避孕措施与细菌性阴道病关系的研究

目的：探讨避孕措施与细菌性阴道病（BV）的关系，为预防BV、指导选择避孕措施提供依据。方法：对某医院妇科门诊接受计划生育服务的育龄妇女非选择性地进行BV筛检。以筛检出的267例BV患者为病例组，其余478例未患BV且无BV史的妇女为对照组进行病例对照研究。结果：与未采用避孕措施者比较，单因素logistic回归分析显示：BV与IUD有正关联，而与避孕套、口服避孕药（OC）无关联。经婚姻状况、性卫生、性行为习惯调整后，BV与IUD的关联仍有统计学意义（OR=2．364，95％C1：1．216～3．620），但与OC及避孕套使用无关。同IUD使用者比较，BV与避孕套使用呈负关联，调整后的OR=0．299（95％C1：0．158～0．566）；BV与OC使用间无关联。结论：使用IUD与未采用避孕措施者比较可能增加BV发生的危险，而避孕套使用者发生BV危险低于IUD使用者。无论从避孕还是预防BV角度，避孕套均是一种较好的选择。     

踝/臂血压指数与传统心血管疾病危险因素聚集关系

目的 探讨踝/臂血压指数(ABI)与传统心血管疾病危险因素间聚集关系.方法 选取广西地区2 005人作为研究人群.采用t检验比较高血压、高TC、高血糖、低HDL-C、超重和肥胖、吸烟者与相应正常人群ABI值的差异.采用Logistic回归(后剔除法,进入P值0.05,移出P值0.10)分析ABI与年龄、性别、血压、总胆固醇(TC)、高密度脂蛋白胆同醇(HDL-C)、体质指数(BMI)、空腹血糖(FPG)、吸烟等因素间的关系.结果 该组人群中超重和肥胖、低HDL-C及吸烟者与相应正常人群间ABI值差别有统计学意义(P<0.05),高血压、高TC、高血糖者与相应正常人群间ABI值差别无统计学意义(P>0.05).Logistic回归分析表明性别(OR=3.874,95%CI:1.920～7.814)、高血压(OR=1.550,95%CI:1.013～2.372)、吸烟(OR=2.018,95%CI:0.930～4.376)为低ABI(ABI<0.9)的主要危险因素;男性以年龄(OR=2.125,95%CI:0.951～4.752)、吸烟(OR=2.332,95%CI:0.981～5.545)为低ABI的主要危险因素;女性以高血压(OR=1.595,95%CI:0.962～2.643)为其危险因素.60岁以上组人群的性别(OR=4.625,95%C/:1.803～11.867)、高血压(OR=2.085,95%CI:1.205～3.608)、吸烟(OR=3.617,95%CI:1.362～9.607)为其危险因素;其中,男性以吸烟(OR=6.817,95%CI:1.558～29.829)为主要危险因素,女性以高血压(OR=2.681,95%CI:1.345～5.342)为主要危险因素.60岁以下组人群的性别(OR=3.636,95%CI:1.721～7.681)为其主要危险因素,其中男女性均无独立危险因素.结论 ABI与传统心血管疾病危险因素间存在聚集关系.女性、高血压、吸烟增加低ABI的危险.     

台州市膀胱癌危险因素的病例对照研究

目的分析台州市居民膀胱癌患病的影响因素,为加强膀胱癌防治工作提供依据。方法选择2012—2017年在台州医院确诊的500例膀胱癌患者为病例组,同期在该院诊疗的非肿瘤、非泌尿系统疾病患者504例为对照组,采用结构式问卷回顾性调查两组患者入院前1年的人口学信息、职业暴露(工作中是否暴露于芳香胺、多环芳香烃、烟草、烟草烟雾和重金属等环境)、健康行为和饮食状况,采用Logistic回归模型分析膀胱癌患病的影响因素。结果病例组和对照组性别、年龄、民族、文化程度和婚姻状况构成差异均无统计学意义(P0.05)。病例组和对照组有职业暴露史分别占31.60%和24.60%;超重/肥胖分别占37.60%和31.74%;吸烟分别占55.80%和46.23%;高蔬菜摄入频率分别占43.80%和52.58%;高水果摄入频率分别占55.40%和62.70%;体力活动活跃分别占24.60%和31.75%。Logistic回归分析结果显示,有职业暴露史(OR=1.861,95%CI:1.229～2.836)、超重/肥胖(OR=1.374,95%CI:1.021～1.863)、现在吸烟(OR=1.664,95%CI:1.101～2.503)和曾经吸烟(OR=1.454,95%CI:1.016～2.066)是膀胱癌患病的危险因素;高蔬菜摄入频率(OR=0.731,95%CI:0.566～0.947)、高水果摄入频率(OR=0.659,95%CI:0.463～0.927)和体力活动活跃(OR=0.566,95%CI:0.403～0.798)是膀胱癌患病的保护因素。结论职业暴露、超重/肥胖、现在吸烟、曾经吸烟是膀胱癌患病的危险因素;高蔬菜摄入频率、高水果摄入频率和体力活动活跃是膀胱癌患病的保护因素。     

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.     

杭州市15岁及以上居民吸烟情况调查

目的了解杭州市15岁及以上常住居民吸烟情况,为开展居民控烟工作提供依据。方法于2017年3—6月采用多阶段随机抽样方法,按县(市、区)、乡镇(街道)、村(居委会)和村(居)民小组逐级抽取杭州市≥15岁常住居民,采用全球成人烟草调查(中国)问卷对居民吸烟、二手烟暴露和戒烟情况进行调查,采用多因素Logistic回归模型分析居民现在吸烟和戒烟的影响因素。结果发放调查问卷1 440份,回收有效问卷1 434份,回收有效率为99.58%。现在吸烟359人,占25.03%;现在每日吸烟333人,占23.22%;现在吸烟者日均吸烟量中位数为15支,开始每日吸烟年龄中位数为21岁;二手烟暴露670人,占62.33%;戒烟成功137人,占27.62%。多因素Logistic回归分析结果显示,男性(OR=73.459,95%CI:38.970～138.458)、≥50岁(OR:1.646～2.632,95%CI:1.020～4.710)、小学文化程度(OR=3.267,95%CI:1.586～6.732)、高中/中专文化程度(OR=1.902,95%CI:1.109～3.261)、二手烟危害知识高分组(OR=2.485,95%CI:1.735～3.559)与现在吸烟有统计学关联;男性(OR=64.454,95%CI:29.031～138.691)、50～60岁组(OR=0.281,95%CI:0.095～0.827)和小学文化程度(OR=0.211,95%CI:0.053～0.841)与戒烟有统计学关联。结论杭州市15岁及以上居民现在吸烟率为25.03%,二手烟暴露率为62.23%;性别、年龄和文化程度均与现在吸烟和戒烟有统计学关联。     

唐山市农村地区慢性阻塞性肺疾病危险因素病例对照研究

目的 分析唐山市农村地区慢性阻塞性肺疾病(COPD)的危险因素.方法 以唐山市农村地区40岁以上人群COPD流行病学调查中确诊的190例(男120例、女70例)患者作为病例组,按性别相同、年龄±5岁的条件从每位患者的邻居中选取两名健康者作为对照组(男240例、女140例),进行1:2匹配的病例对照研究,应用条件Logistic回归进行危险因素分析.结果 单因素分析结果显示,职业性粉尘或化学物质暴露(OR=4.738,95%CI:3.045～7.371)、吸烟(OR=3.973,95%CI:2.749～5.742)、吸烟指数(OR=3.751,95%CI:2.602～5.407)、低体重(OR=2.785,95%CI:2.018～3.844)和呼吸疾病家族史(OR=2.231,95%CI:1.434～3.472)与COPD的关联具有统计学意义(P＜0.05).多因素分析结果显示,职业性粉尘或化学物质暴露(OR=4.997,95%CI:3.033～8.234)、吸烟(OR=3.311,95%CI:1.175～9.327)、低体重(OR=2.479,95%CI:1.732～3.547)和呼吸疾病家族史(OR=2.217,95%CI:1.311～3.750)为COPD的危险因素(P＜0.05).结论 职业性粉尘或化学物质暴露、吸烟、低体重和呼吸疾病家族史是唐山市农村地区人群患COPD的危险因素.     

肺癌危险因素及交互作用研究

目的探讨肺癌的影响因素及其交互作用。方法采用病例对照研究设计,收集781例肺癌病例,并按性别、年龄(±3岁)进行1:1匹配,通过调查问卷获取生活饮食习惯等信息。构建决策树及非条件Logistic回归模型,计算OR值及其95%CI,分析影响因素间的交互作用。结果肺癌的危险因素有吸烟(轻度吸烟OR=1.67,重度吸烟OR=7.27)、被动吸烟(轻度被动吸烟OR=2.63,重度被动吸烟OR=6.25)、居住地污染(吸烟者OR=2.26,不吸烟者OR=1.72)、肺癌家族史(吸烟者OR=15.94);保护因素有常吃水果(吸烟者OR=0.69,不吸烟者OR=0.44)、锻炼(吸烟者OR=0.50)、饮茶(不吸烟者OR=0.57)。吸烟与居住地污染、肺癌家族史存在交互作用,重度吸烟与不锻炼存在交互作用。结论吸烟、被动吸烟、居住地污染、肺癌家族史可增加肺癌风险,常吃水果、锻炼、饮茶有助于预防肺癌。肺癌影响因素间的协同作用应予重视。     

N-乙酰基转移酶-2基因多态性和环境因素与女性乳腺癌的关系

目的分析N-乙酰基转移酶-2(NAT2)基因多态性和环境因素与女性乳腺癌的关系。方法采用以医院为基础的1∶1配对的病例-对照研究,收集唐山市原发性乳腺癌新发女性患者48例与相应非肿瘤患者48例。以问卷调查收集各研究对象的饮食习惯和生活方式、生理生育、环境暴露和职业接触、既往病史、心理等信息。采用聚合酶链反应-限制性片段多态性(PCR-RFLP)技术检测NAT2的野生型等位基因WT、突变型等位基因M1、M2和M3突变频率,分析NAT2基因多态性和环境危险因素与女性乳腺癌的关系。结果被动吸烟大于或等于10年(OR=3.957,95%CI:1.589～10.002)、居住地环境污染(OR=33.571,95%CI:4.270～263.967)、职业接触(OR=9.400,95%CI:1.127～78.405)、烹调时使用排油设备(OR=0.177,95%CI:0.060～0.529)、农药的使用(OR=28.200,95%CI:3.576～222.389)等是乳腺癌的环境危险因素。携带M2、M3等位基因可能是乳腺癌的危险因素,OR值分别为2.563(95%CI:1.155～5.707)和2.083(95%CI:1.068～4.062),而M1等位基因频率在病例组与对照组的分布差异无统计学意义(χ2=0.447,P>0.05)。病例组与对照组突变杂合子基因型(WT/Mx)分布频率差异无统计学意义(χ2=0.021,P>0.05),而两组间突变纯合子(Mx/Mx)分布频率差异有统计学意义(OR=3.545,95%CI:1.141～11.015)。慢乙酰化表型者患乳腺癌的风险是快乙酰化表型者的3.364倍(χ2=7.599,P<0.05)。分层分析发现NAT2慢乙酰化表型与被动吸烟大于或等于10年存在交互作用(OR=9.917,95%CI:1.597～61.597)。结论 NAT2基因多态性和部分环境危险因素与乳腺癌发病存在统计学关联。     

肺癌危险因素的病例对照研究

目的分析肺癌患病的危险因素,为预防控制肺癌提供依据。方法采用病例对照研究方法,选取2015年1月—2017年6月绍兴市461例新发肺癌病例为病例组,采用频数匹配法选取与病例年龄、性别构成相近且同地居住的600名正常居民为对照组;通过问卷调查收集人口学特征、慢性病家族史、既往疾病史和行为因素资料,采用Logistic回归模型分析肺癌患病的危险因素。结果多因素Logistic回归分析结果显示,调整性别、年龄后,有恶性肿瘤家族史(OR=6.606,95%CI:3.439～12.689)、有肺部疾病患病史(OR=2.836,95%CI:1.208～6.659)、生活和工作紧张程度一般/紧张(OR=2.485,95%CI:1.830～3.376)、每周食用新鲜蔬菜天数5天(OR=3.116,95%CI:2.470～3.930)和现在吸烟/偶尔吸烟/已戒烟(OR=6.029,95%CI:3.716～9.783)是肺癌患病的危险因素。进一步分析吸烟与肺癌患病的关联显示,调整年龄、性别、恶性肿瘤家族史、肺部疾病患病史、生活和工作紧张程度及每周食用新鲜蔬菜天数后,与已戒烟≥10年相比,10年是肺癌患病的危险因素(OR=4.751,95%CI:2.404～9.386)。结论恶性肿瘤家族史、肺部疾病患病史、生活和工作中紧张程度高、每周食用新鲜蔬菜天数5天和吸烟是肺癌患病的危险因素。     

大学生心理压力与吸烟行为的相关性分析

目的研究心理压力对大学生吸烟行为的影响,为制定干预措施提供依据。方法采用整群抽样方法,抽取某综合性大学一～三年级在校大学生9 766名,以自填式结构问卷调查学生的心理压力、自身和同伴吸烟情况及社会经济学指标。以"从未吸烟者"作为对照组,分别以"尝试吸烟者"和"现吸烟者"作为病例组,分析心理压力对大学生吸烟行为的影响。结果进入大学后仍有学生尝试或形成吸烟行为。调整社会经济学指标和同伴吸烟行为的影响后,对未来工作和学业的担心(OR=1.021,95%CI=1.002～1.040)是男生尝试吸烟的危险因素;学习压力(OR=1.064,95%CI=1.011～1.116)是女生尝试吸烟的危险因素,人际与环境压力(OR=1.152,95%CI=1.013～1.314)是女生现吸烟的危险因素。结论心理压力与大学生吸烟行为存在一定程度的相关性,并且对不同性别和不同吸烟行为的影响不同。     

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.     

Cigarette smoking and breast cancer.

An epidemiological case-control study was conducted in New York State, with 1617 primary breast cancer patients and an equal number of controls, to examine the relationship between cigarette smoking and breast cancer. Results showed no overall association between ever smokers versus never smokers and breast cancer risk (odds ratio [OR] = 1.03, 95% confidence interval [CI]: 0.90-1.19), nor was there any dose response trend observed with increased levels of smoking. In addition, no association was found with risk and age started smoking, age stopped smoking, amount smoked or total years smoked. Controlling for previously identified risk factors for breast cancer in the analysis did not significantly alter these relationships. Previous studies have found a difference in menopausal age among smokers compared to nonsmokers. The mean menopausal age was only slightly lower in smokers than in never smokers for both cases and controls. Breast cancer risk was observed to be close to unity for premenopausal women (OR = 0.97, 95% CI: 0.74-1.34) and postmenopausal women (OR = 1.06, 95% CI: 0.91-1.26). A recent study suggested breast cancer risk was more strongly related to starting smoking at a young age among women who smoked at least 25 or more cigarettes per day in the most recent year of smoking. This hypothesis was not supported by these data.     

综合评价法在明确中学生吸烟影响因素主导效应中的运用

目的了解深圳市光明新区中学生吸烟情况及影响因素的分布,并对特定人群进行分类,为针对性开展中学生吸烟干预提供依据.方法:运用分层整群抽样法对深圳市光明新区学校544名中学生进行吸烟状况,烟草有关知识,态度和行为,周围环境控烟情况等调查,SAS9.0软件进行分析.结果:深圳市光明新区中学生尝试吸烟率为15.1 %,吸烟率为3.13%.多因素非条件logistic回归分析:女性(OR=0.50, 95%CI:0.26~0.96)为尝试吸烟的保护性因素(P<0.001),好朋友吸烟(OR=1.88, 95%CI:1.08~3.27),具有好朋友给烟肯定会吸意愿(OR=3.11, 95%CI:2.12~4.54),年龄增加(OR=1.33, 95%CI:1.04~1.69)均增加了尝试吸烟的危险因素,CHAID法决策树分析显示,好朋友给烟肯定会吸和男性分别能对50.0%(41/82) 和36.6%( 30 /82) 的尝试吸烟者进行准确分类.尝试吸烟人群中,吸烟者与非吸烟者多因素非条件logistic回归分析,好朋友给烟肯定会吸(OR=8.38, 95%CI:2.27~30.93),父母未告诫不要吸烟(OR=12.29, 95%CI:1.21~34.73)是吸烟的危险因素,而认为吸烟会减少体重(OR=0.25, 95%CI:0.07~0.87)是保护因素;类平均法聚类分析显示,好朋友给烟是否会吸和父母是否告诫不要吸烟将吸烟者分为三类,其中为父母告诫不要吸烟但好朋友给烟会吸者占64.71%(11/17).结论:新区中学生吸烟状况比较严重,对影响尝试吸烟,吸烟的独立影响因素进行分类分析以确定特定因素及特定人群,而进行相应干预将更有助于提高新区中学生控烟效果.     

吸烟与帕金森病关系的病例对照研究

目的　探讨吸烟与帕金森病 (PD)的关系。方法　采用以人群为基础的病例对照研究 ,调查在北京地区 55岁以上PD患病率调查中确诊及 2 0 0 2年 8月至 2 0 0 3年 1月在北京协和医院帕金森研究中心诊治的病例共 1 1 4例 ;以及性别、民族及居住地与其匹配的对照 2 0 5名。结果　吸烟与PD呈显著负相关联。以非吸烟者为对照 ,曾经吸烟者、现在吸烟者和过去吸烟者患PD的危险性低于对照 ,OR值分别为 0 .49(95 %CI:0 .30～ 0 .79)、0 .44(95 %CI :0 .2 3～ 0 .86)和 0 .54(95 %CI:0 .30～0 .96)。此外 ,对吸烟者分别按吸烟年限≥ 2 0年和 <2 0年、戒烟年限≥ 2 0年和 <2 0年以及吸烟量分层和logistic回归分析 ,其负相关联依然存在并具有剂量反应关系的趋势 (P <0 .0 5)。结论　吸烟与PD存在负相关联 ,今后应着重开展有关生物学依据的研究     

安徽省农村已婚育龄妇女细菌性阴道病及相关因素

目的:了解安徽省农村已婚育龄妇女细菌性阴道病(BV)的现状及相关因素。方法:在保证市级代表性的基础上,分层、整群抽取18～49岁54 540例农村已婚育龄妇女进行健康问卷调查、妇科检查和实验室检查。结果:安徽省农村已婚育龄妇女BV患病率为11.9%(6361/53286),汉族、初潮年龄相对较早、月经周期正常(25～34天)、行经期正常(3～8天)、无原发性痛经、洗脚盆与洗下身盆分开罹患BV的可能性相对较低为保护因素;而已婚妇女学历越低、与丈夫性生活前清洗下身的频率越高越容易罹患BV为危险因素。BV患者中宫颈炎、滴虫性阴道炎和盆腔炎的患病率明显高于无BV妇女,是无BV妇女的0.6、0.7和0.7倍,两组比较差异有统计学意义(P<0.01)。结论:安徽省农村已婚育龄妇女BV发生率较高且受多种因素影响,有关部门应开展有针对性的健康教育和妇科普查,做到早检查、早发现、早治疗。     

Nativity and Cigarette Smoking among Lower Income Blacks: Results from the Healthy Directions Study

Blacks in the United States bear the greatest disease burden associated with cigarette smoking. Previous studies have shown that the rapidly increasing population of foreign-born Blacks has lower smoking rates compared to their native-born counterparts. However, less is known about whether cigarette smoking among Blacks varies by region of birth (US, Africa, or the Caribbean), generational status, or acculturation. We examined the association between nativity and cigarette smoking among 667 Black adult men and women enrolled in the Harvard Cancer Prevention Program project. In multi-variable analyses, US-born Blacks were more likely to be smokers compared to those born in the Caribbean (OR = 0.16, 95% CI 0.08, and 0.34) or in Africa (OR = 0.24, 95% CI 0.08, and 0.74). Language acculturation was positively associated with cigarette smoking (OR = 2.62, 95% CI 1.17, and 5.85). We found that US-born Blacks were more likely to be current cigarette smokers than those born in either Caribbean or African countries. Our findings highlight the importance of intervening early new Black immigrants to stem the uptake of cigarette smoking behaviors as individuals become acculturated.     

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.     

Cigarette smoking and risk of breast carcinoma in situ

BACKGROUND: Although the associations with cigarette smoking have been explored extensively for invasive breast cancer, the relation to in situ cancer has not previously been examined in depth. METHODS: We analyzed data from a population-based case-control study of women living in Wisconsin, Massachusetts, and New Hampshire. Eligible cases of incident breast carcinoma in situ were reported to statewide registries in 1997-2001 (n = 1878); similarly aged controls (n = 8041) were randomly selected from population lists. Smoking history and other risk factor information were collected through structured telephone interviews. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated from logistic regression models adjusting for potential confounders. RESULTS: In multivariate models, the OR for breast carcinoma in situ among current smokers was 0.8, compared with never-smokers (95% CI = 0.7-1.0). Risk estimates increased towards the null with greater time since smoking cessation. Odds ratios were also less than 1.0 among women who initiated smoking in adolescence (OR = 0.8) or after a full-term birth (OR = 0.7), relative to women who never smoked. The reduced odds ratios associated with current smoking were strongest among women with annual screening mammograms (OR = 0.7; 95% CI = 0.6-0.9). Odds ratios were not less than 1.0 among current smokers without a recent screening mammogram (1.3; 0.9-2.0). CONCLUSIONS: Our findings suggest an inverse association between current smoking and risk of breast carcinoma in situ among women undergoing breast cancer screening.     

Cigarette smoking and alcohol consumption in the aetiology of uterine cervical cancer

A case-control study of uterine cervical cancer was conducted using 331 cases and 993 age-matched controls identified through the Missouri Cancer Registry during 1984-1986. Patients with smoking- or alcohol-related cancers were excluded from the control series. Logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (Cls) after adjustment for age, cigarette smoking, alcohol consumption, and stage at diagnosis. A dose-response relation was observed between intensity of cigarette smoking and invasive cervical cancer, with light and heavy smokers having elevated risks (OR = 2.2, 95% Cl = 1.4-3.6 and OR = 3.9, 95% Cl = 2.7-5.6, respectively). Former smokers had less elevated risk (OR = 1.7, 95% Cl = 1.0-2.9), a finding consistent with a greater effect of tobacco smoke on late-stage carcinogenesis. Similar results were obtained in age- and control site-specific analyses. Further, the age-specific data suggested a dose-response relation between duration of smoking and invasive cervical cancer. An association between alcohol consumption and invasive cervical cancer was not observed.     

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.