The prevalence and impact of respiratory symptoms in asthmatics and nonasthmatics during deployment

OBJECTIVE: The purpose of this study was to compare the prevalence, severity, and impact of respiratory symptoms in asthmatics and nonasthmatics during Operation Enduring Freedom and Operation Iraqi Freedom. METHODS: A survey was given to 1,250 active duty soldiers and Department of Defense contractors returning from Operation Enduring Freedom/Operation Iraqi Freedom. Subjects were asked about demographics, smoking habits, respiratory symptoms, and impact on job performance before and during deployment. Patients with a history of asthma were asked method of diagnosis, current symptoms, and asthma therapy. RESULTS: A total of 1,193 subjects returned the completed questionnaire (95% response rate). Mean age of respondents was 38 +/- 11 years, 83% (n = 977) were male, and 31% (n = 375) were past or present smokers. Sixty-one subjects (5%) reported a previous diagnosis of asthma. Both asthmatics and nonasthmatics had increased respiratory symptoms of wheezing, cough, sputum production, chest pain/tightness, and allergy symptoms during deployment compared to predeployment (p < 0.05 for all). When compared to nonasthmatics, asthmatic subjects reported more wheezing, sputum production, and chest pain/tightness during deployment (p < 0.0001, 0.05, 0.05 respectively), had more difficulty with military duties (p < 0.05), and were more likely to seek medical attention and receive duty restrictions (p < 0.0001). Twenty-six percent (n = 16) of asthmatics reported poor baseline symptom control, and this group had significantly increased symptoms, functional limitations, and health care utilization when compared to asthmatics who were symptom-controlled at baseline. CONCLUSIONS: Respiratory symptoms were common among both asthmatics and nonasthmatics during deployment. Differences in symptoms and health care utilization in this group of asthmatics were primarily due to subjects with poor baseline control.     

Smoking prevalence in military men,and factors affecting this

The aim of the present study was to determine smoking prevalence among noncommissioned officers and privates and the factors affecting it. This study was carried out in a division of 20,000 soldiers. One of every 10 names on the roster was chosen at random. Responses were received from 1,822 subjects (91.1%), all male, in the final month of their 18-month military service with a mean age of 20.3 +/- 2.2 years. Individuals performing their military service were surveyed using a self-administered, anonymous, personal, and voluntary questionnaire. It was determined that 1,160 (63.7%) of the participants were smokers: 180 (9.9%) were occasional smokers, and 980 (53.8) were heavy smokers. For the fathers of the participants, these rates were 15.4% and 40.5%, respectively. The frequency of smoking was found to be higher in subjects who had high incomes, who had high levels of education, whose fathers smoked, and who were raised in environments in which there were many smokers. It was determined that 31.4% of subjects had begun smoking within the previous 2 years during their period of military service.     

Attitudes to smoking on submarines: results of a questionnaire study

An anonymous survey to assess the attitudes to smoking of men serving on two Trident Nuclear submarines was conducted by questionnaire. A total of 244 questionnaires were completed, representing 87% of the two crews. Thirty-two percent of respondents declared themselves to be smokers, 69% were nonsmokers, and of these, 31% were ex-smokers. Attitudes of all respondents to an enforced ban of smoking on submarines indicated that 55% felt that it would be justifiable, 46% felt that it would be unfair, 42% felt that it was uncalled for, 46% thought that it would be illegal, and 47% thought that a ban was about time. The separate opinions of smokers and nonsmokers were polarized, whereas the overall results indicate indifferent attitudes of crew members. Further research into the atmospheric effects of environmental tobacco smoke on a submarine is required.     

武警某部战士吸烟情况调查及分析

目的 了解武警某部战士吸烟现状及对吸烟的相关认知、态度及行为倾向,为有针对性地开展部队控烟工作提供参考.方法 利用自行设计的吸烟问卷调查表,调查武警某部260名集训新兵及217名老兵的吸烟现状及对吸烟的危害认知、态度及行为倾向,并分析它们之间的关系.结果 战士总体吸烟率为37.32％(178/477),老兵吸烟率62....     

High-resolution computed tomography findings in elderly patients with asthma

OBJECTIVE: Based on the hypothesis that airway remodelling is related to the duration of asthma, HRCT scanning should show greater abnormalities in the early-onset than the late-onset asthmatics. It was, therefore, intended to assess the presence and the frequency of airway and parenchymal abnormalities with high-resolution computed tomography (HRCT) in elderly asthmatic patients, and to determine whether these abnormalities are related to the duration of asthma. PATIENTS AND METHODS: Sixty-eight clinically stable asthmatic patients aged > or =60 yr were included in this prospective study. The patients were separated into two groups according to the duration of symptoms as late-onset asthma (n=31) with disease duration of <5 yr, and early-onset asthma (n=37) with disease duration of > or =5 yr. All patients were lifelong non-smoker and had been using inhaled beta agonists and inhaled steroids. HRCT-scanning and histamine inhalation test were performed on all patients. RESULTS: In comparison with late-onset asthmatic patients, those with early-onset asthma had significantly higher frequency of emphysema (21.6% versus 0.0%, p=0.006), bronchial dilatation (13.9% versus 0.0%, p=0.03) and bronchial wall thickness (41.7% versus 12.9%, p=0.01). Multiple logistic regression analysis identified that early-onset of disease was an independent risk factor for the presence of irreversible HRCT-scan abnormalities in elderly asthmatics [odds ratio (OR): 9.4 (2.7-32.7), p=0.00001]. CONCLUSION: Present data suggest that HRCT abnormalities in early-onset elderly asthmatics reflect parenchymal and airway changes that become irreversible throughout the long course of the disease.     

Nicotine and cotinine in infants dying from sudden infant death syndrome

The aim of this component of the German Study on Sudden Infant Death was to determine (1) nicotine concentrations in hair (NCH), as a marker of long standing exposure to tobacco, (2) cotinine concentrations in pericardial fluid (CCP) and (3) cotinine concentrations in liquor cerebrospinalis (CCL), the latter measures being markers of recent exposure to tobacco in the last few hours of life. The results obtained were compared with data on parental smoking revealed from interviews. In 100 cases of sudden infant death syndrome, material was taken at autopsy to determine NCH. In 41 cases, NCH and CCP, and in 70 cases, NCH and CCL were determined. Infants of mothers who stated having smoked during pregnancy had higher NCH than infants of non-smoking mothers (p = 0.008). Furthermore, there was a weak but statistically significant relationship between NCH's and the daily cigarette consumption of the mother during pregnancy (n = 64, r = 0.24, p = 0.05). In 43% of infants, nicotine could be detected in their hair, although the mothers had said at the interview that they did not smoke during pregnancy. On the other hand, in 33% of infants whose mother stated they had smoked during pregnancy nicotine was not detectable in the infant's hair. CCP's were strongly correlated with CCL's (r = 0.62, p = 0.0027). For this reason, both parameters were treated as equivalent for the detection of tobacco smoke exposure in the last hours before death. The influence of breast-feeding was evaluated by comparison of the nicotine concentrations in breast fed and non-breast-fed infants from smokers and non-smokers. Fivefold higher nicotine concentrations were determined in non-breast-fed infants of parents who smoked as compared to all other groups. It can be concluded that nicotine intake by passive smoking is much more important than by breast-feeding. We conclude that both interview data and biochemical measures should be sought to understand the true exposure to tobacco smoke.     

Functional significance of air trapping detected in moderate asthma

The aim of this study was to evaluate bronchial and lung abnormalities in patients suffering from moderate asthma as defined by international guidelines, with special attention to air trapping on CT in comparison with that detected in smoking and non-smoking normal subjects. Twenty-two patients classified as moderate asthma and control subjects including healthy volunteers, smokers (n = 10) or non-smokers (n = 12) were prospectively explored by high-resolution CT (HRCT) performed at suspended full inspiration and expiration. The same expiratory protocol was performed 15 min after inhalation of 200 μg of salbutamol. Patients underwent pulmonary function tests within the same week and bronchodilator response was assessed following inhalation of salbutamol. Abnormalities of bronchi and lung parenchyma on inspiratory CT and air trapping on expiratory CT, in dependent and non-dependent areas, were assessed and scored semi-quantitatively by two independent observers. Comparison of score mean values between the different groups was performed using Mann-Whitney test and Spearman correlation between CT findings and pulmonary function tests were calculated. Mosaic perfusion was observed in 23 % of asthmatics. Air-trapping scores were significantly higher in asthmatic patients than in non-smoking control subjects (p = 0.003), but not than in smokers. This difference was ascribed to non-dependent zones of the lung for which air-trapping scores were also higher in asthmatic patients (p = 0.003) and in smoking subjects (p = 0.004) than in normal controls. In the asthmatic group, a significant positive correlation was found between airways resistance and bronchial dilatation score (p = 0.01), and between small airways obstruction index and mosaic perfusion score (p = 0.05). In addition, both FEV1 and reversibility of small airways obstruction values correlated with air-trapping score (p = 0.03 and p = 0.007, respectively). No change could be detected in air-trapping score following salbutamol inhalation. Patients suffering from moderate asthma present mosaic perfusion and larger areas of air trapping than normal subjects, particularly in non-dependent areas of the lung. These lung abnormalities are related to small airways obstruction. Received: 28 December 1999; Revised: 27 April 2000; Accepted: 2 May 2000     

Smoking status and smoke-related gingival melanin pigmentation in army recruitments

This study aimed to define the smoking status and smoke-related gingival melanin pigmentation in army recruitments and was conducted with army recruitments in Sivas. Nine hundred eight subjects were examined. The oral and dental health of those subjects was checked and recorded. The smoking status of the subjects was self-reported and recorded on questionnaires by researchers. The chi2 test and Kruskal-Wallis test were used for statistical analysis. More than one-half of the subjects (54.3%) were primary school graduates and the mean age was 20.2 +/- 0.95 years. The response rate regarding smoking was 100%. Of the respondents, 596 (65.7%) were current smokers, 12 (1.3%) were former smokers, and 300 (33.0%) were never smokers. The gingival melanin pigmentation rate was 27.5% in current smokers and 8.6% in those who never smoked (p = 0.000). Smoking five to nine cigarettes a day appeared to be sufficient to cause gingival melanin pigmentation. The proportion of smokers who had melanin pigmentation did not change after 10 cigarettes a day. A rehabilitation project on smoking prevention and smoking cessation for army recruitments is urgently needed.     

Deposition of cigar smoke particles in the lung: evaluation with ventilation scan using (99m)Tc-labeled sulfur colloid particles.

This study examined the degree to which cigar smokers inhale when they smoke cigars. A second objective was to assess the level of association between self-reported inhalation and observable cigar particle deposition in the lung. We hypothesized that cigar smokers with a history of cigarette smoking would show a greater amount of smoke deposition than would cigar smokers with no history of cigarette smoking. We conjectured that self-reported cigar smoke inhalation would be a reliable predictor of observable smoke particle deposition in the lung. METHODS: Twenty-four male cigar smokers were recruited to participate in the study. Twelve of the participants were current or past regular cigarette smokers, and the remaining 12 participants had no history of cigarette smoking. The volunteers completed an anonymous questionnaire commenting on the frequency of their current cigarette and cigar use as well as the degree to which they inhale when they smoke cigars. Volunteers smoked a cigar through a holder that permitted cigar smoke to mix with a radioaerosol of (99m)Tc-labeled sulfur colloid particles. The total radioactivity administered to each volunteer was 100 MBq. Lung ventilation scanning was subsequently performed. RESULTS: Total lung counts showed that volunteers inhaled the cigar smoke to varying degrees, although 100% of nonsmokers and 58% of smokers in the study reported that they never or rarely inhaled when they smoked cigars. With respect to total lung counts, smokers as a group inhaled less than their nonsmoking counterparts; however, this difference reflected a trend in the data and did not reach statistical significance. CONCLUSION: Contrary to the widely held belief that cigar smokers do not inhale when they smoke cigars, we concluded that cigar smoke is inhaled regardless of self-reported inhalation and smoking history.     

Screening Mammography Visits as Opportunities to Engage Smokers With Tobacco Cessation Services and Lung Cancer Screening

ObjectiveTobacco use is the leading cause of preventable mortality in the United States. Screening mammography (SM) visits present opportunities for radiology practices to reduce tobacco-related morbidity and mortality. Our study evaluates implementation of a program that provides tobacco cessation service referrals and screens for lung cancer screening (LCS) eligibility among smokers presenting for SM at a community health center.MethodsIn 2018, two sets of questions were added to our SM patient intake questionnaire to assess (1) smoking history and (2) interest in referral to the health center-based tobacco cessation program for mailed information, telephone-based consultation, and in-person counseling. Primary outcomes were proportion of current smokers who requested a referral and of all smokers who were LCS-eligible. Bivariate logistic regression analyses compared sociodemographic characteristics of smokers who requested versus declined a referral.ResultsOf the 89.3% (1,907 of 2,136) who responded, 10.5% (201 of 1,907) were current and 29.1% (555 of 1,907) were former smokers. Of current smokers, 26.4% (53 of 201) requested referrals: mailed information by 23.9% (48 of 201), in-person counseling by 9% (18 of 201), and telephone-based consultation by 7.5% (15 of 201). No sociodemographic predictors for referral requests were identified. Of all smokers, 9.3% (70 of 756) were eligible for LCS, of which 31.4% (22 of 70) were up to date.ConclusionOne in ten women who underwent SM at our community health center were current smokers, of which one-quarter requested tobacco cessation referrals. Among LCS-eligible smokers, one-third were up to date. SM presents opportunities for radiology practices to advance population health goals such as tobacco cessation and LCS.     

Cabin environment and perception of cabin air quality among commercial aircrew

OBJECTIVE: Our objective was to study the perception of cabin air quality (CAQ) and cabin environment (CE) among commercial cabin crew, and to measure different aspects of CAQ on intercontinental flights. METHODS: A standardized questionnaire was mailed in February-March 1997 to all Stockholm-based aircrew on duty in a Scandinavian flight company (n = 1,857), and office workers from the same company (n = 218). The answers were compared with an external reference group for the questionnaire (MM 040 NA). During this time, smoking was allowed on intercontinental flights, but not on other shorter flights. Smoking was prohibited on all flights after 1 September 1997. The participation rate was 81% (n = 1,513) in the aircrew, and 77% (n = 168) in the office group. Air humidity, temperature, carbon dioxide (CO2) and respirable dust were measured during intercontinental flights, during both smoking and nonsmoking conditions. Statistical analysis was performed by multiple logistic regression analysis, keeping age, gender, smoking, current smoking, occupation, and perceived psychosocial work environment simultanously in the model. RESULTS: Air humidity was very low (mean 5%) during intercontinental flights. In most cases (97%) the CO2 concentration was below 1,000 ppm. The average concentration of respirable particles was 67 microg x m during smoking conditions, and 4 microg x m(-3) during non-smoking conditions. Complaints of draftiness, too high temperature, varying temperature, stuffy air, dry air, static electricity, noise, inadequate illumination, and dust were more common among aircrew as compared with office workers from the same company. Female crew had more complaints on too low temperature, dry air, and dust. Current smokers had less complaints on stuffy air and environmental tobacco smoke (ETS). Younger subjects and those with atopy (childhood eczema, allergy to tree or grass pollen, or furry animals) reported more complaints. Reports on work stress and lack of influence on working conditions were strongly related to perception of a poor cabin environment. Flight deck crew had more complaints about inadequate illumination and dust, but less complaints about other aspects of the cabin environment, as compared with flight attendants. Aircrew who had been on a flight the previous week, where smoking was allowed, had more complaints on dry air and ETS. CONCLUSION: Complaints about work environment seems to be more common among aircrew than office workers, particularly draft, stuffy air, dry air, static electricity, noise, inadequate illumination and dust. We could identify personal factors of importance, and certain conditions that could be improved, to achieve a better perception of the cabin environment. Important factors were work stress, lack of influence on the working conditions, and environmental tobacco smoke on some longer flights. The hygienic measurements in the cabin, performed only on intercontinental smoking flights, showed that air humidity is very low onboard, and tobacco-smoking onboard leads to significant pollution from respirable dust.     

Tri-service Health Questionnaire-1989

An anonymous, self administered health questionnaire survey of the habits and attitudes of servicemen in the 3 Services was conducted. The overall response rate was 75%. This paper reports the results of questions on smoking. The Army had the greatest percentage of smokers, smoked most heavily and had the worst attitude to smoking of the 3 Services. The RAF had the best results in these fields. There was a higher percentage of smoker, who smoke more heavily in Germany/seadraft than UK/shoredraft. There was a rank gradient in percentage smokers, with the lowest ranks smoking the most. A sizeable proportion of the smoking population wish to give up, have tried to do so and feel their Medical Officer should be interested in their smoking habits. A reduction in prevalence of cigarette smoking to less than 30% within 5 years is recommended as a Tri-service Health Policy Goal, with the Army, Tri-Service 16-20 year olds and Private-Corporal rank equivalents and recruits, as specific target groups for intervention. The health promotion strategy should include concerted anti-smoking advice from Medical Officers.     

The smoking habits of young soldiers.

In a survey of the smoking habits of over 6,000 young soldiers, it was found that the prevalence of regular smoking was 45%. Though the prevalence of regular smoking in young soldiers is higher than the general prevalence rate for smoking in 16 to 19-year olds in the civilian population, the excess is considered to be a reflection of the social and geographical background of Army recruits. The survey found that young soldiers who smoke, smoke heavily. Eighty two percent smoked more than 20 cigarettes per week, 58% more than 40 cigarettes per week. This is higher than has been recorded by any previous survey of young soldiers. The proportion of young soldiers who have never smoked has risen markedly over the years. This survey found that 34% had never smoked.     

吸烟与新兵基础训练损伤关系的调查分析

目的　研究吸烟对新兵基础训练的影响。方法　采用问卷调查方式 ,询问参训的新兵吸烟的数量和时间。结果　吸烟人群与不吸烟人群训练伤的发生有非常显著性差异 ,吸烟人群明显高于不吸烟人群。每天吸烟≥ 5支 ,吸烟时间≥1年 ,容易发生训练伤。吸烟人群训练伤主要发生在训练的后期。结论　长期大量吸烟对军训损伤是一个危险因素。     

Drugs, recreational drug use and attitudes towards doping of high school athletes

The purpose of this investigation was to determine the substances used, and the attitudes towards doping of high school athletes. A four-page, self-completed questionnaire was designed to determine the drugs used (licit, illicit and doping substances) along with beliefs about doping and the psychosociological factors associated with their consumption. The questionnaire was distributed to all the high school students enrolled in a school sports association in the Lorraine region in Eastern France. The completed forms were received from 1459 athletes: 4 % stated that they had used doping agents at least once in their life (their main source of supply being peers and health professionals). Thirty-four percent of the sample smoked some tobacco, 66 % used alcohol, 19 % cannabis, 4 % ecstasy, 10 % tranquillizers, 9 % hypnotics, 4 % creatine and 41 % used vitamins against fatigue. Beliefs about doping did not differ among doping agent users and non-users, except for the associated health risks which were minimized by users. Users of doping agents stated that the quality of the relations that they maintain with their parents is sharply degraded, and they reported that they are susceptible to influence and difficult to live with. More often than non-doping agent users, these adolescents are neither happy, nor healthy, while paradoxically, they seem less anxious and they are more self-confident. Our findings suggest that doping prevention among young athletes cannot be limited uniquely to the list of banned drugs.     

Smoking and tobacco use by U.S. military personnel

Findings regarding smoking behavior for the 1985 survey of military personnel were compared to findings from earlier surveys. A decline in the percentage of cigarette smokers was evident for all ranks and ages. Reported use of smokeless tobacco and cigar/pipe smoking indicated that one-fifth of the cigarette smokers also use smokeless tobacco and that two-fifths of the cigarette users smoke a pipe or cigar. Among non-smokers of cigarettes, about one-tenth of the respondents used smokeless tobacco and/or smoked a pipe or cigars. Using self-evaluation of health status, non-smokers reported "excellent" health significantly more than smokers.     

Smoking habits in a sample of young Italian soldiers

The aim of this cross-sectional study was to determine the attitudes and characteristics of smoking patterns in a sample of 450 young, Italian, military men. Data were collected using a self-administered questionnaire. The prevalence of military smokers was 54.4%; 45.7% of military men were smokers before enrollment, whereas 8.7% initiated smoking after enrollment. In multiple logistic regression analysis, the risk of becoming a smoker was associated with "high" cultural class of the family of origin (odds ratio [OR], 1.99; 95% confidence interval [CII, 1.05-4.23), non-nuclear family types (OR, 2.56; 95% CI, 1.25-5.25), parent (OR, 1.73; 95% CI, 1.04-2.90) and sibling/partner (OR, 2.25; 95% CI, 1.45-3.50) smokers, and >12 months of service (OR, 1.39; 95% CI, 1.07-5.43). None of the other variables relative to military status was significantly associated with smoking. Because the prevalence of military smokers was very high, we think that special programs aimed at decreasing the prevalence, with the long-term goal of smoking cessation, are needed.