吸烟与脑卒中关系的病例对照研究

调查１８８例脑卒中病人及１８８例正常对照的吸烟情况后发现，吸烟与脑卒中有关，其ＯＲ＝２．１３，Ｐ＜０．００１，随着吸烟年限的延长、吸烟量的增加，患脑卒中的危险性也在增加（ＯＲ分别为１．０２、Ｐ＜０．００１和１．２１、Ｐ＜０．ＯＯ１）；开始吸烟年龄越大越容易患病，ＯＲ＝１．０２，Ｐ＜０．０５。被动吸烟也与脑卒中密切相关（ＯＲ＝６．５６，Ｐ＜０．００１）。经高血压病史调整后，吸烟、被动吸烟仍与脑卒中密切相关。通过病例组与对照组血脂分析发现：病例组中吸烟者ＴＣ及ＨＤＬ－Ｃ明显低于非吸烟者；对照组吸烟者与非吸烟者血脂水平无明显差异。     

女性非吸烟者中被动吸烟与肺癌关系的探讨

为了探索非吸烟者中肺癌发病原因，采用病例对照的方法对北京市ＳＩＮＯ－ＭＯＮＩＣＡ项目监测人群中的肺癌病例进行了调查，分析结果显示被动吸烟与非吸烟女性患肺癌有一定阳性关联（ＯＲ＝２．５２，Ｐ＜０．０５），并随被动吸烟年支的增加而上升，当达２００年支以上时有显著统计学意义（Ｐ＜０．０５）。环境香烟烟雾（ＥＴＳ）诱发肺腺癌的可能性较大（ＯＲ＝２．３２，Ｐ＜０．０５），而与肺鳞癌似无关系（ＯＲ＝１．０４，Ｐ＜０．０５）。     

女怀非吸烟者中被动吸烟与肺癌关系的探讨

为了探索非吸烟中肺癌发病原因，采用病例对照的方法对北京市ＳＩＮＯ＿ＭＯＮＩＣＡ则人群中的肺癌病例进行了调查，分析结果显示动吸吸烟与非吸烟女性患肺癌有一定的阳性关联（ＯＲ＝２．５２，Ｐ〈０．０５），并随被动吸烟年支的增中而上升，当达２００年支以上时有显统计学意义（Ｐ〈０．０５）。环境香烟烟雾（ＥＴＳ）诱发肺腺癌的可能性较大（ＯＲ＝２．３２，Ｐ〈０．０５），而与肺鳞似无关系（ＯＲ＝１．０４，Ｐ〈０     

女性因素与脑卒中

本文采用条件Ｌｏｇｉｓｔｉｃ回归分析的方法，对１２８例女性脑卒中病人及其健康对照，进行了１：１配对的对比研究，计算其ＯＲ值。单因素结果表明：月经初潮年龄、妊娠次数与女性脑卒中呈明显的正相关（ＯＲ＝１．３０和１．１７，ｐ＜０．００２和Ｐ＜０．０５），而绝经年龄、生产次数、自然流产次数以及生殖周期则和女性脑卒中呈明显的负相关（ＯＲ＝０．９６、０．４５和０．４５．Ｐ分别＜０．０２、＜０．０１、＜０．０１和＜０．００１）；但经高血压病史和吸烟调整以后，则月经初潮年龄晚、绝经年龄早及生殖周期短是女性脑卒中独立的危险因素，ＯＲ值分别为１．３５和１．３３、０．９６和０．９６、０．９２和０．９２。说明初潮年龄早、绝经年龄晚以及生殖周期长是女性脑卒中独立的保护因素。本研究未发现女性激素与女性脑卒中的相关关系。     

缺氧缺血性脑病病因危险因素的病例对照研究

对１００例确诊为新生儿缺氧缺血性脑病的新生儿患者的影响因素进行了病例对 照研究。结果：过期产儿（ Ｐ＜０． ０５，ＯＲ＝３． ９９６）、宫内窘迫（ Ｐ＜０． ０１）、滞产（ Ｐ＜０． ０１）、胎位异 常（ Ｐ＜０． ０１，ＯＲ＝２０． ２７７）、产钳（ Ｐ＜０． ０１，ＯＲ＝１４． ７９３）、创立产（ Ｐ＜０． ０５，ＯＲ＝２． ７４７）、窒 息（ Ｐ＜０． ０１，ＯＲ＝６８． ３０８）、产伤（ Ｐ＜０． ０１，ＯＲ＝１３． ８２１）、肺透明膜病（ Ｐ＜０． ０１）、呼吸暂停 （ Ｐ＜０． ０１，ＯＲ＝１２· ２３６），共 １０个因素对疾病的发生有明显的影响。     

中老年人高脂血症危险因素的病例对照研究

本文对仪化公司１９７名高脂血症病例和１２３名血脂正常者作病例对照研究，对研究对象的文化程度、烟酒茶嗜好、饮食嗜好、家族及个人患病史、体力活动、体重等因素与高脂血症危险程度进行分析，结果显示：腰臀比（ＷＨＲ）是中老年人高脂血症的首要因素，体质指数（ＢＭＩ）是引起高脂血症的另一重要因素（ＷＨＲ：ＯＲ＝２．４１３，９５％Ｃｌ：１．９９０～２．９２６；ＢＭＩ：ＯＲ＝１．７５１，９５％Ｃｌ：１．４８１～２．０９０），除此之外，体力活动过少（ｔ＝２．７９，Ｐ＜０．０５）及吃肉较多（ｒ＝０．１２１４，Ｐ＜０．０５），也是中老年人高脂血症不可忽视的危险因素，本次调查资料未发现吸烟、高血压与高脂血症的关系。     

北京某石化企业育龄妇女自然流产环境影响因素初步筛查

为探讨北京某石化厂育龄女工自然流产的环境影响因素，选择首次妊娠为自然流产，且仅流产过一次的６１对２５～３０岁妇女及年龄和妊娠时间齐同的相应对照配对作为研究对象。对分析指标进行单因素卡方检验和Ｌｏｇｉｓｔｉｃ多因素回归分析。结果初步显示，嗜咸膳食（ＯＲ＝３．１７５，Ｐ＜０．０１）和接触职业毒物（ＯＲ＝２．７６１，Ｐ＜０．０５）为该地区妇女自然流产的主要危险因素；日常多吃蔬菜（ＯＲ＝０．４６８，Ｐ＜０．０５）和妊娠期乘车或骑自行车上班（ＯＲ＝０．４７４，Ｐ＜０．０５）为预防自然流产的保护因素，居住面积大（ＯＲ＝０．９３４，Ｐ＜０．０５）亦有一定影响，值得进一步深入研究。     

儿童被动吸烟与化脓性脑膜炎

笔者对６３例１～１２岁化脓性脑膜炎患儿进行了被动吸烟与化脓性脑膜炎关系的１：１病例对照研究。结果表明，被动吸烟儿童患化脓性脑膜炎的ＯＲ值为３．００，其９５％可信限大于１，Ｐ＜０．０５；并且家长的吸烟量与儿童患化脓性脑膜炎的相对危险性之间存在着显著的剂量效应关系，Ｐ＜０．００５。提示被动吸烟是儿童化脓性脑膜炎发病的危险因素之一。     

吸毒人群丙型肝炎病毒感染危险因素的研究

采用病例对照的研究方法,对广州市５３１名吸毒人员进行丙型肝炎病毒（ＨＣＶ）感染危险因素的调查,资料采用Ｌｏ－ｇｉｓｔｉｃ回归方法分析。结果表明：静脉吸毒（ＯＲ＝６．６８,Ｐ＜０．００１）,非固定婚外性伴侣（ＯＲ＝３．７１,Ｐ＜０．００１）,输液史（ＯＲ＝２．６４,Ｐ＜０．０１）和抗－ＨＢｃ阳性（ＯＲ＝１．７４,Ｐ＜０．０５）是ＨＣＶ感染独立的危险因素,而在性生活中使用避孕套（ＯＲ＝０．３７,Ｐ＜０．００５）是保护因素。提示广州市吸毒人群ＨＣＶ感染的主要途径是血液传播,同时性传播途径也起着重要的作用。     

脑出血病人血脂水平的研究

本文采用病例对照的方法分析了脑出血病人，急性期血中总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）、低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）含量。结果发现：病例组血清ＴＣ明显低于对照组（ｔ＝２．２４０２，Ｐ＜０．０５），病例组ＨＤＬ－Ｃ明显低于对照组，ｔ＝６．４７２７，Ｐ，＜０．００１。未显示ＴＧ及ＬＤＬ－Ｃ病例组与对照组有明显差异（Ｐ＞０．０５）。以上指标与年龄无明显关系。     

Periconceptional smoking: an exploratory study of determinants of change in smoking behavior among women in the fertile age range

How can women who are not yet pregnant be motivated to stop smoking before they become pregnant? Epidemiological studies have suggested that periconceptional smoking and smoking during the first trimester of the pregnancy may lead to congenital abnormalities. To motivate women to stop smoking before pregnancy, more insight is needed into the differences between 'smoking' women who want to have children and those who do not. A sample of 931 women (65% response rate) aged 15-45 years returned a questionnaire with questions about their smoking behavior, wish to have children, risk perceptions, attitude to smoking, personal efficacy and stage of readiness to change. In spite of some positive outcomes (e.g. negative attitude to smoking, relatively high risk perceptions of the relationship between congenital anomalies and smoking), one cannot automatically assume that these women will stop smoking before they get pregnant. (1) Beliefs, attitude and readiness to change were not well integrated and grounded cognitively. (2) Women who smoked were pessimistic about their ability to quit. Future campaigns need to 'invite' women to associate and to integrate risk information about the relationship between smoking and congenital abnormalities with other cognitions (attitude, intention). It is also important to instruct women in how to stop smoking and to remain non-smokers.     

Obesity in relation to smoking: A population study of women in Göteborg,Sweden

A population sample of 1,462 middle-aged women (participation rate 90.1%) was studied in 1968–1969, 1,302 of whom (participation rate 80.3%) were reexamined in 1974–1975. Cigarette smoking was more frequent among younger women. Current smokers were leaner than nonsmokers. A U-shaped relationship was found between obesity index and cigarette consumption. This relationship was not explained by differences in energy intake, physical activity, or social class. Cessation of smoking was correlated with weight gain, and commencement of smoking with weight loss. Of those who quit 13% gained weight ?10.0 kg and 22% gained between 5.0 and 9.9 kg compared with 4 and 14%, respectively, among those who did not change smoking habits. The average weight change was +3.5 and ?0.7 kg among those who quit smoking and started smoking, respectively, compared with +1.4 kg among those who did not change smoking habits. A greater weight gain with the amount smoked was found both in those who stopped smoking and in those who continued smoking. Increased physical activity and reduced energy intake need consideration at cessation of smoking, especially among heavy smokers. The quantitative aspects of the relationship between smoking and obesity, and between cessation of smoking and weight gain, are considered to be of special interest for health personnel engaged in antismoking campaigns.     

Active and passive smoking and tooth loss in Japanese women: baseline data from the osaka maternal and child health study

PURPOSE: Many studies have shown a positive association between cigarette smoking and oral diseases. Few studies, however, have focused on the relationship between passive smoking exposure and oral health in adults. We investigated the association of active and passive smoking exposure with tooth loss in Japan. METHODS: Study subjects were 1002 pregnant women. Tooth loss was defined as previous extraction of one or more teeth. Adjustment was made for age, gestation, parity, family income, education, and body mass index. RESULTS: Of the 1002 subjects, 256 women had lost one or more teeth. Current light smoking was independently related to an increased prevalence of tooth loss, showing a significant exposure-related association with smoking status. A significant positive association of 8 or more pack-years of smoking with the prevalence of tooth loss was observed. Also, a significant positive relationship was found between current heavy passive smoking at home and tooth loss, but not with pack-years of passive smoking at home. No measurable association between passive smoking exposure at work and tooth loss was indicated. CONCLUSIONS: The present findings suggest that passive as well as active smoking may be associated with an increased prevalence of tooth loss in Japanese young adult women.     

Prenatal Smoking Cessation Intervention and Gestational Weight Gain

BackgroundQuitting smoking is often associated with weight gain and prenatal cessation may lead to increased gestational weight gain (GWG). Although previous reports have suggested a link between prenatal smoking cessation and GWG, no studies have examined the relationship between cessation and guideline-recommended GWG, and there is little information about the relationship between the timing of prenatal cessation and GWG. Thus, we examine GWG among women in a community prenatal smoking cessation program and assess the relationship between the timing of prenatal cessation GWG.MethodsPregnant women from care clinics serving economically disadvantaged women who participated in a smoking cessation intervention offered free of charge, self-reported weight, and provided biochemical verification of smoking. Relationships between duration of cessation and GWG were evaluated in t-tests and regression models. GWG was calculated from self-reported weight before pregnancy and self-reported weight at the last visit before delivery.FindingsWomen who quit earlier during pregnancy had greater GWG (16.9 ± 7.5 kg) than did those who never quit (13.6 ± 8.9). After adjusting for timing of weight assessment and prepregnancy body mass index, however, GWG was not different between women who did and did not quit.ConclusionQuitting earlier in pregnancy is associated with greater GWG, but women who do and do not quit do not differ on total GWG. Despite increased GWG with early cessation, the maternal and fetal health benefits of prenatal smoking cessation outweigh risks of potential risks of excessive GWG.     

女性被动吸烟与冠心病

Thirty-four women CHD cases (22 cases diagnosed by coronary arteriography and 12 myocardial infarction) and 68 of non-CHD controls (34 hospital based and 34 population based), matched on age (within five years), race, residence, occupation (and case is to control as 1:2), were interviewed regarding the smoking habits of themselves and their husbands. The odds ratio (i.e. OR) of non-smoking women CHD associated with having a smoking husband are 3.00-3.52, OR 95% CI do not include 1. Significant dose-response relationships between OR of women's CHD and their husband's cigarette consumption, duration of passive smoking and cumulative quantity of passive smoking were found in the study. The logistic regression model analysis with other CHD risk factors showed that the relationship with CHD and passive smoking still existed. It was found that the metabolism of HDL-cholesterol and apolipoproteins with passive smokers was abnormal.     

Does the association between smoking status and selected healthy foods depend on gender? A population-based study of 54 417 middle-aged Danes

OBJECTIVE: Smoking serves different functions for men and women. Thus, we wanted to investigate the association between smoking behaviour and intakes of selected healthy foods in men and women with special focus on differences and similarities between the two genders. DESIGN: In 1993-1997, a random sample of 80 996 men and 79 729 women aged 50-64 y was invited to participate in the study 'Diet, Cancer and Health'. In all, 27 179 men and 29 876 women attended a health examination and completed a 192-item food-frequency questionnaire (FFQ). The association between smoking status and low, median and high intakes of selected foods was examined among 25 821 men and 28 596 women. SETTING: The greater Copenhagen and Aarhus area, Denmark. RESULTS: For both men and women, smoking status group was associated with diet, such that increasing level of smoking status ranging from never smokers over ex-smokers to currently heavy smokers was associated with a lower intake of the healthy foods: fresh fruit, cooked vegetables, raw vegetables/salad, and olive oil. For wine, increasing level of smoking status category was associated with a higher fraction of abstainers and heavy drinkers. The difference between the extreme smoking status categories was larger than the difference between men and women within smoking status categories such that never smoking men in general had a higher intake of healthy foods than heavy smoking women. Correction for age, educational level, and body mass index (BMI) did not affect the results. CONCLUSION: In this middle-aged population, intake of healthy foods were associated with smoking behaviour with a dose-response type of relationship. The overall pattern was similar for men and women.     

The relationship between coffee consumption and serum cholesterol under consideration of smoking history

A large German population sample of 6820 men and 7258 women was used to investigate the relationship between coffee consumption, total serum cholesterol and HDL cholesterol.Analyses were conducted on men and women separately. Differences in age, body mass index, diastolic blood pressure, smoking habits, alcohol, fish, milk and tea consumption, physical activity and medication use were controlled for in the analyses. Interactions between coffee consumption and smoking habits in their relationship with serum cholesterol were part of the analyses. For men, a positive relationship between coffee consumption and total serum cholesterol was found among smokers and life-long abstainers but not in the group of ex-smokers. In women a relationship between coffee consumption and total serum cholesterol was also present, but very weak (only statistical significant in covariance analyses). Levels of HDL cholesterol did not correlate with coffee consumption in either men and women.Hypotheses concerning the peculiarities of the group of ex-smokers are developed, and supporting empirical evidence is given. It is suggested that the group of ex-smokers should always be analysed separately.     

Cigarette smoking and bone mineral density in older men and women.

OBJECTIVES. The association between cigarette smoking and bone mineral density was examined prospectively in a population-based study of older Caucasian men and women. METHODS. Smoking patterns were determined at a 1972-1974 baseline evaluation and, again, 16 years later when 544 men and 822 women had bone mineral density measurements taken. RESULTS. Men and women who were cigarette smokers at baseline demonstrated significantly reduced bone mineral density of the hip compared with nonsmokers. Baseline smoking was not associated with significantly lower bone density at non-hip sites. Women demonstrated a significant dose-response relationship between baseline smoking status at all hip sites measured. Both sexes exhibited significant dose-response relationships between hip bone mineral density and change in smoking status between baseline and follow-up, demonstrating that smoking cessation in later life was beneficial in halting bone density loss associated with smoking. CONCLUSIONS. Smoking was positively and significantly associated with decreased hip bone mineral density in old age. Bone loss associated with smoking would be expected to predict an increased risk of hip fracture in those who do not succumb earlier to another complication of tobacco use.     

Maternal Prenatal Depressive Symptoms, Nicotine Addiction, and Smoking-Related Knowledge, Attitudes, Beliefs, and Behaviors

Maternal smoking is a key preventable cause of poor pregnancy outcomes, such as low birthweight. In many areas of the United States, including Eastern North Carolina, rates of prenatal smoking are high. Prenatal depressive symptoms are associated with maternal smoking, but there remains much to learn about this relationship, especially among Black women, who have double the risk of poor pregnancy outcomes of White women. In the study reported in this paper, we investigated the relationship between maternal prenatal depressive symptoms with smoking behaviors, beliefs and attitudes, environmental factors which promote smoking and nicotine addiction. Pregnant women were enrolled in the study at the first prenatal visit to the clinics of the Departments of Obstetrics and Gynecology and Family Medicine of the Brody School of Medicine, East Carolina University. An interviewer administered a questionnaire to each woman about smoking, smoking-related attitudes, knowledge, beliefs and behaviors, nicotine addiction, and home environmental factors that encourage smoking. The CES-D was used to measure depressive symptoms. We used the cut-point score of 23 or greater to indicate elevated depressive symptoms, which is thought to represent major depressive disorder. The sample consisted of 810 Black women, of whom 18% were smokers. CES-D score was associated with nicotine addiction, not thinking of quitting smoking, and not expecting support from family and friends if they decided to quit. Prenatal depressive symptoms may be a barrier to smoking cessation.     

Cigarette smoking and glycaemia: the EPIC-Norfolk Study. European Prospective Investigation into Cancer.

BACKGROUND: Previous prospective studies have suggested that cigarette smoking may be associated with an increased risk of type 2 diabetes, but the possibility of confounding, particularly by dietary factors has not been fully examined. METHODS: Cross-sectional analysis of the association between cigarette smoking and HbA(1C), a marker of long-term glucose homeostasis in 2704 men and 3385 women, aged 45--74 years who were recruited to a population-based study of diet and chronic disease. RESULTS: Twelve per cent of men and 11% of women reported being current smokers. Mean HbA(1C) was lowest in never smokers, intermediate in former smokers and highest in current smokers. There was a dose-response relationship between HbA(1C) levels and number of cigarettes smoked per day and a positive association with total smoking exposure as measured by pack-years. The unadjusted increase in HbA(1C) for 20 pack-years of smoking was 0.12% (95% CI : 0.09--0.16) in men and 0.12% (95% CI : 0.08--0.17) in women. After adjustment for possible confounders including dietary variables, the values were 0.08% (95% CI : 0.04--0.12) and 0.07% (95% CI : 0.02--0.12) for men and women, respectively. Mean HbA(1C) was inversely related to time since quitting smoking in men. CONCLUSIONS: These results add support to the hypothesis that smoking has long-term effects on glucose homeostasis, an association that cannot be explained by confounding by dietary factors as measured in this study.