Risk factors for bone mineral density at the calcaneus in 40–59 year-old male workers: A cross-sectional study in Korea

Background

Anecdotal reports suggest waterpipe smoking is becoming common in students in western countries. The aim was to examine prevalence, risk factors, symptoms of addiction, and smoke intake.

Methods

This was a cross-sectional survey of students with subsidiary survey of regular waterpipe user and survey of exhaled carbon monoxide (CO) before and after waterpipe smoking in customers of a waterpipe café. 937 students of Birmingham University completed the initial survey with a follow up of 21 regular waterpipe smokers. 63 customers of a waterpipe café near the University completed the study of CO intake.

Results

355 (37.9%, 95% confidence intervals (CI) 34.8 to 41.1%) students had tried waterpipes, the prevalence of trying rising with duration at University. 75 (8.0%, 95%CI 6.4 to 10.0%) were regular smokers, similar to the prevalence of cigarette smoking (9.4%). Although cigarette smoking was the major risk factor for being a regular waterpipe smoker, odds ratio (95%CI) 2.77 (1.52 to 5.06), 65% of waterpipe smokers did not smoke cigarettes. Seven of 21 (33.3%) regular waterpipe smokers experienced cravings. Nearly all regular waterpipe users thought it less harmful than smoking cigarettes. The mean (standard deviation) rise in CO was 37.4 (25.8)ppm, nearly twice as high as a typical cigarette smoker seeking cessation treatment.

Conclusion

Waterpipe smoking is a common part of student culture in one British university, as in the Middle East and in the United States. It poses a potential threat to public health, with evidence of dependence and high smoke intake.     

Estimating the beginning of the waterpipe epidemic in Syria

Background

Waterpipe smoking is becoming a global public health problem, especially in the Eastern Mediterranean region (EMR).

Methods

We try in this study, which is a cross sectional survey among a representative sample of waterpipe smokers in cafes/restaurants in Aleppo-Syria, to assess the time period for the beginning of this new smoking hype. We recruited 268 waterpipe smokers (161 men, 107 women; mean age ± standard deviation (SD) 30.1 ± 10.2, response rate 95.3%). Participants were divided into 4 birth cohorts (≤ 1960, 1961–1970, 1971–1980, >1980) and year of initiation of waterpipe smoking and daily cigarette smoking were plotted according to these birth cohorts.

Results

Data indicate that unlike initiation of cigarette smoking, which shows a clear age-related pattern, the nineties was the starting point for most of waterpipe smoking implicating this time period for the beginning of the waterpipe epidemic in Syria.

Conclusion

The introduction of new flavored and aromatic waterpipe tobacco (Maassel), and the proliferation of satellite and electronic media during the nineties may have helped spread the new hype all over the Arab World.

     

Smoking topography and biomarkers of exposure among Japanese smokers: associations with cigarette emissions obtained using machine smoking protocols

Objectives

Although the relative risk of lung cancer due to smoking is reported to be lower in Japan than in other countries, few studies have examined the characteristics of Japanese cigarettes or potential differences in smoking patterns among Japanese smokers.

Methods

To examine tar, nicotine and carbon monoxide (TNCO) emissions from ten leading cigarettes in Japan, machine smoking tests were conducted using the International Organization for Standardization (ISO) protocol and the Health Canada Intense (HCI) protocol. Smoking topography and tobacco-related biomarkers were collected from 101 Japanese smokers to examine measures of exposure.

Results

The findings indicate considerable variability in the smoking behavior of Japanese smokers. On average, puffing behaviors observed among smokers were more similar to the parameters of the HCI protocol, and brands with greater ventilation that yielded lower machine values using the ISO protocol were smoked more intensely than brands with lower levels of ventilation. The smokers of “ultra-low/low” nicotine-yield cigarettes smoked 2.7-fold more intensively than those of “medium/high” nicotine-yield cigarette smokers to achieve the same level of salivary cotinine (p = 0.024). CO levels in expiratory breath samples were associated with puff volume and self-reported smoking intensity, but not with nominal values of nicotine-yield reported on cigarette packages.

Conclusions

Japanese smokers engaged in “compensatory smoking” to achieve their desired nicotine intake, and levels of exposure were greater than those suggested by the nominal value of nicotine and tar yields reported on cigarette packages.     

Carbon monoxide and respiratory symptoms in young adult passive smokers: A pilot study comparing waterpipe to cigarette

Objectives

Studies have correlated second hand smoke (SHS) with many diseases, especially respiratory effects. The goal of this study was to measure the impact of SHS on the respiratory symptoms and exhaled carbon monoxide.

Material and Methods

The study population consisted of 50 young workers in restaurants serving waterpipes, 48 university students who sit frequently in the university cafeteria where cigarette smoking is allowed and 49 university students spending time in places where smoking is not allowed. Subjects completed questionnaires on socio-demographic characteristics, respiratory symptoms and exposure to SHS. Exhaled carbon monoxide levels were measured. ANOVA and Chi-square tests were used when applicable as well as linear and logistic regression analysis.

Results

Exposure to cigarette smoke in university (adjusted odds ratio (ORa) = 6.06) and occupational exposure to waterpipe smoke (ORa = 7.08) were predictors of chronic cough. Being married (ORa = 6.40), living near a heavy traffic road (ORa = 9.49) or near a local power generator (ORa = 7.54) appeared responsible for chronic sputum production. Moreover, predictors of chronic allergies were: being male (ORa = 7.81), living near a local power generator (ORa = 5.52) and having a family history of chronic respiratory diseases (ORa = 17.01). Carbon monoxide levels were augmented by the number of weekly hours of occupational exposure to waterpipe smoke (β = 1.46) and the number of daily hours of exposure to cigarette smoke (β = 1.14).

Conclusions

In summary, young non-smoker subjects demonstrated more chronic cough and elevated carbon monoxide levels when exposed to SHS while the effect of waterpipe was even more evident.     

Risk factors associated with smokeless tobacco use and cigarette smoking among teenagers in a sub-urban area of south west Nigeria

Aims

To evaluate the prevalence of, and identify risk factors associated with smokeless tobacco (SLT) use and cigarette smoking (CS) among Nigerian teenagers.

Methods

Using a validated self-administered questionnaire adapted from the Global Youth Tobacco Survey, we surveyed 1,272 teenagers selected from the five schools in Ilisan-Remo Nigeria regarding use of CS and SLT products. We used the Pearson chi-squared test and logistic regression to assess correlates of both SLT use and CS. Adjusted odds ratios (AOR) with 95?% confidence intervals (CI) were used to measure magnitudes of associations.

Results

Prevalence of ever users of SLT and CS were 5.0?% (CI: 3.8, 6.2) and 6.9?% (CI: 5.5, 8.3) respectively. Higher prevalence of SLT user was recorded among male (7.9?%), 18–19?years (11.1?%), those who had parents cigarette smokers (35.9?%), those whose best friends were cigarette smokers (47.1?%) and those working after school (9.4?%) compared with their counterparts (p?<?0.05). Similarly, higher prevalence of CSwas recorded among male (9.6?%), 18–19?years (12.7?%), those whose parents smoke (56.4?%), those whose best friends were cigarette smokers (100.0?%) and Muslims (11.1?%) compared with their counterparts. Major factors associated with SLT use were being a cigarette smokers (AOR?=?29.9; CI: 16.5, 54.4), parents smoking (AOR?=?16.1; CI: 9.0, 29.8) and having best friends who smoke (AOR?=?15.1; CI: 7.0, 32.4). Main factors associated with CS included SLT use (AOR?=?29.9; CI: 16.5, 54.4), parent smoking (AOR?=?31.7; CI: 18.2, 55.4 and Muslim (AOR?=?1.8; CI: 1.1, 2.9).

Conclusion

Prevention programmes aimed at reducing cigarette smoking need to be improved to reduce SLT use. The home and places of after school work must also be factored.     

Workplace smoking restrictions: smoking behavior and the intention to change among continuing smokers

Objectives

In this study, the association between three levels of workplace smoking restrictions and smoking behavior and variables related to the intention to quit among continuing smokers was examined.

Methods

Adult smokers were recruited from consecutive patients attending a random sample of 34 general medical practices from a pre-defined, north-eastern German region. Self-reported data were gathered in the waiting room by questionnaire. Cross-sectional data of 1,012 employees were analyzed using ordered logistic regression analyses.

Results

Among the sample, 12% reported a smoke-free workplace, 51% had partial, and 37% no smoking restrictions. Daily cigarette consumption was lower when there were higher levels of restriction. No association was found between smoking restrictions and previous attempts to quit, nicotine dependence, or indicators of adjusted inhalation to compensate for the lower number of cigarettes (e.g. puffs per cigarette, darker coloring of filter). Smoking restrictions were positively associated with single psychological measures related to the intention to quit.

Conclusion

Employees who continue to smoke may benefit from workplace smoking restrictions in terms of reduced, active smoke exposure and psychological effects increasing their readiness to quit.     

Smoking status and body fatness indicators: a cross-sectional survey among 1948 Chinese male adults

Aim

The relationship between cigarette smoking and obesity has been extensively studied, but the existing evidence is inconclusive. Moreover, few previous studies had examined the relationships of cigarette smoking with body mass index (BMI), waist circumference (WC), hip circumference (HC) and waist-to-hip ratio (WHR) simultaneously, which could not fully assess the effects of smoking on fat distribution. This study aimed to investigate the associations of cigarette smoking with BMI, WC, HC and WHR in Chinese male adults.

Subjects and methods

A total of 1,948 Chinese male adults (including 982 non-smokers, 846 current smokers and 210 former smokers) were selected from a community-based chronic disease screening project in Guangzhou and Zhuhai, China. The selected subjects were surveyed about their smoking status and history, and their body fatness indicators (BMI, WC, HC and WHR) were measured. A series of analyses of covariance (ANCOVA) were performed to assess associations between smoking behaviors and the body fatness indicators with adjustment for potential confounders.

Results

Current smokers had lower BMI (23.3 vs. 23.5 kg/m²) and HC (93.5 vs. 94.1 cm) but higher WHR (0.867 vs. 0.859) than non-smokers. Within current smokers, heavy smokers (>15 cigarettes/day) had higher BMI (23.4 vs. 23.0 kg/m²) than light smokers (1–15 cigarettes/day) without controlling for WC, but this association was reversed after adjusting for WC (23.1 vs. 23.3 cm). Heavy smokers had higher WC and WHR but lower HC than non-smokers. Former smokers who had quit for shorter than 1 year had larger BMI than non-smokers and former smokers who quitted for 1 year or longer.

Conclusions

Cigarette smoking is associated with both of the reduced total body mass and the increased waist fat deposit, and the weight gain seems to occur and complete itself in a short time after smoking cessation. These findings may improve the understanding on how cigarette smoking is linked to fat distribution and provide scientific evidence regarding intervention in smoking and obesity.     

Simultaneous measurement of urinary total nicotine and cotinine as biomarkers of active and passive smoking among Japanese individuals

Objectives

Measuring urinary cotinine is a popular and established method of biologically monitoring exposure to tobacco smoke. However, the lower detection limit of cotinine often impedes the evaluation of passive (second-hand) smoking and this, together with unconverted nicotine, does not reflect actual levels of exposure. Furthermore, a portion of the Japanese population might have decreased ability to metabolize nicotine. The present study was therefore carried out to validate the simultaneous analysis of total concentrations of free nicotine and cotinine and their glucuronides to determine actual levels of voluntary and involuntary exposure to cigarette smoke.

Methods

Urine samples from 118 Japanese smokers and 117 non-smokers were analyzed using gas chromatography–mass spectrometry. Voluntary and involuntary smoking status was self-reported and workplace smoking restrictions were objectively evaluated.

Results

The integrated sum of all concentrations showed 2.2- and 2.4-fold higher total levels (free and glucuronide) of nicotine and cotinine relative to the free levels. Median (quartiles) of total nicotine and cotinine were 1635 (2222) and 3948 (3512) ng/mL in smokers, and 3.5 (5.3) and 2.8 (4.2) ng/mL in non-smokers. Concentrations of urinary nicotine were higher than those of cotinine in 21 % of smokers and in 54 % of non-smokers. Nicotine and cotinine levels were significantly associated with a smoking habit, as well as being significantly associated with the workplace and home environments of non-smokers.

Conclusions

The present method can monitor voluntary and involuntary exposure to tobacco smoke. Measuring total urinary nicotine levels might be useful for analyzing exposure to cigarette smoke among non-smokers.     

The effect of health shocks on smoking and obesity

Aim

To investigate whether negative changes in their own health (i.e. health shocks) or in that of a smoking or obese household member, lead smokers to quit smoking and obese individuals to lose weight.

Methods

The study is informed by economic models (‘rational addiction’ and ‘demand for health’ models) which offer hypotheses on the relationship between health shocks and health-related behaviour. Each hypothesis was tested applying a discrete-time hazard model with random effects using up to ten waves of the German Socioeconomic Panel (GSOEP) and statistics on cigarette, food and beverage prices provided by the Federal Statistical Office.

Results

Health shocks had a significant positive impact on the probability that smokers quit during the same year in which they experienced the health shock. Health shocks of a smoking household member between year t?2 and t?1 also motivated smoking cessation, although statistical evidence for this was weaker. Health shocks experienced by obese individuals or their household members had, on the other hand, no significant effect on weight loss, as measured by changes in Body Mass Index (BMI).

Conclusion

The results of the study suggest that smokers are aware of the risks associated with tobacco consumption, know about effective strategies to quit smoking, and are willing to quit for health-related reasons. In contrast, there was no evidence for changes in health-related behaviour among obese individuals after a health shock.     

Evaluation of genotoxic effects of lead in pottery-glaze workers using micronucleus assay, alkaline comet assay and DNA diffusion assay

Purpose

We investigated genotoxic effects of occupational exposure to lead acetate in pottery-glaze ceramic workers.

Methods

The study was carried out in 30 exposed workers and 30 matched controls, to whom several biochemical parameters—the blood lead (B-Pb; range: exposed, 41.68–404.77; controls, 12–52) and cadmium (B-Cd) level, the activity of delta-aminolevulinic acid dehydratase (ALAD), erythrocyte protoporphyrin (EP), the level of vitamin B₁₂ and folate in serum—were measured. The genotoxic effects were evaluated by the alkaline comet assay, the DNA diffusion assay and micronucleus test in peripheral blood lymphocytes.

Results

Subjects exposed to lead had significantly higher B-Pb level and, consequently, increased values of tail intensity (TI), frequency of apoptotic and necrotic cells, and frequency of micronuclei (MN). In contrast, their activity of ALAD, the level of vitamin B₁₂ and folate in serum were significantly lower compared to controls. Poisson regression analysis showed a significant correlation of profession, duration of exposure, smoking, level of cadmium in blood, ALAD and EP with primary DNA damage. A majority of primary damage repairs in a short period after exposure to a genotoxic agent. In addition, the influence of gender and level of vitamin B₁₂ and folate in serum MN frequency in exposed group was observed.

Conclusions

In this study, DNA diffusion and micronucleus test showed higher influence of tested parameters to DNA damage. The results indicate a need for concomitant use of at least two different biomarkers of exposure when estimating a genetic risk of lead exposure.     

Kurzintervention zum Rauchverzicht bei jungen Frauen in gynäkologischen Praxen

Background

Gynecological practices offer good access to young female smokers. Immediate health risks of smoking while using hormonal contraceptives are a promising approach to be used in interventions to increase motivation towards smoking cessation.

Methods

A randomized controlled study with 12-month follow-up, testing the efficacy of a smoking cessation intervention for a proactively recruited sample of female smokers aged 14–25 in gynecological practices, is outlined.

Results

Selected results regarding the feasibility of the intervention are presented. Participation rates were 94.7% for gynecological practices; 98.3% of patients in the age group could be screened. The participation rate of young female smokers was 83.9%. Of these, 93% have so far completed follow-up.

Conclusions

The extraordinarily high participation rates show the feasibility of such an intervention to increase motivation towards smoking cessation for young female smokers in gynecological practices.     

Proaktive Interventionen zur Förderung der Tabakabstinenz in der hausärztlichen Praxis

Aim

This study examines characteristics of target groups that can be reached by proactive smoking interventions in general practices.

Methods

A total of 9,896 consecutive patients from 34 general practices in West Pomerania were registered in this study. The participation in an intervention study including smoking cessation counselling was offered to all smoking patients aged 18–70 years (n=2,016).

Results

Compared to the general population, smokers in the general practice are younger. Among the eligible patients, 82% (n=1,653) gave consent to participate in the intervention study. A total of 65% of the participants did not intend to quit smoking. Patients refusing participation were older, less ready to quit smoking and consumed less tobacco.

Conclusions

Proactive smoking interventions are highly accepted by general practice patients.     

Cigarette consumption by individuals in Malaysia: a zero-inflated ordered probability approach

Aim

To investigate cigarette consumption patterns exhibited by non-smokers, occasional smokers, and daily smokers in Malaysia.

Subjects and methods

A sample of 4204 individuals from the 2011 Malaysian Global Adult Tobacco Survey is analyzed. A zero-inflated ordered probit model is used to accommodate the ordinal nature of smoking outcomes with excessive zero observations of non-smokers.

Results

Socio-demographic characteristics are closely associated with consumption patterns of non-smokers, occasional smokers, and daily smokers. Specifically, urbanites, government employees, and Malays exhibit greater tendencies to be daily smokers and lower propensities to be non-smokers than others. Education is a deterring factor in cigarette smoking as higher education up to the tertiary level raises the propensity of being a non-smoker by 8.16 percentage points. The role of ethnicity is highlighted as individuals of Malay and other ethnic backgrounds are more likely to smoke daily, while exhibiting lower propensities of being non-smokers. Males are more likely to engage in occasional or daily smoking than females. Employment in government or non-government sectors increases the probability of daily smoking.

Conclusions

Our results suggest the need to include measures to cope with internal or external cues among smokers with specific socio-demographic characteristics. Cessation interventions should focus on daily smokers in urban surroundings with low education levels and those of Malay ethnic origins. Anti-smoking measures in line with occasional smoking may include ameliorating the male attitude toward smoking and policies to prohibit workplace indulgence.

     

Wie sich der Gastronomiebesuch nach Inkrafttreten der Rauchverbote entwickelt hat und warum Nichtraucher Raucherkneipen aufsuchen

Aim

The aim of the paper is to assess the changes in visits to restaurants and pubs in the context of smoking bans that were set up in these establishments (2008) and why some of the nonsmokers attend pubs where smoking is allowed.

Method

Mail surveys of the general population of German nationality 18 year onwards in the city of Düsseldorf in 2007 (n?=?732) and 2009 (n?=?1107).

Results

Since the smoking ban was established the frequency of attending restaurants has remained stable, but the frequency of going to pubs has slightly decreased among smokers. About three fourths of smokers mainly/always go to pubs where smoking is allowed. Only half of the nonsmokers mainly go to nonsmoking pubs. Nonsmokers who go to pubs where smoking is allowed are less fearful of passive smoking, feel less concerned about tobacco smoke and have a greater proportion of friends who smoke. Moreover they are younger than the others.     

Attitudes and knowledge about naloxone and overdose prevention among detained drug users in Ningbo, China

Background

The aim of the present study was to investigate epidemiological data about cigarette smoking in relation with risk and preventive factors among Greek adolescents.

Methods

We randomly selected 10% of the whole number of schools in Northern Greece (133 schools, 18,904 participants were included). Two anonymous questionnaires (smoker's and non-smoker's) were both distributed to all students so they selected and filled in only one. A parental signed informed consent was obtained using an informative leaflet about adolescent smoking.

Results

The main findings of the study were: a) 14.2% of the adolescents (mean age+/?SD: 15.3+/?1.7 years) reported regular smoking (24.1% in the age group 16–18 years), b) 84.2% of the current smokers reported daily use, c) students who live in urban and semirural areas smoke more frequently than those in rural areas, d) students in technically oriented schools smoke twice as frequent compared to those in general education, e) risk factors for smoking: male gender, low educational level of parents, friends who smoke (OR: 10.01, 95%CI: 8.53-11.74, p<0.001), frequent visits to internet cafes (OR:1.53, 95%CI: 1.35-1.74, p<0.001), parents, siblings (OR:2.24, 95%CI: 1.99-2.51, p<0.001) and favorite artist (OR:1.18, 95%CI: 1.04-1.33, p=0.009) who smoke, f) protective factors against smoking: participation in sports (OR:0.59, 95%CI: 0.53-0.67, p<0.001), watching television (OR:0.74, 95%CI 0.66-0.84, p<0.001) and influence by health warning messages on cigarette packets (OR:0.42, 95%CI: 0.37, 0.48, p<0.001).

Conclusions

Even though prevalence of cigarette smoking is not too high among Greek adolescents, frequency of everyday cigarette use is alarming. We identified many social and lifestyle risk and preventive factors that should be incorporated in a national smoking prevention program among Greek adolescents.     

Oxidative DNA damage is involved in cigarette smoke-induced lung injury in rats

Objective

Reactive oxygen species (ROS) induced by exogenous toxicants are suggested to be involved in carcinogenesis by oxidative modification of DNA. 8-Hydroxyl-2-deoxyguanosine (8-OHdG) has been considered as a reliable biomarker for oxidative DNA damage both in vivo and in vitro studies. But the effect of smoking on oxidative damage has not yet been fully elucidated.

Methods

Wistar rats were exposed to cigarette smoke at concentrations of 20 and 60 % for 30 min, twice/day for 45 weeks. Then the histopathology of lung tissues, levels of ROS, 8-OHdG, and total antioxidant (T-AOC), expression of DNA repair enzymes, e.g. 8-oxyguaine DNA glycosylase (OGG1), and MutThomolog 1 (Oxidized Purine Nucleoside Triphosphatase, MTH1) were determined in urine, peripheral blood lymphocytes, and lung tissue.

Results

The results showed that long-term cigarette smoke exposure can cause obvious damages of lung tissue in rats. In addition, a significant and cigarette smoke concentration-dependent increase in ROS and 8-OHdG were observed compared with the non-exposed control rats. In contrast, the expression of OGG1 and MTH1, and T-AOC levels were obviously decreased after long-term exposure to cigarette smoke.

Conclusion

These findings indicate that long-term exposure to cigarette smoker increases ROS levels, decreases total antioxidant capacity, and interferes DNA repair capacity that eventually induces oxidative DNA damage, which appears to play an important role in cigarette smoke-induced lung injury in rats, and determination of 8-OHdG levels might be a useful method for monitoring oxidative damage in cigarette smokers.     

Quality-adjusted life expectancy (QALE) loss due to smoking in the United States

Purpose

Estimate quality-adjusted life expectancy (QALE) loss due to smoking and examine trends and state differences in smoking-related QALE loss in the U.S.

Methods

Population health-related quality of life (HRQOL) scores were estimated from the Behavioral Risk Factor Surveillance System. This study constructed life tables based on U.S. mortality files and the mortality linked National Health Interview Survey and calculated QALE for smokers, non-smokers, and the total population.

Results

In 2009, an 18-year-old smoker was expected to have 43.5 (SE = 0.2) more years of QALE, and a non-smoker of the same age was expected to have 54.6 (SE = 0.2) more years of QALE. Therefore, smoking contributed 11.0 (SE = 0.2) years of QALE loss for smokers and 4.1 years (37%) of this loss resulted from reductions in HRQOL alone. At the population level, smoking was associated with 1.9 fewer years of QALE for U.S. adults throughout their lifetime, starting at age 18.

Conclusions

This study demonstrates an application of a recently developed QALE estimation methodology. The analyses show good precision and relatively small bias in estimating QALE––especially at the individual level. Although smokers may live longer today than before, they still have a high disease burden due to morbidities associated with poor HRQOL.     

Arabic validation of the Compulsive Internet Use Scale (CIUS)

Background

Areca nut is the seed of fruit oriental palm known as Areca catechu. Many adverse effects of nut chewing have been well documented in the medical literature. As these nuts are mixed with some other substances like tobacco and flavouring agents, it has been hypothesized that it might also cause some dependency symptoms among its users. Therefore, the objective of this study was to investigate dependency syndrome among areca nut users with and without tobacco additives and compare it with dependency associated with cigarette smoking among the male Pakistani population.

Methods

This was an observational cross sectional study carried out on healthy individuals, who were users of any one of the three products (areca nut only, areca nut with tobacco additives, cigarette smokers). Participants were selected by convenience sampling of people coming to hospital to seek a free oral check up. Information was collected about the socio-demographic profile, pattern of use and symptoms of dependency using the DSM-IV criteria for substance dependence. We carried out multiple logistic regressions to investigate association between socio-demographic profile, pattern of substance use and dependency syndrome.

Results

We carried out final analysis on 851 individuals, of which 36.8% (n = 314) were areca nut users, 28.4% (n = 242) were the chewers of areca with tobacco additives and 34.7% (n = 295) were regular cigarette smokers. Multivariate analyses showed that individuals using areca nut with tobacco additives were significantly more likely to have dependency syndrome (OR = 2.17, 95% CI 1.39-3.40) while cigarette smokers were eight times more likely to have dependency syndrome as compared to areca nut only users.

Conclusions

Areca nut use with and without tobacco additives was significantly associated with dependency syndrome. In comparison to exclusive areca nut users, the smokers were eight times more likely to develop dependence while areca nut users with tobacco additives were also significantly more likely to suffer from the dependence.     

A cytogenetic approach to the effects of low levels of ionizing radiation (IR) on the exposed Tunisian hospital workers

Objectives

The aim of this study is to assess chromosomal damage in Tunisian hospital workers occupationally exposed to low levels of ionizing radiation (IR).

Materials and Methods

The cytokinesis-block micronucleus (CBMN) assay in the peripheral lymphocytes of 67 exposed workers compared to 43 controls matched for gender, age and smoking habits was used. The clastogenic/aneugenic effect of IR was evaluated using the CBMN assay in combination with fluorescence in situ hybridization with human pan-centromeric DNA in all the exposed subjects and controls.

Results

The study showed a significant increase of the micronucleus (MN) frequency in the lymphocytes of the exposed workers compared to the control group (13.63±4.9‰ vs. 6.52±4.21‰, p < 0.05). The centromere analysis performed in our study showed that MNs in hospital staff were predominantly centromere negative (72%) and the mean negative labeled micronucleus (C-MN) frequency was significantly higher in the exposed subjects than in the controls (9.04±4.57‰ vs. 1.17±0.77‰). The multivariate regression analysis, taking into account all confounding factors, showed that only the time of exposure to IR had a significant effect on the level of MNs and C-MN.

Conclusion

The present study shows that chromosomal damage leading to the formation of micronucleated lymphocytes is more frequent in the hospital workers exposed to IR than in the controls, despite the low levels of exposure. The results of the study confirm the well-known clastogenic properties of ionizing radiation. In regards to health monitoring, detection of early genotoxic effects may allow for the adoption of preventive biological control measures, such as hygienic improvements in the workplace or reduction of hours of occupational exposure.     

Beurteilung des Bremischen Gesetzes zur Gewährleistung der Rauchfreiheit von Krankenhäusern, Tageseinrichtungen für Kinder und von Schulen durch die betroffenen Einrichtungen

Background

Second-hand smoke causes a range of chronic and fatal conditions, including lung cancer and chronic obstructive pulmonary disease. The Federal State of Bremen banned smoking in hospitals, schools, and kindergartens as protection from passive smoking in August 2006. The paper reports on a survey which was planned to assess the attitudes of the affected employees towards the law.

Methods

Teachers of all 210 kindergartens and 124 secondary schools as well as the employees of 4 hospitals in Bremen and Bremerhaven (a total of N=14,900) were sent a standardized questionnaire, asking for smoking status and attitudes toward the law.

Results

Of the employees, 10.4% (kindergartens) to 27.8% (hospitals) are daily smokers. One third tried to stop smoking in the last 12 months. Nearly a third of them will reduce smoking at their workplace; 12.4– 23.2% hope that they will quit smoking. More than three quarters (between 74.0 and 81.1%) support the law and evaluate it as positive.

Conclusions

The legislative action is widely supported, even among smokers. Daily smokers hope that the law will help them to quit smoking.