important to increase screening mammography among all women over age 50 and especially among smokers and the oldest women.