Serum thiocyanate and smoking: interpretation of serum thiocyanate levels observed in a large health study

In a Norwegian health study involving 25,300 persons the mean serum thiocyanate level in non-smokers was 33.9 mumol/l for males and 33.5 mumol/l for females. In moderate smokers (five to nine cigarettes per day) the mean level was 59.6 mumol/l for males and 70.9 mumol/l for females. In heavy smokers (greater than 25 cigarettes per day) the mean level was 87.3 mumol/l in males and 99.7 mumol/l in females. The difference between the thiocyanate levels in females and males smoking the same number of cigarettes can be explained by the sex difference in distribution volume for thiocyanate. Among non-smokers the mean level of serum thiocyanate was the same whether the persons had been indirectly exposed to tobacco smoke or not. The mean serum thiocyanate levels were up to 10 mumol/l higher in the last half part of the year than in the first part. This can be explained by seasonal variations in the content of thiocyanate in the diet. The range of the individual thiocyanate level was great both in non-smokers and in smokers, resulting in a large overlap. Serum thiocyanate can therefore not distinguish all non-smokers from all smokers. However, by choosing suitable 'cut-off levels' it is possible to extract from the total population groups consisting of a large majority of smokers and only a few non-smokers and vice versa.     

Motivational interviewing as a smoking cessation intervention for patients with cancer: randomized controlled trial

BACKGROUND: Smoking cessation of patients with cancer can improve treatment efficacy and survival. OBJECTIVE: To determine whether a motivational interviewing intervention increased successful smoking cessation attempts of patients with cancer attending a South Australian public hospital, as compared with usual care. METHODS: A randomized controlled trial was used to study 137 patients with mixed cancer sites, including 74 intervention patients and 63 control patients. The motivational interviewing intervention was delivered over a 3-month period. The intervention included a visit with a smoking cessation counselor, provision of smoking cessation booklets, nicotine replacement therapy, family advice to quit, and an in-person or telephone follow-up conversation. RESULTS: At the 6-month follow-up visit, an intention-to-treat analysis found no difference in biochemically confirmed 3-month prevalence quit rates between the intervention (5%) and control (6%) groups. A sensitivity analysis using more lenient criteria indicated quit rates of 29% for the intervention group and 18% for the control group (p = .32). The predictors of smoking cessation at 6 months for all the patients included a smoking-related cancer site, more cessation attempts in the year before enrollment in the study, and no radiation therapy. CONCLUSIONS: Future efforts to improve smoking cessation in this patient group might focus on the delivery of more direct methods for encouraging spouse cessation and support to the patient in quitting, and the use of bupropion (Zyban) as an adjunct to cessation for this heavy smoking patient group.     

Smoking habits of office-based general practitioners and internists in Austria and their smoking cessation efforts

Tobacco smoking is the major cause of lung disease. This study aimed to determine: 1) the prevalence of tobacco smoking among office-based physicians; 2) their readiness to inquire about their patients' smoking habits and, if need be, to motivate them to stop smoking; 3) whether non-smoking doctors advise their patients more frequently to stop smoking than their smoker colleagues do. A self-designed questionnaire on a post card was sent to 7674 office-based general practitioners (GPs) and internists. 1395 (18.2%) questionnaires were returned. Independent telephone interviews with 91 doctors were also carried out to minimize the bias of self-presentation. Just under 11% of doctors were smokers. About 50% of all doctors who responded described themselves as ex-smokers. 38% of the smokers would accept outside help to stop smoking. About 50% of GPs and 90% of internists inquire about the smoking habits of their patients during history taking. Of these, 85% of GPs and 92% of internists recommend their patients to stop smoking. Doctors who themselves are smokers do so less than their non-smoker colleagues. For this reason, a further reduction in the smoking prevalence among doctors would be of special importance. Inquiry about smoking habits in the initial history taking should be stressed more to identify any smoker who can be subsequently encouraged to stop smoking.     

Serum lipoprotein patterns in patients with coronary atherosclerosis

Collagenolytic activity in synovial tissue was studied by measuring the degradation of collagen in normal and rheumatoid synovial tissue samples. In the assay the 6000-g pellet of the tissue homogenate was incubated in neutral buffer in the presence of Ca²⁺ at 37° for 20 h. Released hydroxyproline-containing material was taken as the measure of collagenolytic activity.The mean value of collagenolytic activity in the rheumatoid arthritis group was about 6–7 times that of controls. High values were found in patients having elevated rheumatoid factor titres.The increased collagenolytic activity in rheumatoid synovial tissue suggests increased breakdown of collagen in the diseased synovium. The high collagenolytic activity in the synovium may be connected with the local tissue destruction in the joint.     

Dietary habits of patients with coronary atherosclerosis: case-control study

AIM: The aim of this study was to identify the dietary-related risk factors for coronary atherosclerosis among Hong Kong Chinese people. BACKGROUND: Prevalence and mortality figures for coronary atherosclerosis are increasing in Chinese communities, including those in Hong Kong. Changes in dietary patterns might explain the increased risk of coronary artery disease among the Hong Kong Chinese. METHOD: A total of 145 consecutive patients scheduled to have coronary angiogram in a regional hospital in Hong Kong completed a self-reported questionnaire on their dietary intake for 1 week. A case-control design was used, and the data were collected from December 2000 to February 2001. RESULTS: Consumption of more than 1120 g of fish [28 tael (Chinese weight unit, 1 tael equals approximately 42 g)] per week (OR = 0.07) and soybean (OR = 0.17) had a beneficial effect in preventing coronary atherosclerosis. In addition, an increased waist-hip ratio (OR = 4.81) and consumption of more than 28 teaspoons of fat per week (OR = 42.36) were identified by logistic regression as independent risk factors for coronary atherosclerosis. Moreover, people who smoked (OR = 1.72), had a lower educational level (OR = 0.51) or higher family income (OR = 1.92) were more vulnerable to coronary atherosclerosis. Patients confirmed as having coronary atherosclerosis were more likely than those with normal coronary vessels to rank deep fry, stir fry, and pan fry as their preferred cooking methods over steaming or boiling. CONCLUSION: The results provide nurses with information on which to develop appropriate health education programmes for patients and the general public in Hong Kong to promote cardiovascular health. Efforts should be directed particularly to promoting boiling and steaming as major cooking methods, rather than frying or deep frying, as protective actions against coronary atherosclerosis.     

阶段性改变模式在高血压患者戒烟中的效果研究

目的 探讨阶段性改变模式在帮助高血压患者戒烟中的效果.方法 在苏州某医院通过方便取样方法,收集89例吸烟或曾吸烟的高血压患者作为研究对象,将其随机分为干预组(44例)和对照组(45例).干预组住院时期及出院后1周接受基于阶段性改变模式的戒烟干预措施,对照组则接受常规戒烟教育.出院后第1～3个月比较两组之间吸烟改变阶段、...     

Multicomponent individualized smoking cessation intervention for patients with lung disease

AIMS: This paper reports a study examining the process and outcomes of a long-term, multicomponent smoking cessation intervention for patients with lung disease initiated while hospitalized and provided over 1-year postdischarge. BACKGROUND: Successful smoking cessation interventions are of primary importance for people with lung disease. Initiation of such an intervention in hospital settings is particularly important as patients may be especially motivated to quit as a result of strong perceptions of vulnerability while hospitalized for a smoking-related disease. Tailoring the intervention to each person's needs is a promising approach to practice. METHODS: All patients who smoked and were admitted to a pulmonary unit over 2 years were invited to participate in this quasi-experimental study (n = 85), and 69 continued beyond the first month. The intervention was shaped by the TransTheoretical Model and used nicotine replacement therapy, along with individual and group counselling and support grounded in the nurse-patient relationship. The intervention was provided during hospitalization and by telephone after discharge at 1 week, and 1, 3, 6 and 12 months. RESULTS: At 12-months postdischarge, 39% of the patients reported continuous abstinence from smoking from the time they joined the programme and 52% were not smoking at that time. No relationship was found between abstinence and the number of quit attempts, readiness to quit, nicotine dependency and length of hospital stay. Readiness to quit had increased and nicotine dependency decreased significantly by the end of the programme. No gender differences were found for the main variables. CONCLUSIONS: Comprehensive, individualized smoking cessation interventions for hospitalized patients having lung disease, with a 1-year follow-up, was successful. Abstinence was high in comparison with other studies. This may in part be explained by significantly enhanced motivation to quit during the smoking cessation programme.     

Smoking habits and predictors of continued smoking in patients with acute coronary syndromes

BACKGROUND: Most patients with acute coronary syndrome quit smoking when hospitalized, although several have been found to relapse and resume smoking within 3 months. AIM: This paper reports a study to identify factors that can predict who will resume smoking after hospitalization for an acute coronary syndrome. METHODS: Patients (n = 1320) below the age of 75 years, admitted to a Swedish university hospital coronary care unit with acute coronary syndromes, between September 1995 and September 1999, were consecutively included. Data were collected from hospital medical records and included information on previous clinical history, former illnesses and smoking. During their hospitalization, an experienced nurse interviewed the patients by using a structured questionnaire to obtain additional information. Patients were followed up 3 months after the discharge. Those who continued to smoke (non-quitters) were compared with those who had stopped (quitters) with regard to age, sex, medical history, clinical course, and intention to quit. To identify factors independently related to continued smoking, a logistical regression in a formal forward stepwise mode was used. RESULTS: Of the patients admitted, 33% were current smokers. Three months after discharge, 51% of these patients were still smoking. There were no significant differences in age, gender or marital status between non-quitters and quitters. In a multivariate analysis, independent predictors of continued smoking were: non-participation in the heart rehabilitation programme (P = 0.0008); use of sedatives/antidepressants at time of admission (P = 0.001); history of cerebral vascular disease (P = 0.002), history of previous cardiac event (P = 0.01); history of smoking-related pulmonary disease (P = 0.03) and cigarette consumption at index (P = 0.03). CONCLUSIONS: Smoking patients who do not participate in a heart rehabilitation programme may need extra help with smoking cessation. The findings may provide means of identifying patients in need of special intervention.     

Exercise and smoking habits in patients with and without low back and leg pain

The exercise and smoking habits of low back or leg pain sufferers vs. persons not having low back or leg pain are compared. The type, frequency and length of exercise is determined from a study of 576 low back or leg pain sufferers compared to 50 persons who state they are symptomatic. The same was done for smoking habits. Thirty-three percent of low back or leg pain sufferers smoked as compared to 14% of those without pain. Forty-seven percent of low back or leg pain sufferers as compared to 86% of non-sufferers exercised regularly. The level of physical activity and general exercise have been found to improve strength, mobility and endurance; this might prevent future back injury. Our study is to determine differences in the exercise habits of persons with low back and/or leg pain vs. those who do not have pain, with the intention being to see if pain sufferers exercise less.     

The effectiveness of nicotine-patch therapy for smoking cessation in patients with schizophrenia

The purpose of this study was to determine the effectiveness of nicotine-patch therapy for smoking cessation in patients with schizophrenia. This was a longitudinal study and sixty-eight schizophrenic patients were assigned to 8 weeks of a nicotine-patch therapy program or a control group. The generalized estimating equation analysis revealed that there were significant reductions in the subjects' nicotine dependence (Fagerstrom Tolerance Questionnaire), the number of cigarettes per day, and CO levels over an 8-week period of nicotine-patch therapy and 3-month follow-up. The point-prevalence rates of abstinence from smoking were an abstinence of 26.9% at 8 weeks and 26.9% at a 3-month follow-up. At the 3-month follow-up, the rate of continuous smoking abstinence in the nicotine-patch group was 23.1%.     

Update on peripheral vascular diseases: from smoking cessation to stenting

Newer pharmacologic agents including gene therapy hold promise for the treatment of atherosclerotic peripheral vascular disease (PVD), as do advances in endovascular revascularization techniques. Nonetheless, the two most important treatments remain the same: stopping smoking and starting a walking program.