Smoking cessation in cancer prevention

Quitting smoking after a cancer diagnosis is associated with high-risk neutrophil-to-lymphocyte ratio among tobacco use-related cancer survivors

Quitting smoking could potentially minimize the risk of a high neutrophil-to-lymphocyte ratio (NLR) among tobacco use-related (TUR) cancer survivors. A total of 1263 TUR cancer survivors aged 20 to 85 years old were investigated using data from the National Health and Nutritional Examination Survey 1999-2018. The primary outcome was the NLR, which was defined as having two levels: high-risk (≥ 3) and low-risk (< 3). The association between smoking cessation time and a high-risk NLR level was analyzed using weighted logistic regression models. Overall, the current smoking rate of TUR cancer survivors was found to be 21.7%. Older age (75 years above), gender and respiratory-related cancers are covariables associated with high risk of NLR levels for individual who identified as Non-Hispanic White (NHW). Non-Hispanic Black (NHB) (n = 27) who quit smoking after a cancer diagnosis were associated with the highest risk of a high NLR (OR 4.83, 95% CI 1.40-16.61, p = 0.01) compared to NHB nonsmokers (n = 139). These findings suggest that the risk of a high NLR level is strongly associated with the time of smoking cessation in NHB TUR cancer survivors. As a result, NHB TUR cancer survivors should quit smoking as soon as possible because the benefits of quitting smoking were observed over the 5 year period following smoking cessation.

An International Consensus on Actions to Improve Lung Cancer Survival: A Modified Delphi Method Among Clinical Experts in the International Cancer Benchmarking Partnership

BACKGROUND

Research from the International Cancer Benchmarking Partnership (ICBP) demonstrates that international variation in lung cancer survival persists, particularly within early stage disease. There is a lack of international consensus on the critical contributing components to variation in lung cancer outcomes and the steps needed to optimise lung cancer services. These are needed to improve the quality of options for and equitable access to treatment, and ultimately improve survival.

METHODS

Semi-structured interviews were conducted with 9 key informants from ICBP countries. An international clinical network representing 6 ICBP countries (Australia, Canada, Denmark, England, Ireland, New Zealand, Northern Ireland, Scotland & Wales) was established to share local clinical insights and examples of best practice. Using a modified Delphi consensus model, network members suggested and rated recommendations to optimise the management of lung cancer. Calls to Action were developed via Delphi voting as the most crucial recommendations, with Good Practice Points included to support their implementation.

RESULTS

Five Calls to Action and thirteen Good Practice Points applicable to high income, comparable countries were developed and achieved 100% consensus. Calls to Action include (1) Implement cost-effective, clinically efficacious, and equitable lung cancer screening initiatives; (2) Ensure diagnosis of lung cancer within 30 days of referral; (3) Develop Thoracic Centres of Excellence; (4) Undertake an international audit of lung cancer care; and (5) Recognise improvements in lung cancer care and outcomes as a priority in cancer policy.

CONCLUSION

The recommendations presented are the voice of an expert international lung cancer clinical network, and signpost key considerations for policymakers in countries within the ICBP but also in other comparable high-income countries. These define a roadmap to help align and focus efforts in improving outcomes and management of lung cancer patients globally.

Cluster of differentiation 8 T-cell population in the laryngeal mucosa of smokers with laryngeal cancer

OBJECTIVE

To study the cluster of differentiation 8 population in the laryngeal mucosa of patients with laryngeal carcinoma. To our knowledge this is the first paper to address this issue.

METHODS

The study group included 40 patients with known laryngeal cancer who were scheduled for laryngectomy. The control groups included 10 smokers and 10 non-smokers who were scheduled for microlaryngeal surgery. Specimens from the three groups were processed for histopathological and histochemical evaluation.

RESULTS

In patients without cancer of the larynx, the number of cluster of differentiation 8 lymphocytes was greater in smokers than non-smokers. The number of cluster of differentiation 8 lymphocytes was greatest in smokers with laryngeal cancer, and the difference between this group and the two control groups was statistically significant.

CONCLUSION

The study showed that smoking increased the number of cluster of differentiation 8 T-lymphocytes in the laryngeal mucosa. The increase was greatest in patients who had developed laryngeal cancer.

Effects of Medicinal Herb Tea on the Smoking Cessation and Reducing Smoking Withdrawal Symptoms

Medicinal herbs (21 species) were screened for the antioxidant activity and nicotine degradation activity (NDA) in vitro. Eleven of them with higher antioxidant activity and NDA were selected for preparation of the medicinal herb tea (MHT) and the effects of MHT on smoking cessation and reducing smoking withdrawal symptoms were evaluated in 100 male human smokers.

Among these medicinal herbs, Eugenia aromaticum and Astragalus membranaceus Bunge showed the highest antioxidant activity ( IC 50 of 30.0 μg/mL) and NDA (1.81), respectively. MHT showed relatively high antioxidant activity ( IC 50 of 50.6 μg/mL) and NDA (1.23). The urinary cotinine level, a metabolite of nicotine, increased in the first 2 weeks and greatly decreased from the 2nd to 4th week in the MHT taking group, which indicates that MHT accelerates the conversion of nicotine into cotinine. Human groups taking MHT for 4 weeks underwent reduced smoking withdrawal symptoms compared to the non-MHT taking subjects, and 38% of subjects taking MHT succeeded in smoking cessation, while only 12% of non-MHT taking subjects succeeded in quitting smoking.

Cigarette smoking and the incidence of breast cancer

BACKGROUND

Tobacco smoke contains carcinogens, which may increase the risk of breast cancer (BC). Conversely, cigarette smoking also has antiestrogenic effects, which may reduce the risk of BC. The association between smoking and BC remains controversial.

METHODS

Prospective cohort study of 111 140 participants of the Nurses' Health Study from 1976 to 2006 for active smoking and 36 017 women from 1982 to 2006 for passive smoking.

RESULTS

During 3 005 863 person-years of follow-up, 8772 incident cases of invasive BC were reported. After adjustment for potential confounders, the hazard ratio (HR) of BC was 1.06% (95% confidence interval [CI], 1.01%-1.10%) for ever smokers relative to never smokers. Breast cancer incidence was associated with a higher quantity of current (P for trend = .02) and past (P for trend = .003) smoking, younger age at smoking initiation (P for trend = .01), longer duration of smoking (P for trend = .01), and more pack-years of smoking (P for trend = .005). Premenopausal smoking was associated with a slightly higher incidence of BC (HR, 1.11; 95% CI, 1.07-1.15 for every increase of 20 pack-years), especially smoking before first birth (1.18; 1.10-1.27 for every increase of 20 pack-years). Conversely, the direction of the association between postmenopausal smoking and BC was inverse (0.93; 0.85-1.02 for every increase of 20 pack-years). Passive smoking in childhood or adulthood was not associated with BC risk.

CONCLUSION

Active smoking, especially smoking before the first birth, may be associated with a modest increase in the risk of BC.

Eliminating carcinogenic pollutants in environment: reducing the tobacco specific nitrosamines level of smoke by zeolite-like calcosilicate

Trapping carcinogens such as tobacco-specific nitrosamines (TSNA) in environmental tobacco smoke (ETS) is a challenge for the application of zeolite in environment protection because most TSNA exist in the particles whose size exceed the micropores of zeolites. In this paper, a new strategy to intercept the particles and to trap the TSNA in smoke by use of the porous calcosilicate material with fiber-like morphology plus two-dimensional eight-ring channel system is depicted and assessed. Owing to the specific fiber-like morphology and chemical composition, zeolite-like calcosilicate CAS-1 can effectively intercept the particles and thus reduces the TSNA level of mainstream smoke in the range of 30-60% once it is added into the cigarette filter, which is superior to zeolite NaA additive with the same amount. Moreover, the importance of morphology of zeolite-like porous materials on the adsorption of nitrosamines in smoke is reported for the first time.

Cigarette smoking and nicotine dependence

Tobacco use is the single most preventable cause of death, disability, and disease in the United States and is projected to be the leading cause of death and disability across all developed countries by the year 2020. Understanding nicotine dependence, its causes, consequences, and effective treatments is critical to the nation's public health agenda. This article presents a brief overview of nicotine dependence with particular emphasis placed on understanding what nicotine dependence is, why it occurs, how it is measured, and how it can be managed through effective treatments.

Changes in smoking habits in adults: results from a prospective study in Spain

PURPOSE

We assessed changes in smoking behavior and its related factors among healthy adults from five regions in Spain.

METHODS

The smoking status at recruitment and after 3 years was compared in 14,288 men and 23,983 women aged 35 to 64 years. The pattern of smoking and several lifestyle factors were investigated as potential predictors of subsequent changes in smoking habits.

RESULTS

Among current smokers at baseline the age-adjusted rates of cessation per 1000 person-years were 57.4 for men and 43.2 for women. Among former smokers at baseline the relapse rates were 37.6 and 48.8 per 1000 person-years for men and women, respectively. The initiation rate per 1000 person-years among men who had never smoked was 12.5 and 2.7 for women. Higher amount currently smoked and longer time since quitting were strong predictors of lower rates of cessation and relapse, respectively, while age was associated with lower initiation rates in women. Increased alcohol consumption was related to low cessation and high relapse and initiation rates, mainly among men, while more educated women had higher cessation and initiation rates.

CONCLUSIONS

The current pattern of changes in smoking behavior in Spanish populations aged 35 to 64 years results in rather small prevalence reduction. Additional efforts should be made to promote successful cessation and prevent initiation to reduce the tobacco burden in Spain.

Attributable and absolute risk of lung cancer death by smoking status: findings from the Japan Collaborative Cohort Study

Estimating the proportion of lung cancer deaths that can be avoided is important in assessing the potential impact of antismoking efforts on the reduction of lung cancer deaths. We calculated the population attributable risk (PAR) and absolute risk of lung cancer death according to smoking status based on the Japan Collaborative Cohort (JACC) Study. The analytic cohort included 45,010 males and 55,724 females aged 40-79 years. Cox proportional hazards model was used to determine age-adjusted relative risks and PAR according to smoking status. We also computed lung cancer mortality according to age and smoking status. In males, 52.2% and 14.8% of lung cancer deaths were attributable to current and former cigarette smoking, respectively. In females, the corresponding figures were 11.8% and 2.8%. Among current male smokers, the relative risk was strongly correlated with the intensity and duration of cigarette smoking. In contrast, the PAR was associated with an intermediate level of smoking except for the years of smoking: the largest PARs were observed in those with 20-29 cigarettes per day, 40-59 pack-years and 20-22 years old at starting smoking. Absolute risks were estimated to increase with age and duration of smoking and not to decrease even after cessation. These findings suggest that avoidable lung cancer deaths are primarily among light to moderate smokers who are considered amenable to population-based antismoking strategies. For all current smokers, immediate cessation is encouraged because it offers the only realistic way to avoid a substantial increase in lung cancer mortality brought about by further continuation of smoking.