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Tohidast SA, Fazeli F, Golmohammadi G, Scherer RC, Mansuri B. Vocal Tract Discomforts among Smokers. J Voice 2023:S0892-1997(23)00289-8. [PMID: 37914658 DOI: 10.1016/j.jvoice.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION Smoking is a dangerous behavior for the human body and the vocal tract. Smoking can cause several laryngeal and vocal tract symptoms in smokers. One of these symptoms can be physical discomfort experienced by this population. Therefore, the aim of the present study was to investigate vocal tract discomfort (VTD) in smokers compared to healthy non-smoker participants. MATERIALS AND METHODS The smokers group was forty-eight men with a mean age of 47.54 ± 9.21 years, and the matched non-smokers group was 48 men with a mean age of 44.88 ± 10.81 years. The participants underwent vocal tract discomfort assessment using the Persian version of the VTD scale. Statistical Package for the Social Science (SPSS) was used for statistical analysis and the Mann-Whitney U test was used to compare variables between groups. RESULTS The smokers more frequently had VTD symptoms (P < 0.05) than non-smokers for all items of the VTD scale with the exception of aches. Also, smokers had more significant VTD severity in all items than non-smokers (P < 0.05). Moreover, there were significant statistical differences between the total score of both frequency and severity of VTD between smokers and non-smokers. The most to the least VTD symptoms in smokers were irritation, sore, tickling, burning, tightness, lump in the throat, dry, and aching symptoms, respectively. CONCLUSION The present study suggests that smoking can cause more physical vocal tract discomfort in smokers compared to non-smokers. These results can inform future research and interventions in the smoker population.
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Affiliation(s)
- Seyed Abolfazl Tohidast
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Faezeh Fazeli
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Golnoosh Golmohammadi
- Department of Speech Therapy, School of Rehabilitation Sciences, Semnan University of Medical Sciences, Semnan, Iran
| | - Ronald C Scherer
- Distinguish Research Professor, Department of Communication Sciences and Disorders, Bowling Green State University, Bowling Green, Ohio
| | - Banafshe Mansuri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.
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Benson NU, Anake WU, Adedapo AE, Fred-Ahmadu OH, Ayejuyo OO. Toxic metals in cigarettes and human health risk assessment associated with inhalation exposure. ENVIRONMENTAL MONITORING AND ASSESSMENT 2017; 189:619. [PMID: 29119337 DOI: 10.1007/s10661-017-6348-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 11/02/2017] [Indexed: 06/07/2023]
Abstract
This study evaluated the concentrations of cadmium (Cd), copper (Cu), iron (Fe), manganese (Mn), lead (Pb), and zinc (Zn) in 10 branded cigarettes commonly consumed in Nigeria. Chemical sequential extraction method and pseudo-total metal digestion procedure were used for extraction of metals from filler tobacco and filter samples. Samples were analyzed using flame atomic absorption spectrometry (FAAS). The filler tobacco of cigarettes had Cd, Cu, Fe, Mn, Pb, and Zn concentrations in the ranges of 5.90-7.94, 18.26-34.94, 192.61-3494.05, 44.67-297.69, 17.21-74.78, and 47.02-167.31 μg/cigarette, respectively. The minimum and maximum concentrations in the filter samples were 8.67-12.34 μg/g of Cd, 1.77-36.48 μg/g of Cu, 1.83-15.27 μg/g of Fe, 3.82-7.44 μg/g of Mn, 4.09-13.78 μg/g of Pb, and 30.07-46.70 μg/g of Zn. The results of this study showed that the concentrations of heavy metals in the filler tobacco samples were consistently higher than those obtained for the cigarette filters except for Cd. Toxic metals were largely found in the most labile chemical fractions. Moderate to very high risks are found associated with potential exposure to Cd and Pb. The carcinogenic risks posed by Cd and Pb ranged between 1.87E-02 and 2.52E-02, 1.05E-03 and 4.76E-03, respectively, while the non-carcinogenic risk estimates for Cd and Pb were greater than 1.0 (HI > 1). Toxic metals in cigarette may have significant carcinogenic and non-carcinogenic health effects associated with inhalation exposure. Continuous monitoring and regulations of the ingredients of imported and locally produced tobacco products are advocated.
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Affiliation(s)
- Nsikak U Benson
- Analytical and Environmental Chemistry Unit, Department of Chemistry, Covenant University, Km 10 Idiroko Road, Ota, Ogun State, Nigeria.
| | - Winifred U Anake
- Analytical and Environmental Chemistry Unit, Department of Chemistry, Covenant University, Km 10 Idiroko Road, Ota, Ogun State, Nigeria
| | - Adebusayo E Adedapo
- Analytical and Environmental Chemistry Unit, Department of Chemistry, Covenant University, Km 10 Idiroko Road, Ota, Ogun State, Nigeria
| | - Omowunmi H Fred-Ahmadu
- Analytical and Environmental Chemistry Unit, Department of Chemistry, Covenant University, Km 10 Idiroko Road, Ota, Ogun State, Nigeria
| | - Olusegun O Ayejuyo
- Analytical and Environmental Chemistry Unit, Department of Chemistry, Covenant University, Km 10 Idiroko Road, Ota, Ogun State, Nigeria
- Department of Chemistry, University of Lagos, Lagos, Nigeria
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Tafiadis D, Toki EI, Miller KJ, Ziavra N. Effects of Early Smoking Habits on Young Adult Female Voices in Greece. J Voice 2017; 31:728-732. [DOI: 10.1016/j.jvoice.2017.03.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 03/19/2017] [Accepted: 03/21/2017] [Indexed: 11/27/2022]
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Tafiadis D, Chronopoulos SK, Kosma EI, Voniati L, Raptis V, Siafaka V, Ziavra N. Using Receiver Operating Characteristic Curve to Define the Cutoff Points of Voice Handicap Index Applied to Young Adult Male Smokers. J Voice 2017; 32:443-448. [PMID: 28709764 DOI: 10.1016/j.jvoice.2017.06.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/10/2017] [Accepted: 06/13/2017] [Indexed: 02/02/2023]
Abstract
Voice performance is an inextricable key factor of everyday life. Obviously, the deterioration of voice quality can cause various problems to human communication and can therefore reduce the performance of social skills (relevant to voice). The deterioration could be originated from changes inside the system of the vocal tract and larynx. Various prognostic methods exist, and among them is the Voice Handicap Index (VHI). This tool includes self-reported questionnaires, used for determining the cutoff points of total score and of its three domains relevant to young male Greek smokers. The interpretation of the calculated cutoff points can serve as a strong indicator of imminent or future evaluation by a clinician. Consistent with previous calculation, the VHI can also act as a feedback for smokers' voice condition and as monitoring procedure toward smoking cessation. Specifically, the sample consisted of 130 male nondysphonic smokers (aged 18-33 years) who all participated in the VHI test procedure. The test results (through receiver operating characteristic analysis) concluded to a total cutoff point score of 19.50 (sensitivity: 0.838, 1-specificity: 0). Also, in terms of constructs, the Functional domain was equal to 7.50 (sensitivity: 0.676, 1-specificity: 0.032), the Physical domain was equal to 7.50 (sensitivity: 0.706, 1-specificity: 0.032), and the Emotional domain was equal to 6.50 (sensitivity: 0.809, 1-specificity: 0.048).
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Affiliation(s)
- Dionysios Tafiadis
- Department of Speech & Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece.
| | - Spyridon K Chronopoulos
- Department of Computer Engineering, Technological Educational Institute of Epirus, Arta, Greece
| | - Evangelia I Kosma
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
| | - Louiza Voniati
- Department of Health Sciences, Speech and Language Therapy, European University, Nicosia, Cyprus
| | - Vasilis Raptis
- Department of Computer Engineering, Technological Educational Institute of Epirus, Arta, Greece
| | - Vasiliki Siafaka
- Department of Speech & Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
| | - Nausica Ziavra
- Department of Speech & Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
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Afridi HI, Talpur FN, Kazi TG, Brabazon D. Effect of Trace and Toxic Elements of Different Brands of Cigarettes on the Essential Elemental Status of Irish Referent and Diabetic Mellitus Consumers. Biol Trace Elem Res 2015; 167:209-24. [PMID: 25805269 DOI: 10.1007/s12011-015-0308-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 03/09/2015] [Indexed: 01/27/2023]
Abstract
Cigarette smoking interferes with the metal homeostasis of the human body, which plays a crucial role for maintaining the health. A significant flux of heavy metals, among other toxins, reaches the lungs through smoking. In the present study, the relationship between toxic element (TE) exposure via cigarette smoking and diabetic mellitus incidence in population living in Dublin, Ireland is investigated. The trace [zinc (Zn) and selenium (Se)] and toxic elements arsenic (As), aluminum (Al), cadmium (Cd), nickel (Ni), mercury (Hg), and lead (Pb) were determined in biological (scalp hair and blood) samples of patients diagnosed with diabetic mellitus, who are smokers living in Dublin, Ireland. These results were compared with age- and sex-matched healthy, nonsmokers controls. The different brands of cigarette (filler tobacco, filter, and ash) consumed by the studied population were also analyzed for As, Al, Cd, Ni, Hg, and Pb. The concentrations of TEs in biological samples and different components of cigarette were measured by inductively coupled plasma atomic emission spectrophotometer after microwave-assisted acid digestion. The validity and accuracy of the methodology were checked using certified reference materials (CRM). The recovery of all the studied elements was found to be in the range of 96.4-99.7% in certified reference materials. The filler tobacco of different branded cigarettes contains Hg, As, Al, Cd, Ni, and Pb concentrations in the ranges of 9.55-12.4 ng/cigarette, 0.432-0.727 μg/cigarette, 360-496 μg/cigarette, 1.70-2.12 μg/cigarette, 0.715-1.52 μg/cigarette, and 0.378-1.16 μg/cigarette, respectively. The results of this study showed that the mean values of Al, As, Cd, Hg, Ni, and Pb were significantly higher in scalp hair and blood samples of diabetic mellitus patients in relation to healthy controls, while the difference was significant in the case of smoker patients (p < 0.001). The levels of all six toxic elements were twofolds to threefolds higher in scalp hair and blood samples of nondiabetic mellitus smoker subjects as compared to nonsmoker controls. The high exposure of toxic metals as a result of cigarette smoking may be synergistic with risk factors associated with diabetic mellitus.
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Affiliation(s)
- Hassan Imran Afridi
- National Center of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, Sindh, 76080, Pakistan,
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Pinar D, Cincik H, Erkul E, Gungor A. Investigating the Effects of Smoking on Young Adult Male Voice by Using Multidimensional Methods. J Voice 2015; 30:721-725. [PMID: 26277074 DOI: 10.1016/j.jvoice.2015.07.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 07/13/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Smoking is one of the most common harmful habits in the world, especially common among young adult male population in Turkey. The purpose of this study was to evaluate the effect of smoking on the young adults' male voice using multidimensional voice assessment methods. STUDY DESIGN This is a case-control study. METHODS The study included 109 young adult men, 51 nonsmokers and 58 smokers between the ages of 20 and 34 years. The voice evaluation protocol consisted of voice handicap index (VHI), maximum phonation time (MPT), and perceptual, acoustic, and videostroboscopic analyses. RESULTS A statistically significant increase for physical, physiological, and total scores of VHI was found in smokers group (P < 0.05). MPT showed significantly lower values among smokers (P < 0.05). There were no significant changes in perceptual analysis of voice samples between smoker and nonsmoker groups. There were no significant changes in any of the acoustic parameters between smoker and nonsmoker groups. Results of videostroboscopic analysis showed significant relationships between smoking and increased vocal fold erythema (P < 0.05). In addition, significantly asymmetry, amplitude, and periodicity abnormality of vocal fold movements were observed in smoker group during phonation (P < 0.05). CONCLUSIONS The results of this study indicate that observable signs of laryngeal irritation and disturbed phonatory physiology occur even in young adults with relatively brief smoking habits. Subjective symptoms of smoking on voice appear to occur earlier than objective findings.
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Affiliation(s)
- Dogan Pinar
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
| | - Hakan Cincik
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - Evren Erkul
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - Atila Gungor
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
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Afridi HI, Kazi TG, Talpur FN, Brabazon D, Naher S. Estimation of toxic elements in the samples of different cigarettes and their impact on human health of Irish hypertensive consumers. Clin Chim Acta 2013; 426:51-7. [PMID: 24012826 DOI: 10.1016/j.cca.2013.08.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 08/27/2013] [Accepted: 08/28/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cigarette smoking interferes with the metal homeostasis of the human body, which plays a crucial role for maintaining the health. A significant flux of heavy metals, among other toxins, reaches the lungs through smoking. In the present study, the relationship between toxic element (TE) exposure via cigarette smoking and hypertension incidence in population living in Dublin, Ireland is investigated. METHODS The different brands of cigarette (filler tobacco, filter and ash) consumed by the studied population were analyzed for cadmium (Cd), nickel (Ni), and lead (Pb). The concentrations of TEs in biological samples and different components of cigarette were measured by inductively coupled plasma atomic emission spectrophotometer after microwave-assisted acid digestion. The validity and accuracy of the methodology were checked using certified reference materials. RESULTS The filler tobacco of different branded cigarettes contains Cd, Ni and Pb concentrations in the ranges of 1.73-2.02, 0.715-1.52 and 0.378-1.16 μg/cigarette, respectively. The results of this study showed that the mean values of Cd, Ni and Pb were significantly higher in scalp hair and blood samples of hypertensive patients in relation to healthy controls, while the difference was significant in the case of smoker patients (p<0.001). The levels of all the three TEs were 2-3 folds higher in scalp hair and blood samples of non-hypertensive smoker subjects as compared to nonsmoker controls. CONCLUSION The high exposure of toxic metals as a result of cigarette smoking may be synergistic with risk factors associated with hypertension.
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Affiliation(s)
- Hassan Imran Afridi
- Mechanical & Manufacturing Engineering, Dublin City University, Dublin, Ireland; National Center of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, Pakistan.
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Afridi HI, Brabazon D, Kazi TG, Naher S. Evaluation of essential trace and toxic elements in scalp hair samples of smokers and alcohol user hypertensive patients. Biol Trace Elem Res 2011; 143:1349-66. [PMID: 21286845 DOI: 10.1007/s12011-011-8984-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Accepted: 01/06/2011] [Indexed: 01/10/2023]
Abstract
The incidence of hypertension has been associated to cigarette smoking and consumption of alcohol. In the present study, trace and toxic elements were determined in scalp hair of patients diagnosed with hypertension who are smokers and habitual alcohol drinkers living in Dublin, Ireland. These results were compared with age- and sex-matched healthy, nonsmokers, nondrinking controls. The concentrations of trace and toxic elements were measured by inductively coupled plasma atomic emission spectrophotometer after microwave-assisted acid digestion. The validity and accuracy of the methodology were checked using certified reference material (NCS ZC 81002b) and by the conventional wet acid digestion method on the same certified reference material and on real samples. The recovery of all the studied elements was found to be in the range of 97.5%-99.7% in certified reference material. The results of this study showed that the mean values of cadmium, copper, iron, nickel and lead were significantly higher in scalp hair samples of both smoker and nonsmoker hypertensive patients than referents (P < 0.001); whereas, the concentration of zinc was lower in the scalp hair samples of hypertensive patients of both genders. The deficiency of zinc and the high exposure of trace and toxic metals as a result of cigarette smoking and alcohol consumption may be synergistic with risk factors associated with hypertension.
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Affiliation(s)
- Hassan Imran Afridi
- Mechanical and Manufacturing Engineering, Dublin City University, Dublin, Ireland.
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Afridi HI, Kazi TG, Kazi N, Kandhro GA, Baig JA, Jamali MK, Arain MB, Shah AQ. Interactions between cadmium and zinc in the biological samples of Pakistani smokers and nonsmokers cardiovascular disease patients. Biol Trace Elem Res 2011; 139:257-68. [PMID: 20162377 DOI: 10.1007/s12011-009-8607-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Accepted: 12/28/2009] [Indexed: 11/24/2022]
Abstract
The pathogenesis of some cardiovascular diseases (CVDs) has been altered with changes in the balance of certain trace and toxic elements. The aim of the present study was to assess the role of zinc (Zn) and cadmium (Cd) in smoker and nonsmoker male CVD patients (n = 457) of two age groups (31-45) and (46-60). The both elements were determined in biological samples (scalp hair, blood, and urine) of CVD patients and healthy referents for comparison purpose. The concentrations of Zn and Cd were measured by atomic absorption spectrophotometer prior to microwave-assisted acid digestion. It was observed that the mean values of Cd were significantly higher in the biological samples of smokers CVD as compared to nonsmoker CVD patients, while the level of Zn was lower in both smoker and nonsmoker patients. The concentrations of Zn in whole blood and scalp hair samples were lower in CVD patients as compared to referents (p > 0.001). Results showed significant changes of levels of Cd and Zn in blood and scalp hair samples of CVD patients when compared with healthy referents, while reverse in the case of urine samples. It was observed that low Zn levels were associated with both smoker and nonsmoker CVD patients, while increased cadmium accumulation was observed in smoker patients as compared to nonsmoker patients (p > 0.025).
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Affiliation(s)
- Hassan Imran Afridi
- National Center of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, Pakistan.
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Chai L, Sprecher AJ, Zhang Y, Liang Y, Chen H, Jiang JJ. Perturbation and nonlinear dynamic analysis of adult male smokers. J Voice 2010; 25:342-7. [PMID: 20472394 DOI: 10.1016/j.jvoice.2010.01.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2009] [Accepted: 01/11/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Smoking results in a voice change, and the perception by smokers of an abnormal voice may encourage quitting behavior. Moreover, a disordered voice is often the first sign of vocal pathology. Efforts to evaluate voice have focused on classical acoustic analysis; however, nonlinear dynamic analysis has been shown to be a reliable objective method for the evaluation of voice. We compare the discriminatory ability of these two methods when applied to normal and smokers' voices. STUDY DESIGN Prospective study. METHODS The study included 73 subjects, 36 nonsmokers and 37 smokers. A segment of sustained vowel production was obtained from each subject. Acoustic dimension and correlation dimension (D2) analyses were applied to the data. Results were compared with a Mann-Whitney rank sum test, logistic regression, and receiver operating characteristics (ROC) analysis. RESULTS D2 values for smokers were significantly higher than D2 values for nonsmokers (P<0.001). Jitter and shimmer analysis showed higher values for these parameters among smokers. Logistic regression indicated a higher predictive power with D2, and ROC analysis found no significant difference between the analysis methods. DISCUSSION This study indicated that D2 is highly sensitive to changes associated with smoking and has the potential to be implemented clinically as an indicator of abnormal voice. Further research could focus on using nonlinear dynamic analysis to create a normative database, producing standards for monitoring voice changes caused by cigarette smoking.
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Affiliation(s)
- Lingying Chai
- Shanghai EENT Hospital of Fudan University, Shanghai, China
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Afridi HI, Kazi TG, Kazi NG, Jamali MK, Arain MB, Sirajuddin, Baig JA, Kandhro GA, Wadhwa SK, Shah AQ. Evaluation of cadmium, lead, nickel and zinc status in biological samples of smokers and nonsmokers hypertensive patients. J Hum Hypertens 2010; 24:34-43. [PMID: 20010608 PMCID: PMC3011091 DOI: 10.1038/jhh.2009.39] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The objective of this study was to evaluate the association between trace and toxic elements zinc (Zn), cadmium (Cd), nickel (Ni) and lead (Pb) in biological samples (scalp hair, blood and urine) of smoker and nonsmoker hypertensive patients (n=457), residents of Hyderabad, Pakistan. For the purpose of comparison, the biological samples of age-matched healthy controls were selected as referents. The concentrations of trace and toxic elements were measured by atomic absorption spectrophotometer prior to microwave-assisted acid digestion. The validity and accuracy of the methodology were checked using certified reference materials and by the conventional wet acid digestion method on the same certified reference materials and real samples. The recovery of all the studied elements was found to be in the range of 97.8-99.3% in certified reference materials. The results of this study showed that the mean values of Cd, Ni and Pb were significantly higher in scalp hair, blood and urine samples of both smoker and nonsmoker patients than in referents (P<0.001), whereas the concentration of Zn was lower in the scalp hair and blood, but higher in the urine samples of hypertensive patients. The deficiency of Zn and the high exposure of toxic metals as a result of tobacco smoking may be synergistic with risk factors associated with hypertension.
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Affiliation(s)
- H I Afridi
- Center of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, Sindh 76080, Pakistan
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[Prevention of respiratory tract diseases]. Internist (Berl) 2009; 49:170-7. [PMID: 18210024 DOI: 10.1007/s00108-007-1997-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
There are multiple possibilities for pulmonary or bronchial damage and their number exceeds that for the other organ systems dealt with in this issue. This multiplicity of diseases which are at least in part attributable to exogenous damage gives rise to manifold approaches to prevention. This overview does not claim to be complete. It is however intended to clarify the possibilities that exist for the prevention of pulmonary diseases. In addition, it intends to show that effective primary and occasionally secondary and tertiary prevention is inadequately utilized in pulmonology or not even used at all. Against the background that individual preventive measures in pulmonology are considerably more successful than curative measures, also from a health economics point of view, various options for successful prevention are described. The great need for studies on the effectiveness of preventive strategies is also addressed.
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Abstract
Today, two generations after the first Surgeon General's report, and with abundant evidence of the catastrophic consequences of smoking, no serious person can be unaware that smokers risk their lives and health. We also know that quitting smoking--at any age--promises significant health benefits. When offered the tools they need, older smokers quit smoking at rates comparable to those of younger smokers despite their skepticism, fatalism, and self-doubt. Older smokers should be encouraged to enter programs that stress the health benefits derived and identify the risks they are avoiding by quitting smoking. These programs establish quit dates, use sound behavioral modification techniques, provide strategies for stress management and relaxation, treat withdrawal symptoms, and provide regular and continuing follow-up. The patient is asked to make an existential change, and the physician should provide encouragement and promote self-confidence by emphasizing that, despite setbacks, with repeated efforts, success can be achieved. Clinicians can influence patients to quit smoking, and they should.
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Affiliation(s)
- David W Appel
- Division of Pulmonary Medicine, Montefiore Medical Center, 1300 Morris Park Avenue, Bronx, NY 10461, USA
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