Comparison of pulmonary function and respiratory symptoms in water pipe and cigarette smokers

Background and objective: A major type of smoking in Middle Eastern countries is water pipe (WP) smoking. In the present study, pulmonary function tests (PFT) and respiratory symptoms (RS) were compared in WP smokers and deep inspiration (S‐DI) or normal inspiration (S‐NI) cigarette smokers. Methods: Pulmonary function and RS were compared among WP smokers, deep or normal inspiration cigarette smokers, and non‐smokers. Results: All PFT values in WP smokers and S‐DI, but only some values in S‐NI, were lower than those of non‐smokers (P < 0.05 to P < 0.001). In addition, all PFT values in WP smokers and S‐DI were lower than the corresponding values in S‐NI, except for forced expiratory volume in 1 s and maximal expiratory flow at 25% of forced vital capacity (P < 0.05 to P < 0.001). The prevalence of RS, except for sputum production, was greater in all three groups of smokers than in non‐smokers (P < 0.05 to P < 0.001). However, the severity of most RS in WP smokers and S‐DI, but only the severity of wheezing in S‐NI, was greater than that in non‐smokers (P < 0.05 to P < 0.01). There were inverse correlations for PFT values and positive correlations for RS, with duration and total amount of smoking (P < 0.05 to P < 0.001). Conclusions: The results from this study showed that there was a profound effect of WP smoking on PFT values and RS, which were similar to the effects of deep inspiration cigarette smoking.     

Does menthol attenuate the effect of bupropion among African American smokers?

Background African Americans have higher tobacco‐related morbidity and mortality and are more likely to smoke menthol cigarettes than their white counterparts. This study examined differences between African American menthol and non‐menthol smokers in smoking characteristics and cessation. Methods The study sample consisted of 600 African American smokers enrolled in a clinical trial that assessed the efficacy of sustained‐release bupropion for smoking cessation. Menthol (n = 471) and non‐menthol (n = 129) smokers were compared on smoking‐related characteristics and abstinence rates at 6 weeks and 6 months. Results Menthol smokers were younger (41.2 versus 52.9 years), more likely to be female (73.7% versus 56.6%) and more likely to smoke their first cigarette within 30 minutes of waking up (81.7% versus 69.8%) compared to non‐menthol smokers (all P < 0.01). Cigarette taste (50% versus 40%, P = 0.054) was rated non‐significantly higher by menthol smokers. Seven‐day point‐prevalence abstinence from smoking at 6 weeks were 28% and 42% (P = 0.006) and at 6 months were 21% and 27% (P = 0.21) for menthol and non‐menthol smokers, respectively. At 6 weeks follow‐up, stepwise logistic regression revealed that among those younger than 50 years, non‐menthol smokers were more likely to quit smoking (odds ratio = 2.0; 95% CI = 1.03–3.95) as were those who received bupropion (odds ratio = 2.12; 95% CI = 1.32–3.39). Conclusion African American menthol smokers had lower smoking cessation rates after 6 weeks of treatment with bupropion‐SR, thereby putting menthol smokers at greater risk from the health effects of smoking. Lower overall cessation rates among African Americans menthol smokers may partially explain ethnic differences in smoking‐related disease risks.     

The relation between cigarette smoking and risk of acute myeloid leukemia: An updated meta‐analysis of epidemiological studies

Smoking has been postulated as an environmental risk factor for acute myeloid leukemia (AML). The primary objective of this meta‐analysis of observational studies was to evaluate the epidemiologic relationship between smoking and the risk of development of AML. Twenty‐three studies published between January 1993 and December 2013 were included in our analysis, and accounted for 7,746 cases of AML. The outcome of interest was the relative risk (RR) with 95% confidence interval (CI) of developing AML in adult cigarette smokers in comparison with non‐smokers, and was estimated using the random‐effects model. Our results showed that current and ever smokers have 40% (RR 1.40, 95% CI 1.22–1.60; P < 0.001) and 25% (RR 1.25, 95% CI 1.15–1.36; P < 0.001) increased risk of developing AML when compared with non‐smokers. The increased RR of AML was increased regardless of sex, study design, geographical region, and quality of the studies. Intensity of smoking of <10, 10–20, 20–30, and >30 cigarettes per day was associated with RRs of AML of 1.27, 1.36, 1.55, and 1.77, respectively (P < 0.001 for trend). Duration of smoking of <20 and >20 years was associated with RRs of 1.07 and 1.44, respectively (P < 0.001 for trend). Cumulative smoking of <10, 10–20, 20–30, and >30 pack‐years was associated with RRs of 1.13, 1.23, 1.39, and 1.71, respectively (P < 0.001 for trend). Overall, cigarette smoking proves to be a significant risk factor for the development of AML in adults. Am. J. Hematol. 89:E125–E132, 2014. © 2014 Wiley Periodicals, Inc.     

Exhaled nitric oxide and exhaled breath condensate pH as predictors of sputum cell counts in optimally treated asthmatic smokers

Background and objective: Smoking is thought to modify the pattern of airway inflammation. Induced sputum provides useful information on cellular phenotype in inflammatory airways disorders; however, it is time‐consuming and difficult to implement in everyday clinical practice. The aim of this study was to determine whether exhaled NO (FeNO) and exhaled breath condensate (EBC) pH differed in asthmatic smokers compared with asthmatic non‐smokers and healthy subjects, and to evaluate the performance of FeNO and EBC pH for predicting the cellular phenotype of induced sputum. Methods: Asthmatic smokers (n = 40) and non‐smoking asthmatic patients (n = 43) were recruited for the study. Healthy smoking (n = 30) or non‐smoking (n = 30) subjects served as controls. FeNO and EBC pH were measured and all subjects underwent sputum induction for assessment of cell counts. Results: EBC pH was significantly lower in asthmatic smokers compared with non‐smokers (P < 0.01). FeNO levels were also significantly lower in asthmatic smokers compared with non‐smokers (P < 0.001). EBC pH was inversely associated with sputum eosinophils in both asthmatic smokers and non‐smokers (P < 0.001), whereas it was inversely associated with sputum neutrophils only in asthmatic smokers (P < 0.001). FeNO was positively associated with sputum eosinophils both in asthmatic smokers and non‐smokers (P < 0.001) but was not associated with sputum neutrophils. In asthmatic smokers, FeNO was a better predictor of sputum eosinophilia, whereas EBC pH was a better predictor of sputum neutrophilia. A combination of FeNO ≤ 14 ppb together with EBC pH > 7.20 predicted the paucigranulocytic induced sputum phenotype. Conclusions: EBC pH and FeNO levels were significantly lower in asthmatic smokers compared with non‐smokers. Combined specific cut‐off levels for FeNO and EBC pH may predict the paucigranulocytic phenotype in asthmatic smokers.     

Scottish smoke‐free legislation and trends in smoking cessation

Aim To investigate trends in smoking cessation before and after the introduction of Scottish smoke‐free legislation and to assess the perceived influence of the legislation on giving up smoking and perceptions of the legislation in smokers. Design, setting and participants Longitudinal data on smoking cessation were obtained from 1998 to 2007 on a cohort of 3350 Scottish adults aged between 50 and 75 years at baseline. All members of the cohort were participating in a clinical trial of aspirin in people at moderately increased risk of cardiovascular events. A subgroup of 474 participants who had smoked in the year prior to the introduction of legislation in March 2006 also completed a questionnaire on the influence and perceptions of the smoke‐free legislation following its introduction. Measurements Smoking status was recorded yearly, including dates of quitting and restarting. Participants who gave up smoking for at least 3 months were recorded as having quit smoking. The questionnaire included scales on whether the smoke‐free legislation had helped/influenced cessation, made the individual think about/prompt them to quit and perceptions of the legislation. Findings The odds of smokers quitting annually increased throughout the 7‐year period prior to introduction of the smoke‐free legislation to 2 years afterwards (odds ratio 1.09, 95% confidence interval 1.05–1.12, P < 0.001). During 2006, the pattern of quarterly quitting rates changed, with an increase in quit rates (to 5.1%) in the 3‐month period prior to introduction of the legislation (January–March 2006). Socio‐economic status was not related to smoking cessation. In the subgroup completing the questionnaire (n = 474), 57 quit smoking between June 2005 and May 2007 and 43.9% of these said that the smoke‐free legislation had helped them to quit. Most (>70%) smokers were positive about the legislation, especially those from more affluent compared with more deprived communities (P = 0.01). Conclusions The Scottish smoke‐free legislation was associated with an increase in the rate of smoking cessation in the 3‐month period immediately prior to its introduction. Overall quit rates in the year the legislation was introduced and the subsequent year were consistent with a gradual increase in quit rates prior to introduction of the legislation. Socio‐economic status was not related to smoking cessation, but individuals from more affluent communities were more positive about the legislation.     

Metabolic syndrome associated with habitual indulgence and dietary behavior in middle‐aged health‐care professionals

Aims/Introduction: Few studies, especially in Asia, have examined the relevance between metabolic syndrome (MetS), habitual indulgence and dietary behaviors in health‐care professionals. The present study evaluates metabolic syndrome rate and its association with habitual indulgence (coffee, tea, alcohol and cigarette smoking) and diet behavior in health‐care professionals. Materials and Methods: Information was collected from 514 health‐care professionals (147 men, 367 women) who underwent routine physical examinations at a medical center in central Taiwan. Results: Mean age was 48 ± 5 years for men and 45 ± 4 years for women. Mean body mass index was 25.2 ± 4.0 kg/m² for men and 22.5 ± 3.4 kg/m² for women. The age‐adjusted MetS rate among subjects was 24.8–11.7% in men and 7.8–5.4% in women, using two different definitions, respectively. The MetS rate among those who occasionally or frequently consumed tea was higher than among those who never consumed tea (P < 0.05). Although the proportion of subjects who had MetS differed among those with differing alcohol drinking habits (never, quit and current; P < 0.05), a posteriori comparisons showed no significant differences between the two groups. Compared with those who had never smoked, the rate was higher in former smokers and current smokers (P < 0.001). No significant association with coffee consumption was found. People with MetS often consumed sweetened beverages (P < 0.05), rarely read nutrition labels and seldom consumed dairy products. Conclusions: Health‐care professionals who regularly consume tea, smoke, frequently have sweetened drinks, rarely read nutrition labels or rarely consume dairy products are at higher risk of suffering from MetS. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2010.00055.x, 2010)     

Delay discounting by adolescents experimenting with cigarette smoking

Aims To evaluate delay discounting and self‐reported impulsive behavior in a sample of adolescents experimenting with cigarette smoking compared with adolescents who had never smoked or were daily smokers. Design A cross‐sectional design was used to compare smoking‐status groups. Setting Columbus, Ohio, a city of approximately 780 000 people. Participants A sample of 141 male and female adolescents with a mean age of 15.37 (standard deviation = 1.09) years. Measurements Primary measures included a computerized assessment of delay discounting, a self‐report assessment of impulsivity [Barratt Impulsiveness Scale—adolescent (BIS‐11‐A)] and verifications of cigarette smoking status (breath carbon monoxide and urinary cotinine level). Findings Smokers discounted more by delay and had higher impulsivity scores than non‐smokers. Experimenters had scores intermediate to those of smokers and non‐smokers on both measures. In some analyses the difference between experimenters and non‐smokers was significant, with experimenters showing greater delay discounting, but in no case did experimenters differ significantly from the smokers. Conclusions Young people who experiment with cigarettes appear to be similar to those who smoke regularly in terms of tendency to discount future gains and report impulsive tendencies, and generally higher in these traits than non‐smokers.     

Urokinase‐type plasminogen activator system and human cationic antimicrobial protein 18 in serum and induced sputum of patients with chronic obstructive pulmonary disease

Background and objective: There is increasing evidence that the innate immune system plays an important role in the pathogenesis of COPD. The objective of this study was to quantify several innate immune biomarkers in serum and induced sputum of COPD patients, and healthy non‐smokers and smokers. Methods: Serum and induced sputum levels of urokinase‐type plasminogen activator (uPA), urokinase‐type plasminogen activator receptor (uPAR), urokinase‐type plasminogen activator inhibitor (PAI‐1) and human cationic antimicrobial protein 18 (CAP18) were measured by ELISA, in 13 patients with stage I or stage II COPD (COPD I + II), 15 patients with stage III or stage IV COPD (COPD III + IV), 18 healthy non‐smokers and 14 healthy smokers. In addition, membrane‐bound uPAR in peripheral blood and induced sputum was assessed by flow cytometry. Results: Levels of uPAR, PAI‐1 and CAP18 were elevated in induced sputum of COPD I + II and COPD III + IV patients, compared with healthy non‐smokers (P < 0.05) and healthy smokers (P < 0.05). uPAR, PAI‐1 and CAP18 levels were significantly higher in COPD III + IV patients compared with COPD I + II patients (P < 0.05). The expression of uPAR on induced sputum neutrophils and macrophages was significantly higher in COPD patients compared with healthy non‐smokers (P < 0.05) and healthy smokers (P < 0.05). Sputum uPAR and CAP18 levels showed significant inverse correlations with FEV₁% and 6MWD, and significant positive correlations with St. George's Respiratory Questionnaire scores. Conclusions: In COPD patients, increased induced sputum levels of uPAR, PAI‐1 and CAP18 were associated with airflow limitation, health status and exercise tolerance, suggesting that these biomarkers may be implicated in the pathogenesis of COPD.     

Effects of nicotine deprivation on urges to drink and smoke in alcoholic smokers

Aim This study examined the effect of nicotine deprivation on alcohol and smoking urges in a sample of alcohol‐dependent smokers in early recovery. Design Using a within‐subjects design, participants underwent two cue‐reactivity laboratory sessions in which they rated their urges for alcohol and cigarettes during the following three trials: baseline, neutral cue and mood induction combined with alcohol beverage cue exposure. One session was completed after 34 hours of nicotine deprivation and another in a non‐deprived state. Participants Forty alcohol‐dependent heavy smokers recruited from a substance abuse day treatment program. Measurements Self‐reported urge to drink, urge to smoke and salivation. Findings Results showed that during the non‐deprived session, alcohol cue presentations were associated with significant increases in urges to drink and urges to smoke. Acute nicotine deprivation led to increased smoking urges, but was not associated with increased urges to drink alcohol. Conclusions Findings suggest that the acute effects of smoking cessation are unlikely to increase risk of relapse to alcohol in alcoholic patients who are undergoing treatment.     

Human papillomavirus (HPV) infection and the risk of esophageal squamous cell carcinoma

There is currently no consensus on the relationship between human papillomavirus (HPV) infection and the pathogenic process of esophageal squamous cell carcinoma (ESCC). Therefore, a retrospective study was performed to explore the association between HPV infection and ESCC, where 225 patients with diagnosed ESCC and 224 matched controls were enrolled in the study and stratified according to smoking and alcohol consumption. Enzyme‐linked immunosorbent assay was used to determine seropositivity to HPV by the detection of either IgG or IgM anti‐HPV antibodies. In the non‐smoking and non‐alcohol‐consuming subgroup, the incidence of ESCC of HPV seropositive subjects was similar with that of HPV seronegative subjects (P= 0.737, odds ratio [OR] 1.14, 95% confidence interval [CI] 0.54–2.40). However, in the smoking subgroup, there was a significant difference in the incidence of ESCC between HPV seropositive subjects and HPV seronegative subjects (P= 0.009, OR 2.22, 95% CI 1.22–4.04). In addition, there was a significantly higher association of the development of ESCC in HPV seropositive patients that smoke and drink than those that do not (P < 0.001, OR 10.31, 95% CI 4.04–26.29). Therefore, HPV infection is not an independent risk factor for developing ESCC in the non‐smoking and non‐alcohol‐consuming group. For smokers, however, HPV infection increases the risk of the incidence of ESCC.     

The hematopoietic cell transplantation‐specific comorbidity index (HCT‐CI) is an outcome predictor for partially matched related donor transplantation

To validate the predictive ability of the Hematopoietic Cell Transplantation‐Specific Comorbidity Index (HCT‐CI) on the outcome of hematopoietic stem cell transplantation (HSCT) patients who received transplants from partially matched related donors (PMRD), a total of 526 patients who received PMRD HSCT between January 2006 and December 2009 at the Institute of Hematology, Peking University were enrolled. Patients were grouped according to their HCT‐CI score; 31.0%, 31.4%, and 37.6% of patients had HCT‐CI scores of 0, 1–2, and ≥3, respectively. Patients with HCT‐CI scores of ≥3 had a significantly poorer 2‐year overall survival (OS) than patients with HCT‐CI scores of 0–2 (54.55% vs. 78.05%, P < 0.001). In addition, patients with HCT‐CI scores of ≥3 had a significantly higher 2‐year cumulative incidence of relapse and nonrelapse mortality (NRM) than patients with scores of 0–2 (relapse: 23.23% vs. 11.59%, P < 0.001; NRM: 34.30% vs. 15.93%, P < 0.001). HCT‐CI scores of <3 were associated with better OS, less relapse, and lower NRM in multivariate analysis. Patients who had high comorbidity scores as well as high‐risk disease had the poorest outcomes. Therefore, we found that HCT‐CI is associated with the outcomes of PMRD HSCT and we should closely monitor patients with a high comorbidity burden. Am. J. Hematol. 88:497–502, 2013. © 2013 Wiley Periodicals, Inc.     

Cigarette smoking is associated with increased severity of gambling problems in treatment-seeking gamblers

Aims Cigarette smoking and gambling often co‐occur, but very little is known about smoking or its correlates in disordered gamblers. This study compared gambling and psychosocial problems in treatment‐seeking gamblers who smoke versus those who do not. Methods At intake to gambling treatment programs, gamblers completed the addiction severity index (ASI) and gambling questionnaires. Subjects were categorized into non‐daily smokers (n = 107) and daily smokers (n = 210). Differences in demographics, gambling variables and ASI composite scores were compared between the groups. Results The daily smokers were more likely to have a history of treatment for a substance use disorder than the non‐daily smokers. After controlling for substance abuse treatment histories, gender and age, the daily smokers demonstrated more severe gambling, family/social and psychiatric problems. Compared to non‐daily smokers, the daily smokers gambled on more days and spent more money gambling; they also ‘craved’ gambling more and had lower perceived control over their gambling. The daily smokers were more likely to be taking psychiatric medications, and they experienced psychiatric symptoms, especially anxiety symptoms, on a greater number of days than non‐daily smokers. Implications Results from this study suggest that about two‐thirds of treatment‐seeking gamblers are current daily cigarette smokers, and smoking status is associated with more severe gambling and psychiatric symptoms. These results warrant further investigation of smoking in gamblers and whether smoking adversely affects the course of treatment or outcomes among gamblers.     

Acute subjective and physiological responses to smoking in adolescents

Aims . To determine the topography of cigarette smoking and the subjective and physiological effects of abstinence and nicotine in adolescents who smoke on a daily versus a non-daily basis.
Design . Repeated measures experiment, non-blinded, involving a single test session.
Setting . Human psychopharmacology laboratory.
Participants . Twenty-one daily and 21 non-daily adolescent cigarette smokers (21 females; 21 males; age 13-18 years) with life-time use greater than 10 cigarettes, responding to radio and print advertisements.
Intervention . Overnight abstinence from cigarettes followed by smoking of a single cigarette furnished by the participant at test.
Measurements . The Fagerstrom Test for Nicotine Dependence, saliva nicotine and cotinine, expired air carbon monoxide (CO), heart rate (HR), self-report scales and smoking topography. Most measurements were performed before and after smoking.
Findings . Saliva nicotine, CO and HR increased, and self-reported intention and desire to smoke decreased, after smoking ( p < 0.001). Fagerstrom scores indicated greater dependence and desire to smoke in daily than in non-daily smokers. HR increased substantially over pre-smoking levels in both groups. Puff topography did not differ between the groups, although collectively these participants appeared to take smaller and more puffs than adult smokers tested under similar conditions.
Conclusion . This study provides initial evidence that adolescent cigarette smokers self-administer physiologically active doses of nicotine very early in their smoking careers. Nicotine dependence in adolescents appears to be a function of the current frequency of cigarette use, and subjective-behavioral consequences of abstinence and smoking are evident even in non-daily smokers.     

Depressive mood,suicide ideation and anxiety in smokers who do and smokers who do not manage to stop smoking after a target quit day

Aims The effect of successful and unsuccessful smoking cessation on depressive mood, anxiety‐ and suicide‐related outcomes is unclear. The aim of this secondary analysis was to explore the relationship between abstinence status and these outcomes. Design Cohort of adult smokers attempting to stop smoking. Smoking status was assessed by a daily diary; depressed mood, anxiety and suicidal tendencies by the Hamilton Depression Rating Scale (HDRS). The association of complete and point‐prevalence abstinence with the HDRS variables was assessed using multi‐level linear regression models. Setting Randomized trial of sertraline versus placebo for smoking cessation with weekly behavioural support provided in a clinic. Participants A total of 133 adult smokers with past major depression. Findings Pre‐quit mood scores did not predict smoking status post‐quit day. Both continuous and point‐prevalence abstainers had significantly lower total HDRS, suicide and anxiety scores, adjusted for all potential confounders, during the period following quit day than did non‐abstainers who experienced a significant mood deterioration. There was a significant effect of sertraline on post‐quit HDRS scores but not on abstinence. Conclusions Contrary to expectation, smoking abstinence among smokers with a history of major depression did not lead to increase in depression, anxiety or suicide ideation; however, failed quit attempts did. Persisting with a quit attempt while unable to achieve abstinence may be associated with mood deterioration.     

Frequency of osteopenia in adolescents with early‐onset juvenile idiopathic arthritis: A long‐term outcome study of one hundred five patients

Objective

To determine the frequency of low bone mineral content (BMC) and low bone mineral density (BMD) as long‐term complications in adolescents with early‐onset juvenile idiopathic arthritis (JIA), and to identify disease variables, patient characteristics, and biochemical bone markers related to low bone mass.

Methods

One hundred five (87%) of 121 adolescent patients with early‐onset JIA (ages 13–19 years, 80 girls and 25 boys, mean age at onset of JIA 2.8 years), from a cohort first admitted to the hospital between 1980 and 1985, were assessed after a mean disease duration of 14.2 years. BMC and BMD of the total body, the lumbar spine at L2–L4, and the femoral neck were measured by dual‐energy x‐ray absorptiometry. Age‐ and sex‐specific reference values from a pooled, healthy reference population were used to calculate Z scores. Low bone mass was defined as a Z score less than −1 SD.

Results

Among the 103 adolescent JIA patients who underwent total‐body imaging, 41% had low total‐body BMC and 34% had low total‐body BMD. Compared with adolescent JIA patients who had normal total‐body BMC, those with low BMC had lower mean weight (P < 0.001), height (P < 0.001), lean mass (P < 0.001), and remission rates (P = 0.016), had longer duration of active disease (P = 0.013), had higher numbers of active and mobility‐restricted joints (P < 0.001 and P = 0.001, respectively), had more disability (P = 0.011), had higher frequencies of joint erosions (P < 0.001), and had higher erythrocyte sedimentation rates (P = 0.033). In multiple linear regression analyses of total‐body BMC, 88% of the variance was explained by the duration of active disease, the number of joints with restricted mobility, the bone area, urinary deoxypyridinoline values, age, weight, and height.

Conclusion

Forty‐one percent of the adolescents with early‐onset JIA had low bone mass >11 years after disease onset. The development of low total‐body BMC was related to the duration of active disease, disease severity, measures of bone resorption, weight, and height.

     

The association between exposure to point-of-sale anti-smoking warnings and smokers' interest in quitting and quit attempts: findings from the International Tobacco Control Four Country Survey

Aims This study aimed to examine the associations between reported exposure to anti‐smoking warnings at the point‐of‐sale (POS) and smokers' interest in quitting and their subsequent quit attempts by comparing reactions in Australia where warnings are prominent to smokers in other countries. Design A prospective multi‐country cohort design was employed. Setting Australia, Canada, the United Kingdom and the United States. Participants A total of 21 613 adult smokers who completed at least one of the seven waves (2002–08) of the International Tobacco Control Four Country Survey were included in the analysis. Measurements Reported exposure to POS anti‐smoking warnings and smokers' interest in quitting at the same wave and quit attempts over the following year. Findings Compared to smokers in Canada, the United Kingdom and the United States, Australian smokers reported higher levels of awareness of POS anti‐smoking warnings, and this difference was consistent over the study period. Over waves in Australia (but not in the other three countries) there was a significantly positive association between reported exposure to POS anti‐smoking warnings and interest in quitting [adjusted odds ratio = 1.139, 95% confidence interval (CI) 1.039–1.249, P < 0.01] and prospective quit attempts (adjusted odds ratio = 1.216, 95% CI 1.114–1.327, P < 0.001) when controlling for demographics, smoking characteristics, overall salience of anti‐smoking information and awareness of anti‐smoking material from channels other than POS. Conclusions Point‐of‐sale health warnings about tobacco are more prominent in Australia than the United Kingdom, the United States or Canada and appear to act as a prompt to quitting.     

Sex‐specific associations between smoking habits and reaching longevity: Netherlands Cohort Study

Aim

Tobacco smoking has been found to be significantly associated with a decreased chance of reaching longevity in men, but not in women. Furthermore, it is still unclear how the association of smoking status with longevity varies under the influence of underlying smoking characteristics. Therefore, we aimed to quantify the association between several smoking characteristics and the chance of reaching the age of 90 years in men and women separately.

Methods

We carried out a prospective cohort study among the oldest birth cohorts (1916–1917) of the Netherlands Cohort Study, who completed a baseline questionnaire in 1986 (at ages 68–70), and had complete vital status information until 90 years‐of‐age (2006–2007, n = 7807). Multivariable‐adjusted analyses were based on 6642 men and women, of which 16.0% and 34.3% reached longevity, respectively.

Results

The relationship of smoking status with longevity was stronger in men than in women (current vs never smokers; risk ratio 0.44, 95% CI 0.34–0.56 in men, and risk ratio 0.67, 95% CI 0.57–0.79 in women). Furthermore, significantly inverse associations were found between longevity and increasing cigarette smoking quantity, duration, and tar and nicotine exposure, which partially explain the observed difference between both sexes. Quitting smoking significantly increased the chance of reaching longevity compared with current smokers.

Conclusions

The effect of smoking status on reaching longevity seemed stronger in men compared with women, which can be partially explained by differences in smoking habits. Never smokers had the highest chance of reaching 90 years‐of‐age in both sexes. Geriatr Gerontol Int 2018; 18: 1249–1258 .     

Reversibility of impaired nasal mucociliary clearance in smokers following a smoking cessation programme

Background and objective: Smoking cessation (SC) is recognized as reducing tobacco‐associated mortality and morbidity. The effect of SC on nasal mucociliary clearance (MC) in smokers was evaluated during a 180‐day period. Methods: Thirty‐three current smokers enrolled in a SC intervention programme were evaluated after they had stopped smoking. Smoking history, Fagerström's test, lung function, exhaled carbon monoxide (eCO), carboxyhaemoglobin (COHb) and nasal MC as assessed by the saccharin transit time (STT) test were evaluated. All parameters were also measured at baseline in 33 matched non‐smokers. Results: Smokers (mean age 49 ± 12 years, mean pack‐year index 44 ± 25) were enrolled in a SC intervention and 27% (n = 9) abstained for 180 days, 30% (n = 11) for 120 days, 49.5% (n = 15) for 90 days or 60 days, 62.7% (n = 19) for 30 days and 75.9% (n = 23) for 15 days. A moderate degree of nicotine dependence, higher education levels and less use of bupropion were associated with the capacity to stop smoking (P < 0.05). The STT was prolonged in smokers compared with non‐smokers (P = 0.002) and dysfunction of MC was present at baseline both in smokers who had abstained and those who had not abstained for 180 days. eCO and COHb were also significantly increased in smokers compared with non‐smokers. STT values decreased to within the normal range on day 15 after SC (P < 0.01), and remained in the normal range until the end of the study period. Similarly, eCO values were reduced from the seventh day after SC. Conclusions: A SC programme contributed to improvement in MC among smokers from the 15th day after cessation of smoking, and these beneficial effects persisted for 180 days.     

Long‐term effects of a preoperative smoking cessation programme

Introduction: Preoperative smoking intervention programmes reduce post‐operative complications in smokers. Little is known about the long‐term effect upon smoking cessation. Aim: To discover long‐term quit rates and the reasons behind successful cessation. Materials and Methods: 101 one of 120 smokers, randomised to smoking intervention or no intervention before hip and knee surgery, completed questionnaires concerning smoking after 1 year. We selected representative men and women for focus group interviews. Results: Significantly more patients from the intervention group abstained from smoking for 1 year post‐operatively [13 in 60 patients (22%) vs 2 in 60 (3%), P < 0.01]. Sex (male), low nicotine dependency, non‐smoking spouse and preoperative smoking intervention were related to smoking cessation. All patients gave the same reasons for smoking cessation: improved health and saving money. Follow‐up for 5 years showed 17% of the controls and 8% in the intervention group (P = 0.42) had died. Conclusion: The intervention group had a significantly higher quit rate 1 year after a preoperative smoking cessation programme. Please cite this paper as: Villebro NM, Pedersen T, Møller AM and Tønnesen H. Long‐term effects of a preoperative smoking cessation programme. The Clinical Respiratory Journal 2008; 2: 175–182.     

Assessment of factors associated with smoking cessation at diagnosis or during follow‐up of Crohn's disease

Background and Aim

Smoking cessation is known to improve the course of Crohn's disease (CD). However, the factors associated with smoking cessation after CD diagnosis have not been well established.

Methods

Clinical characteristics and change in smoking status were evaluated in 445 current smokers at the time of CD diagnosis. Patients were classified into three subgroups based on their final smoking status and time of smoking cessation: non‐quitters, quitters at diagnosis, and quitters during follow‐up.

Results

The overall smoking cessation rate was 55.7% (248 of 445 patients). The diagnosis of CD was the main reason for quitting (41.5%, 103 of 248 patients). Smoking cessation at the time of CD diagnosis was associated with intestinal resection within 3 months from CD diagnosis (odds ratio [OR] 2.355, 95% confidence interval [CI] 1.348–4.116, P = 0.003), light smoking (OR 2.041, 95% CI 1.157–3.602, P = 0.014), and initiation of smoking before 18 years of age (OR 0.570, 95% CI 0.327–0.994, P = 0.047). Light smoking (OR 1.762, 95% CI 1.019–3.144, P = 0.043) and initiation of smoking before 18 years (OR 0.588, 95% CI 0.381–0.908, P = 0.017) were also associated with overall smoking cessation.

Conclusion

Quitters after CD diagnosis, including quitters at diagnosis and quitters during follow‐up, had features distinct from those of non‐quitters. Given the motivation at CD diagnosis, a detailed history of smoking habits should be taken and all current smokers should be encouraged to quit smoking at the time of CD diagnosis.