吸烟,饮酒与缺血性脑卒中关系

采用配比病例对照研究方法,从医院选取158名缺血性脑卒中病例,并从社区和研究医院为病例选配两种对照,病例与两种对照分别作配比分析,以探讨吸烟、饮酒与缺血性脑卒中的关系。单因素分析结果表明:吸烟者患缺血性脑卒中的 OR 约为1.5～2(P<0.05),饮酒者患缺血性脑卒中的OR 约为3(P<0.01)。多因素分析结果显示大量吸烟(>20支/天)是缺血性脑卒中重要的危险因素;饮酒(尤其中、重度饮酒:>50ml/天)是一项独立的危险因素。     

Smoking, Alcohol Consumption, and the Risk of Amyotrophic Lateral Sclerosis: A Population-based Study

Smoking has been posited as a possible risk factor for amyotrophic lateral sclerosis (ALS), but large population-based studies of patients with incident disease are still needed. The authors performed a population-based case-control study in the Netherlands between 2006 and 2009, including 494 patients with incident ALS and 1,599 controls. To prove the relevance of population-based incidence cohorts in case-control studies, the authors compared results with those from cohorts including patients with prevalent ALS and referral patients. Subjects were sent a questionnaire. Multivariate analyses showed an increased risk of ALS among current smokers (odds ratio = 1.38, 95% confidence interval (CI): 1.02, 1.88) in the incident patient group only. Cox regression models showed that current smoking was also independently associated with shorter survival (hazard ratio = 1.51, 95% CI: 1.07, 2.15), explaining the lack of association in the prevalent and referral patient groups. Current alcohol consumption was associated with a reduced risk of ALS (incident patient group: odds ratio = 0.52, 95% CI: 0.40, 0.75). These findings indicate that current smoking is associated with an increased risk of ALS, as well as a worse prognosis, and alcohol consumption is associated with a reduced risk of ALS, further corroborating the role of lifestyle factors in the pathogenesis of ALS. The importance of population-based incident patient cohorts in identifying risk factors is highlighted by this study.     

国内吸烟、饮酒与缺血性脑卒中关系的Meta分析

目的探讨吸烟、饮酒与缺血性脑卒中的关系.方法应用Meta分析方法对检索到的国内10个吸烟、饮酒与缺血性脑卒中关系的研究结果进行定量综合分析,一致性检验后,应用随机效应模型(D-L法)计算,合并比值比(OR)及其95%的可信区间(95% CI).结果吸烟、饮酒的合并OR(95% CI)分别为2.01(1.41～2.85)和2.36(1.87～2.98).吸烟、饮酒高危人群缺血性脑卒中的病因分值为50.25%和57.63%,一般人群归因危险百分比为26.66%和34.83%.结论吸烟、饮酒是我国缺血性脑卒中的重要危险因素,开展人群戒烟限酒干预是缺血性脑卒中病因预防的一项重要措施.     

Relationships of Cigarette Smoking and Alcohol Consumption to Metabolic Syndrome in Japanese Men

Background

Cigarette smoking is an important, aggravating factor in metabolic syndrome (MetS). In addition, some studies have reported that MetS is related to alcohol consumption irrespective of the amount consumed. However, the relationship of the combination of the 2 habits to MetS has not been fully described.

Methods

In this cross-sectional survey, a questionnaire was used to collect information on cigarette smoking and alcohol consumption from 3904 Japanese men aged 20 years or older. MetS was defined according to Japanese criteria. Logistic regression analysis was used to analyze relationships of cigarette smoking and alcohol consumption with MetS, after adjustment for potential confounding factors.

Results

Among the subjects, 581 (14.9%) had MetS. Daily cigarette and alcohol consumption were significantly associated with the prevalence of MetS (P < 0.0001, P = 0.030 for trend). The multivariate-adjusted odds ratio for the prevalence of MetS was 1.89 (95% confidence interval: 1.34–2.65) for subjects who smoked ≥30 cigarettes/day, as compared with nonsmokers; 1.54 (1.06–2.23) for those who consumed ≥69 grams of ethanol/day, as compared with nondrinkers; and 3.63 (1.91–6.90) for those who smoked ≥30 cigarettes/day and consumed ≥69 grams of ethanol/day, as compared with those who neither smoked nor drank. The interaction of smoking ≥30 cigarettes/day with drinking ≥69 grams/day was 2.03 (1.02–4.01, P = 0.043).

Conclusions

Cigarette smoking and alcohol drinking had independent relations to the prevalence of MetS. In addition, the prevalence of MetS was higher among Japanese men who smoked and drank heavily.Key words: metabolic syndrome, cigarette smoking, alcohol consumption, cross-sectional study, Japan     

A Case-Control Study of Renal Cell Carcinoma in Relation to Occupation,Smoking, and Alcohol Consumption

A case-control study based on data from a cancer registry was conducted to evaluate the effects of smoking, alcohol use, and occupation on renal cell cancer risk. Information was obtained for 326 male and female cases and 978 age- and sex-matched controls. Elevated risks were identified for cigarette smokers and for men employed as truck drivers. No relationship between alcohol consumption and renal cancer was observed.     

Alcohol Consumption and Smoking During Covid-19 Pandemic: Association with Sociodemographic,Behavioral, and Mental Health Characteristics

Journal of Community Health - The Covid-19 pandemic is related to increased alcohol consumption and smoking. These behaviors may be related to several sociodemographic, behavioral and mental health...     

Associations of Cigarette Smoking and Alcohol Consumption With Metabolic Syndrome in a Male Chinese Population: A Cross-Sectional Study

Background

Whether cigarette smoking and alcohol consumption are associated with the risk of metabolic syndrome (MetS) remains controversial. This study investigated the associations of cigarette smoking and alcohol consumption with MetS in a male population in China.

Methods

We conducted a cross-sectional study. A questionnaire was used to collect data on cigarette smoking, alcohol consumption, MetS status, and other related information from 8169 men aged 19–97 years. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between smoking and alcohol consumption and the risk of MetS.

Results

The prevalence of MetS was 15.2% in the study population. Proportions of current smokers and drinkers were 48.2% and 46.5%, respectively. Adjusted OR of MetS was 1.34 (95% CI, 1.01–1.79) among smokers who smoked ≥40 cigarettes/day compared with nonsmokers and 1.22 (95% CI 1.03–1.46) for those who consumed 0.1–99 grams of alcohol/day compared with nondrinkers. Adjusted OR was 2.32 (95% CI 1.45–3.73) among ex-drinkers who never smoked, 1.98 (95% CI 1.35–2.91) among ex-drinkers who were current smokers, and 1.34 (95% CI 1.08–1.68) among current drinkers who never smoked compared with those who neither smoked nor drank. There was a significant interaction between smoking and drinking alcohol on MetS (P for interaction is 0.001).

Conclusions

Our study indicated that smoking and drinking is associated with higher prevalence of MetS. Interactions between smoking and drinking on the risk of MetS in men in China may also exist. Our findings need to be confirmed in future case-control or cohort studies.Key words: cigarette smoking, alcohol consumption, metabolic syndrome, Chinese man, interaction     

The Health and Economic Consequences of Moderate Alcohol Consumption in Germany 2002

Objective:  Moderate alcohol consumption is associated with both positive and negative health effects. This study aims to estimate the positive and negative consequences on mortality, years of potential life (YPL), quality-adjusted life-years (QALYs), resource utilization, and societal costs attributable to moderate alcohol consumption in Germany in 2002.
Methods:  The concept of attributable risks and a prevalence-based approach was used to calculate age- and sex-specific alcohol attributable mortality and resource utilization for a wide range of disorders, and avoided mortality and resource utilization for diabetes mellitus, coronary heart disease, stroke, and cholelithiasis. The literature provided prevalence of moderate alcohol consumption in Germany by age and sex and relative risks. Direct costs were calculated using routine utilization and expenditure statistics. Indirect costs were calculated using the human capital approach.
Results:  Due to moderate alcohol consumption, 14,457 lives, 205,691 YPL, and 179,964 QALYs were lost, whereas 29,918 lives, 300,382 YPL, and 258,284 QALYs were gained. Up to an age of 55 to 60 (62.5–67.5) years, more lives were lost than gained among men (women), whereas in older age groups more lives were gained than lost. Moderate alcohol consumption caused €3049 million of direct and €2630 million of indirect costs, whereas €2094 million of direct and €2604 million of indirect costs were avoided.
Conclusion:  Despite considerable uncertainty, moderate alcohol consumption seems to result in an overall net effect of gained lives, YPL, and QALYs, realized among the elderly, but overall increased societal costs. Thus, moderate alcohol consumption should still be seen critical, especially among youths.     

Witnessing a Violent Death and Smoking,Alcohol Consumption,and Marijuana Use among Adolescents

Witnessing violence has been linked to maladaptive coping behaviors such as smoking, alcohol consumption, and marijuana use. However, more research is required to identify mechanisms in which witnessing violence leads to these behaviors. The objectives of this investigation were to examine the association between witnessing a violent death and smoking, alcohol consumption, and marijuana use among adolescents, to identify whether exhibiting depressive symptoms was a mediator within this relationship, and to determine if those who had adult support in school were less likely to engage in risky health behaviors. Data were collected from a sample of 1,878 urban students, from 18 public high schools participating in the 2008 Boston Youth Survey. In 2012, we used multilevel log-binomial regression models and propensity score matching to estimate the association between witnessing a violent death and smoking, alcohol consumption, and marijuana use. Analyses indicated that girls who witnessed a violent death were more likely to use marijuana (relative risk (RR) = 1.09, 95 % confidence interval (CI) = 1.02, 1.17), and tended towards a higher likelihood to smoke (RR = 1.06, 95 % CI = 1.00, 1.13) and consume alcohol (RR = 1.07, 95 % CI = 0.97, 1.18). Among boys, those who witnessed a violent death were significantly more likely to smoke (RR = 1.20, 95 % CI = 1.11, 1.29), consume alcohol (RR = 1.30, 95 % CI = 1.17, 1.45) and use marijuana (RR = 1.33, 95 % CI = 1.21, 1.46). When exhibiting depressive symptoms was included, estimates were not attenuated. However, among girls who witnessed a violent death, having an adult at school for support was protective against alcohol consumption. When we used propensity score matching, findings were consistent with the main analyses among boys only. This study adds insight into how witnessing violence can lead to adoption of adverse health behaviors.     

Alcohol Consumption and Mortality in the Korean Multi-center Cancer Cohort Study

Objectives

To examine the association between alcohol consumption habit, types of beverages, alcohol consumption quantity, and overall and cancer-specific mortality among Korean adults.

Methods

The alcohol consumption information of a total of 16 320 participants who were 20 years or older from the Korean Multi-center Cancer Cohort were analyzed to examine the association between alcohol consumption habit and mortality (median follow-up of 9.3 years). The Cox proportional hazard model was used to estimate the hazard ratio (HR) of alcohol consumption to mortality adjusting for age, sex, geographic areas, education, smoking status, and body mass index.

Results

Alcohol drinkers showed an increased risk for total mortality compared with never drinkers (HR, 1.72; 95% confidence interval [CI], 1.38 to 2.14 for past drinkers; HR, 1.21; 95% CI, 1.06 to 1.39 for current drinkers), while past drinkers only were associated with higher risk for cancer deaths (HR, 1.84; 95% CI, 1.34 to 2.53). The quantity of alcohol consumed per week showed a J-shaped association with risk of mortality. Relative to light drinkers (0.01 to 90 g/wk), never drinkers and heavy drinkers (>504 g/wk) had an increased risk for all-cause and cancer deaths: (HR, 1.18; 95% CI, 0.96 to 1.45) and (HR, 1.39; 95% CI, 1.05 to 1.83) for all-cause mortality; and (HR, 1.55; 95% CI, 1.15 to 2.11) and (HR, 2.07; 95% CI, 1.39 to 3.09) for all cancer mortality, respectively. Heavy drinkers (>504 g/wk) showed an elevated risk for death from stomach and liver cancers.

Conclusions

The present study supports the existence of a J-shaped association between alcohol consumption quantity and the risk of all-cause and cancer deaths. Heavy drinkers had an increased risk of death from cancer overall and liver and stomach cancer.     

The Global Impact of Alcohol Consumption on Premature Mortality and Health in 2016

This study aimed to estimate the impact of alcohol use on mortality and health among people 69 years of age and younger in 2016. A comparative risk assessment approach was utilized, with population-attributable fractions being estimated by combining alcohol use data from the Global Information System on Alcohol and Health with corresponding relative risk estimates from meta-analyses. The mortality and health data were obtained from the Global Health Observatory. Among people 69 years of age and younger in 2016, 2.0 million deaths and 117.2 million Disability Adjusted Life Years (DALYs) lost were attributable to alcohol consumption, representing 7.1% and 5.5% of all deaths and DALYs lost in that year, respectively. The leading causes of the burden of alcohol-attributable deaths were cirrhosis of the liver (457,000 deaths), road injuries (338,000 deaths), and tuberculosis (190,000 deaths). The numbers of premature deaths per 100,000 people were highest in Eastern Europe (155.8 deaths per 100,000), Central Europe (52.3 deaths per 100,000 people), and Western sub-Saharan Africa (48.7 deaths per 100,000). A large portion of the burden of disease caused by alcohol among people 69 years of age and younger is preventable through the implementation of cost-effective alcohol policies such as increases in taxation.     

Alcohol Consumption and Risk of Lung Cancer in the VITamins And Lifestyle Study

The effect of alcoholic beverage consumption on lung cancer risk was investigated in the VITamins And Lifestyle (VITAL) Study. The VITAL study is a prospective cohort of residents aged 50–76 yr in Washington state. Five hundred and eighty incident lung cancer cases diagnosed between study baseline (2000–2002) and 2007 were identified among 66,186 participants without previous cancer through the Washington Surveillance Epidemiology and End Result cancer registry. Multivariable Cox's regression was used to examine the effects of beer, red wine, white wine, liquor, combined alcoholic beverage intake at study baseline, and alcohol intake at age 30 and 45 on lung cancer risk, with careful adjustment for smoking. There was no clear association between lung cancer and consumption of beer, red wine, white wine, or liquor at ≥1 drink/day. Combined alcoholic beverage intake of up to ≥3 drink/day was not associated with elevated overall lung cancer risk. Heavy consumption of alcohol at study baseline and at age 45 was, however, associated with more than doubling of risk for squamous cell carcinoma (hazard ratio for ≥3 drink/day at study baseline = 2.54, 95% CI: 1.36–4.73, P value for linear trend = 0.002) but not for adenocarcinoma. Alcohol intake at age 30 was not associated with lung cancer risk.     

Concurrent Alcohol Use or Heavier Use of Alcohol and Cigarette Smoking Among Women of Childbearing Age with Accessible Health Care

This study was conducted to provide nationally representative findings on the prevalence and distribution of concurrent alcohol use or heavier use of alcohol and cigarette smoking among women of childbearing age with accessible health care. For the years 2003–2005, a total of 20,912 women 18–44 years of age who participated in the National Health Interview Survey (NHIS) reported that during the study period, there was a place where they would usually go for health care when sick or in need of advice about their health. The prevalence and distribution of concurrent alcohol use or heavier use of alcohol and cigarette smoking reported by such women was calculated. Logistic regression analysis was used to evaluate the “most often visited health care place” among concurrent users who reported having seen or talked to a health care provider during the previous 12 months. Among surveyed women with accessible health care, 12.3% reported concurrent alcohol use and cigarette smoking, and 1.9% reported concurrent heavier use of alcohol and cigarette smoking during the study period. Of women who reported either type of concurrent use, at least 84.4% also indicated having seen or talked to one or more health care providers during the previous 12 months. Such women were more likely than non-concurrent users to indicate that the “most often visited health care place” was a “hospital emergency room or outpatient department or some other place” or a “clinic or health center,” as opposed to an “HMO or doctor’s office.” Concurrent alcohol use or heavier use of alcohol and cigarette smoking among women of childbearing age is an important public health concern in the United States. The findings of this study highlight the importance of screening and behavioral counseling interventions for excessive drinking and cigarette smoking by health care providers in both primary care and emergency department settings.     

A Trial-Based Predictive Microsimulation Assessing the Public Health Benefits of Nalmefene and Psychosocial Support for the Reduction of Alcohol Consumption in Alcohol Dependence

Background

Alcohol dependence causes considerable harm to patients. Treatment with nalmefene, aiming to reduce consumption rather than maintain complete abstinence, has been licensed based on trials demonstrating a reduction in total alcohol consumption and heavy drinking days. Relating these trial outcomes to harmful events avoided is important to demonstrate the clinical relevance of nalmefene treatment.

Methods

A predictive microsimulation model was developed to compare nalmefene plus brief psychosocial intervention (BRENDA) versus placebo plus BRENDA for the treatment of patients with alcohol dependence and a high or very high drinking risk level based on three pooled clinical trials. The model simulated patterns and level of alcohol consumption, day-by-day, for 12 months, to estimate the occurrence of alcohol-attributable diseases, injuries and deaths; assessing the clinical relevance of reducing alcohol consumption with treatment.

Results

The microsimulation model predicted that, in a cohort of 100,000 patients, 971 (95 % confidence interval [CI] 904–1038) alcohol-attributable diseases and injuries and 133 (95 % CI 117–150) deaths would be avoided with nalmefene versus placebo. This level of benefit has been considered clinically relevant by the European Medicines Agency.

Conclusions

This microsimulation model supports the clinical relevance of the reduction in alcohol consumption, and has estimated the extent of the public health benefit of treatment with nalmefene in patients with alcohol dependence and a high or very high drinking risk level.

     

Development and validation of the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS)

The goal of the current investigation was to develop and validate a measure to assess an individual's eating-related behaviors related to alcohol consumption, specifically behaviors intended to compensate for calories so that more alcohol could be consumed or restrict calories to enhance the psychoactive effects of alcohol consumption. Two hundred and seventy four undergraduate students (n=51 males; 75.2% Caucasian) completed a newly developed scale, the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS), along with measures of eating restriction, bulimia, and body dissatisfaction. An exploratory factor analysis on the CEBRACS revealed the existence of 4 clear-cut factors: alcohol effects, bulimia, dieting and exercise, and restriction. Internal consistency statistics for all subscales ranged from .79 to .95. Pearson product-moment correlations between the CEBRACS and measures of bulimia, restriction, and body dissatisfaction ranged from .04 to .44. T-tests revealed no gender differences in compensatory eating behaviors. Future research directions and limitations of the current study are discussed.     

Bacteriophage for Gastrointestinal Health (PHAGE) Study: Evaluating the Safety and Tolerability of Supplemental Bacteriophage Consumption

Objective: The gut microbiota has been recognized as a critical regulator of human health, and novel interventions to selectively modulate the microbiota are actively being sought. Bacteriophages (bacterial viruses) have the potential to selectively eliminate specific detrimental microbes while enhancing beneficial microbe populations. The Bacteriophage for Gastrointestinal Health (PHAGE) study aimed to determine the safety and tolerability of supplemental bacteriophage consumption in a population of healthy adults with mild to moderate gastrointestinal distress.

Methods: The PHAGE study was a randomized, double-blind, placebo-controlled crossover intervention. Healthy adults with self-reported gastrointestinal distress were recruited and asked to consume one 15-mg capsule containing 4 strains of bacteriophages (LH01-Myoviridae, LL5-Siphoviridae, T4D-Myoviridae, and LL12-Myoviridae) and a placebo, each for 28 days. Participants were randomly assigned to the starting treatment, which was followed by a 2-week washout period before they began the second arm of the intervention. Primary outcome measures included a comprehensive metabolic panel and gastrointestinal health questionnaire. In addition, samples were collected for future analysis of several secondary outcome measures, including global microbiota profiles, plasma lipids, and markers of local and systemic inflammation.

Results: Forty-three individuals met all study criteria and consented to participate. Of these participants, 36 completed at least one arm of the trial and 32 completed the study. There were no effects of treatment sequence on comprehensive metabolic panel outcomes, but there were 1- and 2-way carryover effects on gastrointestinal questionnaire data. Levels of aspartate aminotransferase significantly decreased while participants were taking the treatment but not placebo; however, all mean values remained within clinically acceptable ranges. Participants also reported significant improvements in several symptoms of gastrointestinal distress while taking both the treatment and the placebo.

Conclusions: Consumption of therapeutic doses of a mixture of 4 bacteriophages was both safe and tolerable in a target human population.