Measures in the campaign against smoking and their efficacy according to the results of a 3-year observation under the conditions of a district polyclinic

Examination of 4185 men aged 30 to 59 years, carried out within the framework of investigations into multifactorial prevention of coronary heart disease enabled one to establish that the number of tobacco-smokers among that group men amounts to 45.1%. The percentage of tobacco-smokers appreciably decreases with age. Every second tobacco-smoker starts smoking at the age of 15 to 25 years and smokers out up to 20 and over cigarettes a day. It has been established that 86% of the tobacco-smokers have been smoking for more than 20 years, which allows attributing them to a group of persons suffering from stage III-IV tobacco-smoking, needing therapeutic care. Tobacco-smoking control consisting in group and individual interviews made it possible to lower the populational level of tobacco-smoking by 8.4% for 2 years. In the reference group, that indicator decreased by 1.4%. A new narcologic method of the treatment of tobacco-smoking has been elaborated, the efficacy of which amounted to 85.3% for a year. The use of the method led to the lowering of the populational level of tobacco-smoking by 15.1% during 3 years. In the reference group, the number of tobacco-smokers dropped by 4.7%.     

The incidence of ischemic heart disease and its risk factors in 20- to 54-year-old male workers in physical and intellectual jobs]

The low incidence of coronary heart disease (CHD) was established in the course of a one-stage epidemiological examination of 2562 men aged 20-54 years (a random sample from an open city population). It was found to be associated with an insignificant prevalence of lipid metabolism abnormalities (excluding hypoalphacholesterolemia) and did not depend on the nature of labour (4.3% among white collars and 4.4% among blue collars). The incidence of overweight and high AP turned out approximately identical, whereas tobacco-smoking, hypercholesterolemia and hypertriglyceridemia were mostly recorded in blue collars. The prevalence of CHD and its risk factors increased with age, excluding tobacco-smoking. In the latter case, it reduced with age.     

Prevalence of tobacco smoking among urban population of Samara and causative factors

AIM: To examine prevalence and intensity of smoking among general population of Samara, physicians and students of Samara Medical University; to study dependence of this prevalence on different social factors. MATERIAL AND METHODS: A representative sample of adult population was selected by the lists of outpatients of Samara outpatient clinic. The study enrolled 2931 outpatients (1272 males, 1659 females aged 15 years and older)--3.95% of all Samara outpatients. The questionnaire survey covered 360 physicians aged 28-57 years (the response 96.5%), 652 senior medical students aged 21-24 years (the response 93.14%). The results were processed with the statistical computer program BIOSTAT. RESULTS: The percentage of smoking men among 15-19-year-olds was 42.94%, 20-29-year-olds--59.29% (p < 0.01), 30-39-year-olds--62.18%, 60-year-olds and older--35.64%. This proportion for smoking women was 15.04%, 27.11% (p < 0.01), 22.92%, 9.06% (p < 0.001), 5.04%, respectively. Among male physicians smokers were 47.37% (14.29% smoked less than 10 cigarettes, 50.79%--10-20 cigarettes, 34.92%--more than 20 cigarettes a day); 16.54% male physicians smoked earlier, 36.09% never smoked. Relevant percentage for female physicians was 25.99 (38.98, 47.46, 13.56, 13.66 and 60.35, respectively). Among male medical students smokers were 58.6% (29.2% less than 10 cigarettes a day, 55.8%--0-20, 14.9%--more than 20 cigarettes a day); 9.1% smoked earlier, 32.3% never smoked. Among female medical students smokers were 20.3% (70.9, 21.5, 7.6, 9.3 and 70.4%, respectively). CONCLUSION: Tobacco smoking depends on education and marital status. Both in men and women the least number of smokers are among persons with higher education and married ones.     

Epidemiology of ischemic heart disease as related to the main risk factors among the male population in various Soviet cities (a cooperative study)

A study was made of the prevalence of coronary heart disease, risk factors (arterial hypertension, hypercholesterolemia, hypertriglyceridemia, hypo-alpha-cholesterolemia, overweight, tobacco-smoking) and of the relation of coronary heart disease to the risk factors in men aged 20 to 39 years and 40 to 54 years, living in 8 cities of the USSR. The study was carried out on material of random representative samples. It has been established that the prevalence of coronary heart disease and risk factors is bigger among the populations living in the European part of the USSR and Siberia, being lower among the populations of Central Asia. The relationship between coronary heart disease and the risk factors is pronounced to a greater measure in arterial hypertension and overweight and to a less degree in other conditions. Besides, the relation of coronary heart disease to the risk factors is marked to a much greater measure among men belonging to the senior age groups.     

Sex differences in nicotine dependence among addictions clients accessing a smoking cessation programme in Vancouver, British Columbia, Canada

ACCESSIBLE SUMMARY: ? The purpose of this study was to examine differences in substance use disorders, psychiatric disorders and nicotine dependence among 323 women and men accessing a smoking cessation programme in an addiction treatment setting in Vancouver, British Columbia, Canada. ? Individuals with substance use and psychiatric disorders have smoking prevalence rates nearly double that of the general population. Yet, there are distinct differences between men and women in their smoking behaviour and responses to smoking cessation treatment. Few studies have examined such sex differences among individuals with substance use and psychiatric disorders. ? The study found that compared with individuals with no psychiatric diagnosis, those with a mood, anxiety and psychotic disorders were significantly more likely to be female; whereas compared with those without a substance use disorder, individuals with alcohol, cocaine or marijuana disorder were more likely to be male. Moreover, among women having an anxiety disorder history and smoking a greater number of cigarettes per day were significantly associated with high nicotine dependence. Among men, smoking a greater number of cigarettes per day and having a lower confidence in quitting were significantly associated with high nicotine dependence. ? These findings suggest the need for appropriate assessment of smoking behaviour and nicotine dependence among individuals accessing addictions treatment services. Moreover, these findings further provide evidence of the need for tailored interventions for tobacco dependence among men and women with histories of substance use and psychiatric disorder. ABSTRACT: Most individuals in drug treatment programmes use tobacco and are dependent on nicotine. For 323 participants (65% men, mean age = 49.3 years) with a history of substance use disorder (SUD) and/or psychiatric disorders (PD) enrolled in a tobacco dependence clinic programme, we compared baseline characteristics among women and men and examined factors associated with nicotine dependence (ND). Individuals with mood, anxiety and psychotic disorders were more likely to be female, whereas men were more likely to be characterized by alcohol, cocaine and marijuana use, older age, older age at smoking initiation and higher confidence in quitting smoking scores. In stratified multivariate analyses, among women, history of an anxiety disorder and a greater number of cigarettes smoked per day were associated with higher ND scores; among men, a greater number of cigarettes smoked per day and higher confidence in quitting scores were associated with higher ND scores. Given the differences in smoking, SUD and PD histories between women and men accessing addiction treatment, and differential associations with ND, it is important to further explore factors that may enhance tailored treatments and inform future studies examining biological and psychosocial factors for tobacco use in SUD and PD treatment populations.     

Cellular immunity in cigarette smokers

T-lymphocyte counts have been measured and the skin test with amnestic antigens performed in 85 clinically healthy men aged 18-42 (the mean age 34) smoking 15-25 cigarettes daily during 2-25 years and in a reference group of 49 non-smokers aged 17-50 (the mean age 31). The absolute count of circulating lymphocytes has been found increased in 38 subjects who smoked for up to 10 years (the mean period 6.5 years), whereas in the subjects who smoked for more than 10 years (the mean period 18.5 years) the absolute and the relative counts of T-lymphocytes have been decreased, the tuberculin test has been much more often negative (14.9% vs. 6.1 and 5.3%), as well as the distreptase test (19.1% vs. 8.2 and 5.3%). These data confirm the suppressor effect of tobacco smoke, inhaled for a long time, on cell-mediated immunity in humans.     

Mean values of risk factors for ischemic heart disease and their percentile distributions in the Alma-Ata population of men aged 20-54]

The authors analyze the results of a one-stage epidemiological study of the open population of men aged 20-54 years (n-2886), carried out with a purpose of revealing coronary heart disease (CHD) and its risk factors (RF). The study was performed with the aid of the standard WHO methods of epidemiological investigations. The prevalence of the main CHD RF (arterial and borderline hypertension, overweight, tobacco-smoking, dyslipoproteinemias) was established. The mean values of RF in different age groups were calculated. The regional 90% cut-off points of RF distributions were defined: the body weight index (30.0), systolic arterial pressure (141 mm Hg), diastolic arterial pressure (95 mm Hg), cholesterol level (6.50 mmol/l, triglycerides (2.15 mmol/l). The 10% cut-off point for alpha-cholesterol amounted to 0.98 mmol/l. The regional values obtained can be used in prophylactic screenings when making up groups to be placed under dispensary observation.     

浙江省奉化市居民吸烟现状调查

目的 了解浙江省奉化市居民吸烟现状。 方法 采用多阶段分层随机抽样的方法,抽取600名居民进行问卷调查。 结果 奉化市居民吸烟率为25.83%,标化吸烟率为24.79%,其中男性吸烟率为58.56%,女性吸烟率为0.30%;吸烟者开始吸烟的平均年龄为21.13岁,每日平均吸烟量为20.13支,平均每盒烟费用14.93元;戒烟率为28.90%,被动吸烟率为54.83%。 结论 男性是实施控烟健康教育的重点人群,开始吸烟者年龄趋于年轻化,奉化市控烟工作比较艰巨,相关部门应引起重视。     

Smoking behaviour in young families: Do parents take practical measures to prevent passive smoking by the children?

Objective - To investigate smoking behaviour in young families.

Design - Cross-sectional study.

Setting - Mother and child health centres in Oslo, Norway.

Subjects - the families of 1046 children attending the health centres for 6-weeks-, 2- or 4- year well child visits.

Main outcome measures - Daily smoking, smoking quantity and practical measures taken by the parents to prevent passive smoking among the children as assessed by parental reports.

Results - in 48% of the families at least one adult was smoking. 33% of the smoking parents smoked more than ten cigarettes per day. 47% of the smoking families reported that they did not smoke indoors.

Conclusions - the parents were less likely to smoke if they were more than 35 years of age, had a child aged less than one year, had' a spouse/co-habitee or had a long education. Smoking parents smoked less if they had a spouse/co-habitee, had a child aged less than one year or had few children. Smoking parents were more often careful and did not smoke indoors if they had a child aged less than one year, had a spouse/co-habitee, did not have a smoking spouse/co-habitee or smoked a low number of cigarettes per day.     

Smoking as a precipitating factor for migraine: a survey in medical students

Our aim was to analyse the relationship between migraine and smoking in medical students. Medical students who had already received teaching on migraine were asked to answer an ad hoc questionnaire. A total of 361 students filled in the questionnaire: 245 (68%) were women. International Headache Society criteria were fulfilled by 58 (prevalence of migraine 16%) students. A total of 74 (20%) were current smokers: 21 males (18% of men were smokers) and 53 females (22% smokers). Within those 58 students with migraine, 17 (29%) smoke: only 2 were males (14% of males with migraine smoked) while the remaining 15 were females (34% of women with migraine smoked). Within those 17 students who were smokers and migraineurs, 12 (71%) thought that smoking worsens migraine and 10 (59%) that smoking precipitates attacks. The minimum number of cigarettes which subjectively precipitates attacks was 5. Migraine prevalence in the 20s in Spain is 16%. Our data obtained in medical students suggest that smoking can be a precipitating factor for migraine attacks, as the prevalence of active smoking is one-third higher in migraineurs and as there seems to be a relationship between the number of cigarettes and the development of migraine attacks.     

Risk factors related to hazardous alcohol consumption among Korean men with hypertension

The present study examines the alcohol consumption behaviors and risk factors related to hazardous alcohol consumption in men with hypertension in South Korea. The participants were 490 Korean hypertensive men > 20 years of age. The Alcohol Use Disorders Identification Test was used to detect hazardous alcohol consumption. The majority of the participants were current drinkers, and 37.4% were hazardous drinkers. However, very few participants had received consultation about alcohol consumption. Of the participants, 37.7% were current smokers, and almost half of them smoked more than one pack of cigarettes daily. The hazardous drinkers smoked much more than the normal drinkers, and their stress levels were higher than that of normal drinkers. Participants aged 40-49 and 50-59 years (odds ratio = 7.91, 95% confidence interval = 1.50-41.70; odds ratio = 7.57, 95% confidence interval = 1.31-43.70), those without stroke (odds ratio = 4.86, 95% confidence interval = 1.33-17.77), and current smokers (odds ratio = 4.24, 95% confidence interval = 2.00-8.98) were more likely to be involved in hazardous alcohol consumption. Successful blood pressure management will necessitate the education of such hypertensive men with consideration of their risk factors.     

Results of 5-year multifactorial primary and secondary prevention of coronary heart disease in Tashkent

The program of multifactorial primary prophylaxis was carried out for 5 years among the non-organized male population aged 40-59 years. A possibility of the disease control was demonstrated in respect to such risk factors as arterial hypertension and tobacco-smoking. No substantial changes were discovered in the prevalence of hypercholesterolemia, overweight, low physical activity as well as in the lethality due to coronary heart disease or in the rate of new cases of myocardial infarction. In the group of patients suffering from coronary heart disease, measures aimed at multifactorial secondary prophylaxis promoted a significant reduction of the lethality due to that disease and of the rate of new cases of myocardial infarction since the third year of intervention.     

Adolescent smoking prevention--primary health care in cooperation with local schools. A controlled intervention study

OBJECTIVE: To evaluate a secondary school smoking prevention program in a small rural Norwegian municipality. DESIGN: The project applied grade specific intervention strategies to all students grades 6-9 and comprised a total of 32 lessons over a period of 3 years, with high student activity. A non-randomised control group was constituted by all 6th-9th grade students in municipalities of similar characteristics in the same county. Results were recorded in annual class-based surveys. SUBJECTS: The intervention group totalled 187 and the control group 364 students. MAIN OUTCOME MEASURES: Prevalence of daily and occasional smoking and number of cigarettes smoked, during the intervention period. RESULTS: An 80% lower rate of daily smoking and 50% fewer cigarettes smoked by daily smokers. Lower rates of smoking in 9th grade occurred mostly among girls. CONCLUSION: The project resulted in a lower recruitment of daily smokers up to grade 9, as well as fewer cigarettes smoked by daily smokers. The intervention was more successful among girls than boys.     

The effect of smoking on the composition of the peripheral blood in normal subjects]

The peripheral blood erythrocytic and leukocytic status was studied in 60 healthy young tobacco-smokers and in 30 non-smokers. The smokers were divided into two subgroups, each with 30 members: those smoking for not more than 5 years and those smoking for 6 to 10 years. A trend to inhibition of erythro- and leukocytopoiesis was detected in Subgroup 1 tobacco smokers: reticulocyte maturation rate was reduced, as was bone marrow production and the level of circulating red cells, macrocyte count was increased and planocytosis was likely to develop, leukocyte counts were decreased at the expense of the neutrophils, eosinophils, and monocytes; basophil count was growing. Subgroup 2 tobacco-smokers presented with normalization of erythro- and leukocytopoiesis: reticulocyte maturation rate was growing, as was bone marrow production and the count of circulating red cells, erythrocytogram normalized, leukocyte count was increasing at the expense of the neutrophils, eosinophils, and lymphocytes; basophil count has decreased. The detected changes in the peripheral blood erythro- and leukocytic composition, related to the duration of tobacco-smoking, appear to reflect different phases of tobacco smoke toxic product effects on the bone marrow and the formation of the defense, adaptive, allergic, and immunologic reactions of the body in conditions of prolonged tobacco antigenemia.     

Study of arterial pressure, body weight, motor activity and prevalence of smoking in two independent samples of Moscow schoolchildren 11 and 14 years of age

The paper treats the results of a comparative 6-year study of arterial blood pressure, body weight, motor activity, and tobacco-smoking prevalence with respect to two representative samples of schoolchildren aged 11 and 14 years living in one of the districts of Moscow. A total of 1999 and 1219 persons were examined. The scope of examination amounted to 88 to 93 percent. From 1978-1980 to 1985-1986 the levels of systolic and diastolic arterial blood pressure increased whereas the physical activity of the schoolchildren of the same age declined. The situation with tobacco-smoking changed towards better. Thus the number of tobacco-smoking boys aged 14 years reduced almost 2-fold in spite of the lack of any prophylactic interventions in that population.     

Smoking behavior and desire to quit among low-income female caregivers.

The purpose of this study was to examine smoking behavior and the desire to quit among low-income women. Two hundred and eight women caregivers were surveyed about their smoking status, exposure to environmental tobacco smoke in the home, and desire to quit smoking. Most of the smokers (74%) wanted to quit smoking. With a logistic regression model, the number of years smoked was the only significant predictor variable for the dependent variable of thoughts about quitting when age, years of smoking, number of children, marital status, number of smokers in the home, cigarettes smoked per day, and money spent per week on cigarettes were entered as independent variables. The fewer years smoked the more likely the women wanted to quit.     

Prevalence of gastroesophageal reflux disease in Moscow: results of a population study

AIM: To study prevalence of the principal symptoms of gastroesophageal reflux disease (GERD) in Moscow. MATERIAL AND METHODS: A total of 1065 respondents aged 15-85 years (a random representative sample of population of one of the typical Moscow districts) participated in a questionnaire survey using the international questionnaire for detection of GERD incidence. RESULTS: Epigastric burning (EB) occurs in 39.6% examinees. GERD prevalence is 14.2%. Subjects with EB have the following symptoms of GERD: regurgitation (66.3%), epigastric pain (discomfort) (53.0%), nausea (43.6%), vomiting (23.2%), dysphagia (20.6%), chest pain (18.0%), odinophagia (5.5%), singultus (4.6%). There is a direct correlation between incidence rate of EB, height, body mass index, number of alcohol excesses and smoked cigarettes. CONCLUSION: EB occurs in both young and aged men and women with similar frequency. Significant differences were detected only in the age group 45-59 years in which EB is more frequent in women. All the symptoms excluding cough and singultus were seen in women significantly more frequently. With age, these differences disappeared but noncardial pain in the chest that was less frequent in the elderly. Muscovites with GERD symptoms are older (61.26 +/- 13.47 years) than those without such symptoms (58.44 +/- 16.28, p < 0.0001).     

Contemporary smoking habits among nurses in Mainland China

Although China is the world's largest consumer of tobacco and tobacco-related products, the epidemiology of smoking has not been well studied among nurses. Given this serious gap in the literature, we considered it necessary to investigate tobacco smoking habits among a large cross-section of contemporary Chinese nurses, by means of a questionnaire survey. A total of 509 replies were obtained from 520 nurses (response rate: 97.9%). The overall prevalence of smoking was 2.6% (95%CI 1.5 - 4.3). When stratified by gender, the prevalence rate among male nurses was 52.2% (33.0 - 70.8). Of those who smoked, the median number was 11 smokes per day for a period of 25.0 years. When categorized by severity, 15.4% were light smokers, 69.2% moderate smokers and 15.4% heavy smokers. When stratified by age there were no smokers under 25 years, with the prevalence between 25 and 34 years similarly low, at 1.1%. The highest smoking rate was seen among nurses aged 45 to 50 years (10.1%), even though they only comprised 9.8% of the total workforce. Although our study suggests that tobacco usage is relatively uncommon among Chinese nurses overall, the rate among male nurses was alarmingly high. The distribution of smoking by age was not uniform however, with a high proportion being concentrated in the older age ranges. As such, future preventive measures will need to consider the individual situation of Chinese nurses who smoke, particularly those who occupy the older age groups.     

1990-2010年中国病毒性肝炎的疾病负担及变化趋势

目的 了解我国分性别、分年龄组甲、乙、丙、戊型病毒性肝炎的患病、死亡、疾病负担情况及20年的变化规律。 方法 利用2010年全球疾病负担研究(GBD 2010)中国病毒性肝炎结果,以2010年全国人口普查数据作为标准人口,对患病率、死亡率和疾病负担率指标进行标化;分性别、分年龄组对4种病毒性肝炎患病情况、死亡情况和疾病负担指标进行统计描述。 结果 中国1990年病毒性肝炎的患病数、标化患病率、死亡数、标化死亡率、伤残调整生命年 (disability-adjusted life years,DALY)、标化DALY率、早死造成的生命损失年(years of life lost,YLL)、标化YLL率、伤残损失的健康生命年(years lived with disability,YLD)和标化YLD率分别为5 912 987.44例、42 903.75/1000万、33 267.39例、348.06/1000万、1 480 678.28人年、13 841.84年/1000万、1 366 636.53人年、13 016.86年/1000万、114 041.75人年和825.15年/1000万,与之相比,2010年患病数、标化患病率、死亡数、YLD和标化YLD率增加,增幅分别为10.40%、10.09%、24.01%、8.12%和7.70%;标化死亡率、DALY、标化DALY率、YLL和标化YLL下降,减幅分别为2.37%、2.63%、25.34%、3.64%和28.26%。对于甲肝, 除15岁组患病数和YLD在20年间呈上升趋势外,其余各年龄组的所有指标呈下降趋势; 5岁组的儿童是甲肝高患病率和高DALY率人群,其值1990年分别为73 523.00/1000万和5023.00年/1000万,2010年分别为73 333.00/1000万和1935.00年/1000万。乙肝随年龄组增大患病率大致呈下降趋势,而死亡率大致呈上升趋势; 15～49岁组乙肝患病人数最多,患病率最低,50～69岁组DALY在20年间迅速上升,2010年为507 041.40人年,其值在各年龄组中最高。15～49 岁和50～69岁组是丙肝高患病和高负担人群,70岁组是其高死亡率人群,其值从1990年的33.40/1000万上升到2010年的52.80/1000万,增幅为36.74%。关于戊肝, 5岁和5～14岁组患病率和YLD率在过去20年呈上升趋势,其余各指标均呈下降趋势;50～69岁和70岁组各指标均呈上升趋势,其中50～69岁组患病率、死亡率和DALY的增幅分别为36.03%、20.10%和53.82%,70岁组分别为30.48%、31.96%和58.38%。 结论 按分性别、分年龄组描述患病、死亡和疾病负担更能准确地突出病毒性肝炎的防控重点,针对存在的主要问题,提出行之有效的策略措施。     

The potentialities of capnography in the early diagnosis of obstructive ventilatory disorders

A total of 52 subjects (27 normal persons not abusing tobacco-smoking and 25 tobacco-smokers without respiratory disorders) were examined for external respiration function. A study was also made of the capnography data. It has been demonstrated that the classical criteria of the functional disorders of ventilation (FVC, RFV1, RFV1/FVC, MPV) do not enable one to make an early diagnosis of the ventilatory alterations in subjects with a risk of the development of CNPD (in tobacco-smokers). Analysis of the last third of the forced expiration curve flow-volume appeared to be of great informative value. There was a marked correlation between the capnogram characteristics and external respiration function characterizing patency of the small bronchi. It is concluded that capnography can be used as a method for assessing bronchial patency. The most informative criteria of the capnogram are provided.