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Leiter A, Veluswamy RR, Wisnivesky JP. The global burden of lung cancer: current status and future trends. Nat Rev Clin Oncol 2023; 20:624-639. [PMID: 37479810 DOI: 10.1038/s41571-023-00798-3] [Citation(s) in RCA: 150] [Impact Index Per Article: 150.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2023] [Indexed: 07/23/2023]
Abstract
Lung cancer is the leading cause of cancer-related death worldwide. However, lung cancer incidence and mortality rates differ substantially across the world, reflecting varying patterns of tobacco smoking, exposure to environmental risk factors and genetics. Tobacco smoking is the leading risk factor for lung cancer. Lung cancer incidence largely reflects trends in smoking patterns, which generally vary by sex and economic development. For this reason, tobacco control campaigns are a central part of global strategies designed to reduce lung cancer mortality. Environmental and occupational lung cancer risk factors, such as unprocessed biomass fuels, asbestos, arsenic and radon, can also contribute to lung cancer incidence in certain parts of the world. Over the past decade, large-cohort clinical studies have established that low-dose CT screening reduces lung cancer mortality, largely owing to increased diagnosis and treatment at earlier disease stages. These data have led to recommendations that individuals with a high risk of lung cancer undergo screening in several economically developed countries and increased implementation of screening worldwide. In this Review, we provide an overview of the global epidemiology of lung cancer. Lung cancer risk factors and global risk reduction efforts are also discussed. Finally, we summarize lung cancer screening policies and their implementation worldwide.
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Affiliation(s)
- Amanda Leiter
- Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Rajwanth R Veluswamy
- Division of Hematology and Oncology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Juan P Wisnivesky
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Zou K, Sun P, Huang H, Zhuo H, Qie R, Xie Y, Luo J, Li N, Li J, He J, Aschebrook-Kilfoy B, Zhang Y. Etiology of lung cancer: Evidence from epidemiologic studies. JOURNAL OF THE NATIONAL CANCER CENTER 2022; 2:216-225. [PMID: 39036545 PMCID: PMC11256564 DOI: 10.1016/j.jncc.2022.09.004] [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: 01/25/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 12/05/2022] Open
Abstract
Lung cancer is one of the leading causes of cancer incidence and mortality worldwide. While smoking, radon, air pollution, as well as occupational exposure to asbestos, diesel fumes, arsenic, beryllium, cadmium, chromium, nickel, and silica are well-established risk factors, many lung cancer cases cannot be explained by these known risk factors. Over the last two decades the incidence of adenocarcinoma has risen, and it now surpasses squamous cell carcinoma as the most common histologic subtype. This increase warrants new efforts to identify additional risk factors for specific lung cancer subtypes as well as a comprehensive review of current evidence from epidemiologic studies to inform future studies. Given the myriad exposures individuals experience in real-world settings, it is essential to investigate mixture effects from complex exposures and gene-environment interactions in relation to lung cancer and its subtypes.
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Affiliation(s)
- Kaiyong Zou
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Peiyuan Sun
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huang Huang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haoran Zhuo
- Yale School of Public Health, New Haven, United States of America
| | - Ranran Qie
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuting Xie
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiajun Luo
- Department of Public Health Sciences, the University of Chicago, Chicago, United States of America
| | - Ni Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiang Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie He
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | - Yawei Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Abstract
The use of inhaled psychotropic substances is widespread in our society. In addition to the wide variety of tobacco-containing smoking products, e‑cigarettes, cannabis, sniffing substances, cocaine and heroin are consumed by inhalation. While the harmful effects of most tobacco-containing smoking products on the lungs have been sufficiently researched, there is still a lack of scientifically sound evidence for many other substances consumed by inhalation. In particular, for novel products, such as e‑cigarettes and tobacco heaters, there is a lack of independent standardized data demonstrating reduced health risk as a result of lower exposure to harmful substances. Clear conclusions are also currently not possible for the long-term effects of cannabis use on the lungs and respiratory tract. For the inhaled use of cocaine and heroin, on the other hand, considerable damage to the lungs can be documented, especially in the case of extensive and chronic use.
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Braun M, Dehm M, Klingelhöfer D, Groneberg DA. High particulate matter burden by cigarillos: A laser spectrometric analysis of second-hand smoke of common brands with and without filter. PLoS One 2021; 16:e0254537. [PMID: 34242367 PMCID: PMC8270437 DOI: 10.1371/journal.pone.0254537] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/28/2021] [Indexed: 11/18/2022] Open
Abstract
Although the global tobacco market of cigarillos is substantial, little is known about their particulate matter (PM) emissions. For exposure risk assessment of cigarillos, the PM fractions PM10, PM2.5, and PM1 of eight cigarillo brands (four with filters) and a reference cigarette were measured. For this purpose, second-hand smoke was generated by an automatic smoke pump in a measuring chamber with a volume of 2.88 m³. The mean particle concentrations of the cigarillos ranged from 2783 μg/m³ to 6686 μg/m³ for PM10, from 2767 μg/m³ to 6585 μg/m³ for PM2.5, and from 2441 to 4680 μg/m³ for PM1. Mean concentrations of the reference cigarette for PM10, PM2.5, and PM1 were 4400 μg/m³, 4335 μg/m³, and 3289 μg/m³, respectively. Filter-tipped cigarillos showed between 5% and 38% lower PM10 and PM2.5 levels, respectively, and between 4% and 30% lower PM1 levels. Our findings show generally high PM emissions for all investigated tobacco products. Therefore, the declaration of PM amounts to government authorities should be mandatory for all tobacco products. Policymakers should ensure that corresponding information will be provided in the future.
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Affiliation(s)
- Markus Braun
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
- * E-mail:
| | - Maike Dehm
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
| | - Doris Klingelhöfer
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
| | - David A. Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
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Kirkham F, Pera A, Simanek AM, Bano A, Morrow G, Reus B, Caserta S, Smith HE, Davies KA, Rajkumar C, Kern F. Cytomegalovirus infection is associated with an increase in aortic stiffness in older men which may be mediated in part by CD4 memory T-cells. Theranostics 2021; 11:5728-5741. [PMID: 33897878 PMCID: PMC8058738 DOI: 10.7150/thno.58356] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/07/2021] [Indexed: 12/31/2022] Open
Abstract
Human Cytomegalovirus (CMV) infection is associated with atherosclerosis, higher cardiovascular disease (CVD) risk, and an increase in memory T-cells (Tmem). T-cells have also been implicated in CVD, independently of CMV infection. To better understand the CMV-associated CVD risk, we examined the association between CMV (IgG) serostatus and central aortic (carotid-to-femoral) pulse wave velocity (cfPWV), an early, independent predictor of CVD. We also investigated if such an association might be reflected by the distribution of Tmem and/or other T-cell subsets. Methods: Healthy older volunteers (60-93 years) underwent routine clinical and laboratory evaluation, including assessment of cfPWV in eligible participants. Flow-cytometry was used to assess proportions of memory T-cells, CD28null T-cells, and CMV-specific T-cells. The following associations were examined; CMV serostatus/cfPWV, CMV serostatus/proportion of Tmem, proportion of Tmem/cfPWV, CD28null T-cells/cfPWV, and CMV-specific T-cells/cfPWV. Linear regression models were used to adjust for age, sex, socioeconomic status, smoking, waist-to-hip ratio, cholesterol, and blood pressure as required. Results: Statistically significant positive associations were found (P-values for the fully adjusted models are given); CMV serostatus/cfPWV in men (P ≤ 0.01) but not in women, CMV serostatus/proportions of CD4 Tmem in men (P ≤ 0.05) but not in women; proportions of CD4 Tmem/cfPWV among CMV seropositive (CMV+) people (P ≤ 0.05) but not CMV seronegative (CMV-) people. Conclusion: CMV infection increases the CVD risk of older men by increasing cfPWV. This may be mediated in part by increased proportions of CD4 Tmem, higher numbers of which are found in CMV+ older people and more so among men than women. Given the high prevalence of CMV worldwide, our findings point to a significant global health issue. Novel strategies to mitigate the increased CVD risk associated with CMV may be required.
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Sitarek P, Merecz-Sadowska A, Śliwiński T, Zajdel R, Kowalczyk T. An In Vitro Evaluation of the Molecular Mechanisms of Action of Medical Plants from the Lamiaceae Family as Effective Sources of Active Compounds against Human Cancer Cell Lines. Cancers (Basel) 2020; 12:E2957. [PMID: 33066157 PMCID: PMC7601952 DOI: 10.3390/cancers12102957] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/05/2020] [Accepted: 10/09/2020] [Indexed: 12/25/2022] Open
Abstract
It is predicted that 1.8 million new cancer cases will be diagnosed worldwide in 2020; of these, the incidence of lung, colon, breast, and prostate cancers will be 22%, 9%, 7%, and 5%, respectively according to the National Cancer Institute. As the global medical cost of cancer in 2020 will exceed about $150 billion, new approaches and novel alternative chemoprevention molecules are needed. Research indicates that the plants of the Lamiaceae family may offer such potential. The present study reviews selected species from the Lamiaceae and their active compounds that may have the potential to inhibit the growth of lung, breast, prostate, and colon cancer cells; it examines the effects of whole extracts, individual compounds, and essential oils, and it discusses their underlying molecular mechanisms of action. The studied members of the Lamiaceae are sources of crucial phytochemicals that may be important modulators of cancer-related molecular targets and can be used as effective factors to support anti-tumor treatment.
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Affiliation(s)
- Przemysław Sitarek
- Department of Biology and Pharmaceutical Botany, Medical University of Lodz, 90-151 Lodz, Poland
| | - Anna Merecz-Sadowska
- Department of Economic Informatics, University of Lodz, 90-214 Lodz, Poland; (A.M.-S.); (R.Z.)
| | - Tomasz Śliwiński
- Laboratory of Medical Genetics, Faculty of Biology and Environmental Protection, University of Lodz, 90-236 Lodz, Poland;
| | - Radosław Zajdel
- Department of Economic Informatics, University of Lodz, 90-214 Lodz, Poland; (A.M.-S.); (R.Z.)
| | - Tomasz Kowalczyk
- Department of Molecular Biotechnology and Genetics, University of Lodz, 90-237 Lodz, Poland;
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Hulkkonen S, Auvinen J, Miettunen J, Karppinen J, Ryhänen J. Smoking as risk factor for carpal tunnel syndrome: A birth cohort study. Muscle Nerve 2019; 60:299-304. [PMID: 31271456 DOI: 10.1002/mus.26627] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 06/25/2019] [Accepted: 07/01/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Our aim was to determine whether maternal smoking and offspring's own smoking affect the offspring's risk for carpal tunnel syndrome (CTS). METHOD The study sample consisted of the Northern Finland Birth Cohort 1966 (N = 8703). Information on maternal smoking was collected from the participants' mothers. At 31 years, information on smoking, body mass index, socioeconomic status, and long-term illnesses were collected, combined with data of CTS diagnoses from the Care Register for Health Care (1997-2016). RESULTS Maternal smoking was not associated with increased risk of CTS in offspring. Before the age of 31 years, smoking ≤10 pack years (hazard ratio [HR] = 1.54, 95% confidence interval [CI] = 1.11-2.15) and >10 pack years (HR = 1.90; 95% CI = 1.20-3.01) among women, and >10 pack years (HR = 1.89; 95% CI = 1.14-3.12) among men was associated with CTS compared with nonsmokers. CONCLUSIONS In this birth cohort, offsprings' own smoking was associated with CTS; however, maternal smoking was not.
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Affiliation(s)
- Sina Hulkkonen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Finland, P.O. Box 266, FI-00029 HUS, Finland
| | - Juha Auvinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jorma Ryhänen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Finland, P.O. Box 266, FI-00029 HUS, Finland
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Smoking is associated with ulnar nerve entrapment: a birth cohort study. Sci Rep 2019; 9:9450. [PMID: 31263183 PMCID: PMC6603028 DOI: 10.1038/s41598-019-45675-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/11/2019] [Indexed: 11/08/2022] Open
Abstract
Ulnar nerve entrapment is the second most common compression neuropathy of the upper extremity. It has been associated with smoking in cross-sectional studies. Our aim was to study whether smoking is associated with ulnar nerve entrapment. The study population consisted of the Northern Finland Birth Cohort 1966 participants, who attended the 31-year follow-up in 1997 (N = 8,716). Information on smoking, body mass index (BMI), long-term illnesses, and socio-economic status were recorded at baseline in 1997. Data on hospitalizations due to ulnar nerve entrapment neuropathies was obtained from the Care Register for Health Care, 1997-2016. Hazard ratios (HR) with 95% confidence intervals (CI) and population attributable risk (PAR) were calculated adjusted for gender, BMI and socio-economic status. 66 patients were diagnosed with ulnar nerve entrapment in the follow-up 1997-2016. Before the age of 31 years, smoking ≤10 pack years associated with more than doubled (HR = 2.57, 95% CI = 1.29-5.15) and smoking >10 pack years with more than five-folded (HR = 5.61, 95% CI = 2.80-11.23) risk for ulnar nerve entrapment compared to non-smokers in the adjusted analyses. Adjusted PAR for smoking (reference of no smoking) was 53.6%. In our study, smoking associated with increased risk for ulnar nerve entrapment, accounting for considerable proportion of increased risk.
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Chattopadhyay S, Smyth EM, Kulkarni P, Babik KR, Reid M, Hittle LE, Clark PI, Mongodin EF, Sapkota AR. Little cigars and cigarillos harbor diverse bacterial communities that differ between the tobacco and the wrapper. PLoS One 2019; 14:e0211705. [PMID: 30794551 PMCID: PMC6386278 DOI: 10.1371/journal.pone.0211705] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 01/18/2019] [Indexed: 11/18/2022] Open
Abstract
Despite their potential importance with regard to infectious and chronic diseases among tobacco users, microbial constituents of tobacco products lack characterization. Specifically, to our knowledge, there are no data describing the bacterial diversity of little cigars or cigarillos. To address this knowledge gap, we tested four brands of little cigars and cigarillos. Tobacco and wrapper subsamples (n = 132) were separately subjected to DNA extraction, followed by PCR amplification of the V3V4 hypervariable region of the 16S rRNA gene, and sequencing using Illumina HiSeq. Sequences were analyzed using QIIME and Phyloseq implemented in R. We identified 2,681 operational taxonomic units across all products. Significant differences in alpha and beta diversity were observed between Swisher Sweets and Cheyenne products. Alpha and beta diversity was also significantly different between tobacco and wrapper subsamples within the same product. Beta diversity analyses of only tobacco samples identified no significant differences in the bacterial microbiota of different lots of the same products; however, the microbiota in the wrapper differed significantly across lots for all brands. Overall, Firmicutes were found to dominate in the wrapper, whereas Proteobacteria were most abundant in the tobacco. At the genus level, Bacillus and Lactobacillus dominated in the wrappers, and Staphylococcus and Pseudomonas dominated in the tobacco. Our findings suggest that the bacterial microbiota of little cigars and cigarillos is diverse and differs significantly between the tobacco and the wrapper, and across brands. Future work is necessary to evaluate the potential public health implications of these findings.
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Affiliation(s)
- Suhana Chattopadhyay
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, United States of America
| | - Eoghan M. Smyth
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, United States of America
- Institute for Genome Sciences and Department of Microbiology and Immunology, University of Maryland, School of Medicine, Baltimore, Maryland, United States of America
| | - Prachi Kulkarni
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, United States of America
| | - Kelsey R. Babik
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, United States of America
| | - Molly Reid
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, United States of America
| | - Lauren E. Hittle
- Institute for Genome Sciences and Department of Microbiology and Immunology, University of Maryland, School of Medicine, Baltimore, Maryland, United States of America
| | - Pamela I. Clark
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, College Park, Maryland, United States of America
| | - Emmanuel F. Mongodin
- Institute for Genome Sciences and Department of Microbiology and Immunology, University of Maryland, School of Medicine, Baltimore, Maryland, United States of America
| | - Amy R. Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, United States of America
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Abstract
While lung cancer has been the leading cause of cancer-related deaths for many years in the United States, incidence and mortality statistics - among other measures - vary widely worldwide. The aim of this study was to review the evidence on lung cancer epidemiology, including data of international scope with comparisons of economically, socially, and biologically different patient groups. In industrialized nations, evolving social and cultural smoking patterns have led to rising or plateauing rates of lung cancer in women, lagging the long-declining smoking and cancer incidence rates in men. In contrast, emerging economies vary widely in smoking practices and cancer incidence but commonly also harbor risks from environmental exposures, particularly widespread air pollution. Recent research has also revealed clinical, radiologic, and pathologic correlates, leading to greater knowledge in molecular profiling and targeted therapeutics, as well as an emphasis on the rising incidence of adenocarcinoma histology. Furthermore, emergent evidence about the benefits of lung cancer screening has led to efforts to identify high-risk smokers and development of prediction tools. This review also includes a discussion on the epidemiologic characteristics of special groups including women and nonsmokers. Varying trends in smoking largely dictate international patterns in lung cancer incidence and mortality. With declining smoking rates in developed countries and knowledge gains made through molecular profiling of tumors, the emergence of new risk factors and disease features will lead to changes in the landscape of lung cancer epidemiology.
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Affiliation(s)
- Julie A. Barta
- Division of Pulmonary and Critical Care Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, US
| | - Charles A. Powell
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, US
| | - Juan P. Wisnivesky
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, US
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, US
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Loverdos K, Fotiadis A, Kontogianni C, Iliopoulou M, Gaga M. Lung nodules: A comprehensive review on current approach and management. Ann Thorac Med 2019; 14:226-238. [PMID: 31620206 PMCID: PMC6784443 DOI: 10.4103/atm.atm_110_19] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
In daily clinical practice, radiologists and pulmonologists are faced with incidental radiographic findings of pulmonary nodules. Deciding how to manage these findings is very important as many of them may be benign and require no further action, but others may represent early disease and importantly early-stage lung cancer and require prompt diagnosis and definitive treatment. As the diagnosis of pulmonary nodules includes invasive procedures which can be relatively minimal, such as bronchoscopy or transthoracic aspiration or biopsy, but also more invasive procedures such as thoracic surgical biopsies, and as these procedures are linked to anxiety and to cost, it is important to have clearly defined algorithms for the description, management, and follow-up of these nodules. Clear algorithms for the imaging protocols and the management of positive findings should also exist in lung cancer screening programs, which are already established in the USA and which will hopefully be established worldwide. This article reviews current knowledge on nodule definition, diagnostic evaluation, and management based on literature data and mainly recent guidelines.
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Affiliation(s)
| | - Andreas Fotiadis
- 7th Respiratory Medicine Department, Athens Chest Hospital, Athens, Greece
| | | | | | - Mina Gaga
- 7th Respiratory Medicine Department, Athens Chest Hospital, Athens, Greece
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Johnson ES, Faramawi M, Chedjieu IP, Delongchamp R, Choi KM, Shen T. Excess lung cancer occurrence in poultry plants. Occupational risk factors: Findings for oncogenic viruses exposure and other occupational exposures. ENVIRONMENTAL RESEARCH 2018; 167:393-410. [PMID: 30099266 DOI: 10.1016/j.envres.2018.07.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 06/15/2018] [Accepted: 07/28/2018] [Indexed: 06/08/2023]
Abstract
Certain viruses naturally infect and cause cancer in chickens and turkeys. Humans are widely exposed. The viruses cause cancer in primates, and transform human cells in vitro, but it is not known if they cause cancer in humans, mainly because of the lack of epidemiologic evidence. We conducted cohort mortality studies of workers in poultry slaughtering/processing plants across the United States, because they have the highest human exposures. An excess of lung cancer and other deaths was recorded in the poultry workers. Here, we report on a case-cohort study of the lung cancer deaths nested within these cohorts, that was conducted to provide epidemiologic evidence linking these viruses with human cancer occurrence, while adjusting for possible confounders, including workplace chemical carcinogens. We obtained interviews for 339 lung cancer deaths and 457 controls, selected from our combined cohorts of 30,411 poultry plant workers and 16,405 non-poultry workers, belonging to United Food & Commercial Workers unions. Data was analyzed by both logistic regression and Cox regression, adjusting for smoking and other confounders. Lung cancer risk was independently associated with tasks or work areas indicative of exposure to both poultry oncogenic viruses and to workplace chemical carcinogens. The study provides an incremental piece of evidence (epidemiologic), indirectly linking the oncogenic viruses of poultry with the occurrence of cancer in humans, and thus may have public health implications, but the limitations highlighted must be considered. Confirmatory studies, particularly molecular studies providing definitive proof of poultry oncogenic retrovirus integration in human DNA are needed, before the findings observed in this study can be put into proper perspective.
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Affiliation(s)
- Eric S Johnson
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 21205, USA.
| | - Mohammed Faramawi
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 21205, USA
| | - Irene P Chedjieu
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 21205, USA
| | - Robert Delongchamp
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 21205, USA
| | - Kyung-Mee Choi
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 21205, USA; Korea Centers for Disease Control & Prevention, National Research Institute of Health, Cheongju-si, Republic of Korea
| | - Tianjiao Shen
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 21205, USA
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13
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Majeed BA, Nyman A, Sterling KL, Slovic P. Little cigars and cigarillos: Affect and perceived relative harm among U.S. adults, 2015. Addict Behav 2018; 85:107-112. [PMID: 29886248 DOI: 10.1016/j.addbeh.2018.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 05/22/2018] [Accepted: 05/24/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Similar to cigarette smoking, consumption of cigars delivers nicotine and byproducts of tobacco combustion and elevates the risk of addiction, illness, and premature death. This study examined the relationship of affect, perceived relative harm, and LCC smoking behavior among U.S. adults. METHODS Data were from Tobacco Products and Risk Perceptions Survey conducted in 2015. The study included a probability based sample of 6051 adults (18+) drawn from an online research panel. A current LCC smoker was defined as having ever smoked LCCs and was currently smoking LCCs every day, somedays, or rarely. Participants were asked whether smoking LCCs was less harmful, had about the same level of harm, or was more harmful than smoking regular cigarettes. Feelings about LCCs were collected using word association technique. Descriptive and multinomial logistic regression analyses were conducted. RESULTS About 7% of the study participants were current LCC smokers. Adults with positive feelings had four-fold the adjusted odds to be current LCC smokers. Perceiving LCCs to be less harmful had 2.7 higher adjusted odds of being current LCC smokers. CONCLUSIONS Compared to cigarettes, LCCs evoked more positive feelings among adults and these positive feelings were strongly associated with both perceiving LCCs as less harmful than cigarettes and with current LCC smoking. Cessation and prevention interventions would benefit from applying the principles of social marketing in which information is provided not only to inform consumers but also to evoke negative feelings and associations with LCC smoking.
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Affiliation(s)
- Ban A Majeed
- Division of Epidemiology, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA.
| | - Amy Nyman
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, USA
| | | | - Paul Slovic
- Decision Research, Eugene, OR, USA; Department of Psychology, University of Oregon, Eugene, OR, USA
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Ramos MFKP, Ribeiro Júnior U, Viscondi JKY, Zilberstein B, Cecconello I, Eluf-Neto J. Risk factors associated with the development of gastric cancer - case-control study. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2018; 64:611-619. [PMID: 30365663 DOI: 10.1590/1806-9282.64.07.611] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 12/14/2017] [Indexed: 02/06/2023]
Affiliation(s)
| | - Ulysses Ribeiro Júnior
- Gastroenterology Department of the University of São Paulo Medical School, São Paulo-SP, Brasil
| | | | - Bruno Zilberstein
- Gastroenterology Department of the University of São Paulo Medical School, São Paulo-SP, Brasil
| | - Ivan Cecconello
- Gastroenterology Department of the University of São Paulo Medical School, São Paulo-SP, Brasil
| | - José Eluf-Neto
- Preventive Medicine Department of the University of São Paulo Medical School, São Paulo-SP, Brasil
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Malhotra J, Borron C, Freedman ND, Abnet CC, van den Brandt PA, White E, Milne RL, Giles GG, Boffetta P. Association between Cigar or Pipe Smoking and Cancer Risk in Men: A Pooled Analysis of Five Cohort Studies. Cancer Prev Res (Phila) 2017; 10:704-709. [PMID: 28972007 DOI: 10.1158/1940-6207.capr-17-0084] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 08/04/2017] [Accepted: 09/21/2017] [Indexed: 11/16/2022]
Abstract
Introduction: Use of non-cigarette tobacco products such as cigars and pipe has been increasing, even though these products entail exposure to similar carcinogens to those in cigarettes. More research is needed to explore the risk of these products to guide cancer prevention efforts.Methods: To measure the association between cigars and/or pipe smoking, and cancer incidence in men, we performed meta-analyses of data from five prospective cohorts. Cox regression was used to evaluate the association between different aspects of cigars and pipe smoking and risk of each smoking-related cancer (head and neck, esophagus, lung, stomach, liver, pancreas, kidney, and bladder) for each study. Adjusted HRs were combined using random-effects models.Results: Cigars and/or pipe smokers were at increased risk for head and neck [HR, 1.51; 95% confidence interval (CI), 1.22-1.87], lung (HR, 2.04; 95% CI, 1.68-2.47), and liver cancers (HR, 1.56; 95% CI, 1.08-2.26). Ever-smokers of cigars and/or pipe had an increased risk of developing a smoking-related cancer when compared with never smokers of any tobacco product (overall HR, 1.07; 95% CI, 1.03-1.12). The risk for smoking-related cancers was also increased in mixed smokers who smoked cigars or pipe as well as cigarettes, even when they were smoking predominantly pipe or cigars.Discussion: This pooled analysis highlights the increased risk for smoking-related cancers, particularly for lung and head and neck cancers in exclusive and predominant smokers (former and current) of cigars and pipe. Tobacco prevention efforts should include these products in addition to cigarettes. Cancer Prev Res; 10(12); 704-9. ©2017 AACR.
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Affiliation(s)
- Jyoti Malhotra
- Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey.
| | - Claire Borron
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Piet A van den Brandt
- Department of Epidemiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Emily White
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Roger L Milne
- Cancer Epidemiology Center, Cancer Council Victoria, Melbourne, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Graham G Giles
- Cancer Epidemiology Center, Cancer Council Victoria, Melbourne, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
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Hudmon KS, Corelli RL, Kroon LA, Shreve MS, Prokhorov AV. Reducing Pulmonary Disease: The Pharmacist’s Role in Smoking Cessation. J Pharm Pract 2016. [DOI: 10.1106/j00t-w7m9-c18c-q6y6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
As an important interface with the healthcare system for many patients, pharmacists are in a unique position to assist patients with quitting smoking, thereby improving patients’ pulmonary health. Because nicotine replacement therapy products and bupropion are available to patients largely via pharmacies, the pharmacist has become a logical candidate for providing smoking cessation assistance. Furthermore, research has shown that when pharmacists counsel patients on medications for quitting smoking, their intervention positively impacts smoking cessation rates. This article provides a review of methods for cessation and provides pharmacists with feasible and effective smoking cessation counseling strategies for implementation into everyday practice. The intervention approach draws heavily upon the U.S. Public Health Service Clinical Practice Guideline for Treating Tobacco Use and Dependence.
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Affiliation(s)
- Karen Suchanek Hudmon
- School of Pharmacy, University of California, San Francisco, 521 Parnassus Avenue, Room C152, San Francisco, CA 94143-0622
| | - Robin L. Corelli
- School of Pharmacy, University of California, San Francisco, 521 Parnassus Avenue, Room C152, San Francisco, CA 94143-0622
| | - Lisa A. Kroon
- School of Pharmacy, University of California, San Francisco, 521 Parnassus Avenue, Room C152, San Francisco, CA 94143-0622
| | - Marilyn Standifer Shreve
- California State Board of Pharmacy, Department of Consumer Affairs, 400 R. Street, Suite 4070, Sacramento, CA 95814-6200
| | - Alexander V. Prokhorov
- The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 243, Houston, TX 77030
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Was it the drink? The conditioned association of alcohol and desire to quit smoking on the dual use of little cigars/cigarillos and cigarettes among men and women. Addict Behav 2016; 59:48-51. [PMID: 27070096 DOI: 10.1016/j.addbeh.2016.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 03/15/2016] [Accepted: 03/17/2016] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Dual use of little cigars/cigarillos (LCCs) with cigarettes is becoming more popular; especially among men, but infrequently studied. Dual tobacco users show a higher prevalence of health-risk behaviors such as drug and alcohol use, are likely exposed to higher levels of nicotine and tobacco-related toxicants, and have greater difficulty quitting and maintaining abstinence. This study examined the effects of alcohol use, and desire to quit smoking on dual use of LCCs and cigarettes among men and women. METHODS Data utilized responses from a screening survey of 571 adult smokers. Basic demographic information, current cigarette use, desire to quit smoking, frequency of current LCC use, and alcohol and drug use were collected. RESULTS Dual users were more likely to be male and younger, report drug use in the past 90-days, and have a lower desire to quit smoking. Regression analyses showed a 3-way interaction of gender, alcohol use frequency, and desire to quit smoking, such that men who drank alcohol more frequently who had a higher desire to quit smoking used LCCs more frequently than men with a lower desire to quit. DISCUSSION Alcohol use may be a risk factor for men's dual use of LCCs and cigarettes among those who want to quit smoking. Implications for prevention and treatment are discussed.
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Sutter ME, Nasim A, Veldheer S, Cobb CO. Associations between unhealthy dieting behaviors and tobacco use among adolescents. J Eat Disord 2016; 4:39. [PMID: 28018597 PMCID: PMC5159949 DOI: 10.1186/s40337-016-0126-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 11/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cigarette smoking is an important risk factor for unhealthy dieting behaviors (UDBs) in youth. The role of alternative tobacco products and UDB engagement has yet to be examined empirically despite concerning trends in use. This study aimed to examine UDB prevalence in a U.S. geographic region-specific adolescent sample and associations with a variety of tobacco use behaviors and perceptions. METHODS Weighted data from the 2013 Virginia Youth Survey were analyzed (n = 6903). UDBs assessed included past 30-day fasting, diet pill use, and vomiting/laxative use. Tobacco-related items were ever and past 30-day cigarette smoking, past 30-day smokeless tobacco and cigar use, and the perception that smokers have more friends. UDB prevalence was recoded by the number of behaviors endorsed (0, 1, and 2+). Bivariate and multinomial regression models were used to examine associations between covariates and number of UDBs endorsed by gender. RESULTS Overall, nearly 16% engaged in at least one UDB. Fasting was most prevalent (14.2%) followed by vomiting/laxative (7.0%) and diet pill use (6.1%). Across gender, ever cigarette smoking, past 30-day cigar use, and the perception that smokers have more friends were positively associated with UDB engagement in relative isolation as well as in combination. CONCLUSIONS Findings highlight the importance of tobacco-related factors for weight control behaviors and are the first to identify an association between UDB incidence and an alternative tobacco product, cigars. This work should inform prevention efforts for tobacco use and UDBs and underscores the need to address the use of any tobacco for weight control.
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Affiliation(s)
- Megan E Sutter
- Department of Psychology, Virginia Commonwealth University, 808 West Franklin St, Richmond, VA 23284 USA
| | - Aashir Nasim
- Department of African American Studies, Virginia Commonwealth University, Richmond, VA USA
| | - Susan Veldheer
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA USA
| | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, 808 West Franklin St, Richmond, VA 23284 USA ; Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA USA
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Nasim A, Guy MC, Soule EK, Cobb CO, Blank MD, Eissenberg T. Characteristics and Patterns of Black & Mild Use Among African American Smokers. Nicotine Tob Res 2015; 18:842-9. [PMID: 26615202 DOI: 10.1093/ntr/ntv260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 11/12/2015] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Increased consumption of little cigars and cigarillos (LCCs) among late adolescent and young adult African American smokers is an emerging public health concern. Despite a growing body of epidemiological evidence, there is scant research on systematic variations in LCC use among young adult African Americans. This study aimed to disaggregate African American Black & Mild (B&M) smokers and to identify subgroups of cigarillo smokers' behaviors and associated characteristics. METHODS Using telephone screening data for a NIH-funded clinical laboratory study of toxicant exposure associated with B&M use, latent class analysis (LCA) was used to classify 331 African American B&M smokers' based on daily use, average daily consumption, preference for flavors, preference for product design tips, and product modification behaviors. RESULTS Results showed five classes, three of which (Daily-Hypers, Daily-Flavored, and Heavy-Daily-Hypers) reflected daily use and average daily consumption rate ranging between 2.7 and 8.9 B&M cigarillos per day. Non-Daily-Hypers and Non-Daily-Flavored classes represented non-daily use patterns and averaged less than 1.0 B&M cigarillo per day. Both sets of classes defined by daily users and non-daily users included smokers who preferred flavored tobacco and who practiced product modification techniques involving hyping and blunting. CONCLUSIONS Latent class analysis is a useful method to detect subtle differences in B&M product preferences and smoking behaviors among African Americans. Study findings highlight the importance of developing tailored interventions that consider within group differences in order to reduce the prevalence of cigarillo smoking among those with the greatest burden. IMPLICATIONS The current study is the first to identify unique subgroups of African American B&M smokers based on cigarillo use behaviors and associated characteristics. Latent class analyses may prove useful for understanding other subgroups of tobacco users. Current findings concerning patterns of LCC use illustrate how future tobacco cessation and prevention interventions may be tailored for African American smokers.
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Affiliation(s)
- Aashir Nasim
- Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA; Office of the Provost and Vice President for Academic Affairs, Virginia Commonwealth University, Richmond, VA;
| | - Mignonne C Guy
- Department of African American Studies and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
| | - Eric K Soule
- Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
| | - Caroline O Cobb
- Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
| | - Melissa D Blank
- Department of Psychology, West Virginia University, Morgantown, VA
| | - Thomas Eissenberg
- Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
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Cohn A, Cobb CO, Niaura RS, Richardson A. The Other Combustible Products: Prevalence and Correlates of Little Cigar/Cigarillo Use Among Cigarette Smokers. Nicotine Tob Res 2015; 17:1473-81. [PMID: 25634932 DOI: 10.1093/ntr/ntv022] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 01/18/2015] [Indexed: 11/13/2022]
Abstract
BACKGROUND Despite the increasing consumption of little cigars and cigarillos (LCCs), few studies have examined unique predictors and correlates of LCC use among adult cigarette smokers. This study explored differences between cigarette smokers with and without a history of LCC use on harm perceptions, use of other tobacco products (chewing tobacco, snus, e-cigarettes, and dissolvables), cigarette smoking/cessation-related behaviors/cognitions, and mental health and substance use disorder symptoms. METHODS A geographically diverse sample of current cigarette smokers were included in analyses (n = 1270). Frequencies of LCC use, awareness, purchase, and harm perceptions were examined and logistic regression models investigated differences between LCC ever and never users on a variety of factors, controlling for demographics. RESULTS Bivariate analyses showed that LCC users were more likely to be male, younger, have lower income, have tried other tobacco products, perceive LCCs as less harmful than cigarettes, and endorse lifetime substance disorder symptoms. Menthol and other tobacco product use were the only significant correlates of LCC use in logistic regression models. Post-hoc analyses showed that other tobacco product use partially mediated an association between substance use disorder symptoms and LCC use. CONCLUSIONS A third of the sample had tried LCCs, and LCC users were more likely to have experimented with other tobacco products and used menthol. The high degree of co-use of cigarette smoking and LCCs with other tobacco products and the association of LCC use to substance use suggests that these users have unique risk factors and deserve specific targeting in public health campaigns.
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Affiliation(s)
- Amy Cohn
- Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC;
| | - Caroline O Cobb
- Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC
| | - Raymond S Niaura
- Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC; Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, DC
| | - Amanda Richardson
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Health Behavior, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC
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Ghaemi SN, Dalley S, Catania C, Barroilhet S. Bipolar or borderline: a clinical overview. Acta Psychiatr Scand 2014; 130:99-108. [PMID: 24571137 DOI: 10.1111/acps.12257] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2014] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To examine the empirical literature on diagnostic validators in borderline personality and bipolar illness. METHOD Using principles of evidence-based medicine, the highest levels of evidence were emphasized in interpretation of similarities or differences between bipolar illness and borderline personality on the five standard diagnostic validators in psychiatric nosology: symptoms, course, genetics, treatment response, and neurobiology. RESULTS Bipolar illness and borderline personality were found to be similar in the nosological validator of symptoms of mood lability and impulsivity, but differed notably on all other diagnostic validators, especially the course validator of past sexual abuse and the genetic validator of a bipolar family history. They also differ notably in the symptom validator of parasuicidal self-harm. Treatment response and neurobiological differences were also present and consistent. CONCLUSION This review of the literature indicates that these two conditions, bipolar illness and borderline personality, are different and can be distinguished. The much stronger biological and genetic evidence for bipolar illness in particular suggests that the two conditions can be reasonably seen as different kinds of clinical entities, namely a biological disease versus a psychosocially caused clinical picture. If this interpretation is correct, similarities between the two conditions, such as mood lability and impulsivity, are superficial, while differences are profound. Further, true comorbidity may be much less common than often presumed.
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Affiliation(s)
- S N Ghaemi
- Mood Disorders Program, Department of Psychiatry, Tufts Medical Center, Boston, MA, USA; Tufts University School of Medicine, Boston, MA, USA
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22
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Ka D, Marignac G, Desquilbet L, Freyburger L, Hubert B, Garelik D, Perrot S. Association between passive smoking and atopic dermatitis in dogs. Food Chem Toxicol 2014; 66:329-33. [DOI: 10.1016/j.fct.2014.01.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 12/16/2013] [Accepted: 01/10/2014] [Indexed: 10/25/2022]
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Yates EA, Dubray J, Schwartz R, Kirst M, Lacombe-Duncan A, Suwal J, Hatcher J. Patterns of cigarillo use among Canadian young adults in two urban settings. Canadian Journal of Public Health 2014; 105:e11-4. [PMID: 24735690 DOI: 10.17269/cjph.105.3879] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 02/10/2014] [Accepted: 11/28/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Current estimates indicate that cigarillo use has become commonplace among young adults in Canada despite the established risks to health. However, little else is known about patterns of cigarillo use in this subpopulation. The intent of this research was to examine the patterns, attitudes, and beliefs regarding cigarillo use and co-use of cigarillos and cigarettes among Canadian young adults. METHODS Canadians aged 19-29 years from the Greater Toronto Area, Ontario and Edmonton, Alberta were recruited from September 2009 to February 2010 and in June 2010, respectively (n=133). Eligible participants completed questionnaires assessing cigarillo, cigarette, and cannabis use; social influence of usage; and beliefs about cigarillo use. RESULTS Cigarillo use was common in social settings, with friends, and during leisure time. The majority of participants were co-users of cigarillos and cigarettes (82%), and currently used cannabis (72%). Respondents reported "replacing cigarette smoking" and "flavour" as main reasons for smoking cigarillos; and half (52%) believed they were not at all addicted to cigarillos. Disconcertingly, participants perceived the risk of cancer attributed to smoking cigarillos as significantly less than the risk of cancer attributed to smoking cigarettes (p<0.0001). CONCLUSION These findings highlight the social nature of cigarillo use, and suggest a lack of awareness of the health risks associated with cigarillo and polytobacco use in this small convenience sample of Canadian young adults. Population-level analyses are needed to further investigate cigarillo, polytobacco and concurrent cannabis use patterns and beliefs among Canadian young adults.
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Lauterstein D, Hoshino R, Gordon T, Watkins BX, Weitzman M, Zelikoff J. The changing face of tobacco use among United States youth. CURRENT DRUG ABUSE REVIEWS 2014; 7:29-43. [PMID: 25323124 PMCID: PMC4469045 DOI: 10.2174/1874473707666141015220110] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 10/01/2014] [Accepted: 10/01/2014] [Indexed: 11/22/2022]
Abstract
Tobacco use, primarily in the form of cigarettes, is the leading cause of preventable morbidity and mortality in the United States (U.S.). The adverse effects of tobacco use began to be recognized in the 1940's and new hazards of active smoking and secondhand smoke (SHS) exposure from cigarettes continue to be identified to this day. This has led to a sustained and wide-ranging array of highly effective regulatory, public health, and clinical efforts that have been informed by extensive scientific data, resulting in marked decreases in the use of cigarettes. Unfortunately, the dramatic recent decline in cigarette use in the U.S., has been accompanied by an upsurge in adolescent and young adult use of new, non-cigarette tobacco and nicotine-delivery products, commonly referred to as alternative tobacco products (ATPs). Commonly used ATPs include hookah, cigars, smokeless tobacco, and electronic cigarettes. While there have been a number of review articles that focus on adult ATP use, the purpose of this review is to provide an overview of what is, and is not known about emerging ATP use among U.S. adolescents on a national scale; as well as to identify research gaps in knowledge, and discuss future health and policy needs for this growing public health concern. This paper is not meant to systemically review all published survey data, but to present clear depiction of selected ATP usage in youth populations using national survey data.
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Affiliation(s)
- Dana Lauterstein
- Department of Environmental Medicine, New York University School of Medicine
| | - Risa Hoshino
- Department of Pediatrics, New York University School of Medicine
- Department of Pediatrics, Mount Sinai Hospital
| | - Terry Gordon
- Department of Environmental Medicine, New York University School of Medicine
| | | | - Michael Weitzman
- Department of Environmental Medicine, New York University School of Medicine
- Department of Pediatrics, New York University School of Medicine
- Global Institute for Public Health, New York University
| | - Judith Zelikoff
- Department of Environmental Medicine, New York University School of Medicine
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Alberg AJ, Brock MV, Ford JG, Samet JM, Spivack SD. Epidemiology of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013; 143:e1S-e29S. [PMID: 23649439 DOI: 10.1378/chest.12-2345] [Citation(s) in RCA: 459] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Ever since a lung cancer epidemic emerged in the mid-1900 s, the epidemiology of lung cancer has been intensively investigated to characterize its causes and patterns of occurrence. This report summarizes the key findings of this research. METHODS A detailed literature search provided the basis for a narrative review, identifying and summarizing key reports on population patterns and factors that affect lung cancer risk. RESULTS Established environmental risk factors for lung cancer include smoking cigarettes and other tobacco products and exposure to secondhand tobacco smoke, occupational lung carcinogens, radiation, and indoor and outdoor air pollution. Cigarette smoking is the predominant cause of lung cancer and the leading worldwide cause of cancer death. Smoking prevalence in developing nations has increased, starting new lung cancer epidemics in these nations. A positive family history and acquired lung disease are examples of host factors that are clinically useful risk indicators. Risk prediction models based on lung cancer risk factors have been developed, but further refinement is needed to provide clinically useful risk stratification. Promising biomarkers of lung cancer risk and early detection have been identified, but none are ready for broad clinical application. CONCLUSIONS Almost all lung cancer deaths are caused by cigarette smoking, underscoring the need for ongoing efforts at tobacco control throughout the world. Further research is needed into the reasons underlying lung cancer disparities, the causes of lung cancer in never smokers, the potential role of HIV in lung carcinogenesis, and the development of biomarkers.
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Affiliation(s)
- Anthony J Alberg
- Hollings Cancer Center and the Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC.
| | - Malcolm V Brock
- Department of Surgery, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Jean G Ford
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Jonathan M Samet
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Simon D Spivack
- Division of Pulmonary Medicine, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
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Sun Z, Xiao Z. 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) regulates CTL activation and memory programming. Biochem Biophys Res Commun 2013; 435:472-6. [PMID: 23673295 PMCID: PMC3787869 DOI: 10.1016/j.bbrc.2013.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 05/04/2013] [Indexed: 12/27/2022]
Abstract
4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) is one of the major carcinogens in tobacco. NNK has been associated with various cancers in tobacco users, especially lung cancer. However, the effects of NNK on cytotoxic T lymphocytes (CTLs), the cells responsible for destrcution of maligant and pathogen-infected cells, has not been elucidated. Using transgenic CTLs in vitro and in vivo, we show that NNK can directly affect CTL activation. NNK can enhance the expression of adhesion molecule CD62L in CTLs during their activation in vitro, but has no effects on their expansion and production of effector molecules such as IFN and granzyme B. After transferred into recipient mice, however, the NNK pretreated CTLs suffer an early loss in expansion. The percentage of memory precursors is higher in NNK pretreated CTLs, but the total amount of memory precursors is similar to controls. The final memory CTL population from NNK pretreated CTLs is reduced, but sustains a more central memory phenotype. In conclusion, NNK can affect CTL activation by modulating adhension molecule expression and reducing memory programming.
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Affiliation(s)
- Zhifeng Sun
- Department of Animal and Avian Sciences, University of Maryland, College Park, MD 20742, USA
| | - Zhengguo Xiao
- Department of Animal and Avian Sciences, University of Maryland, College Park, MD 20742, USA
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Richardson A, Rath J, Ganz O, Xiao H, Vallone D. Primary and dual users of little cigars/cigarillos and large cigars: demographic and tobacco use profiles. Nicotine Tob Res 2013; 15:1729-36. [PMID: 23645607 DOI: 10.1093/ntr/ntt053] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Although cigarettes are regulated through the Family Smoking Prevention and Tobacco Control Act, cigars are currently not regulated and tend to be lower in price. Despite the rising use of cigars in the United States, little is known about the prevalence of use of little cigars/cigarillos (LCCs) versus large cigars (LCs) and the profile of these distinct cigar users. METHODS This study uses data from Legacy's Young Adult Cohort, a nationally representative study of 4,215 young adults, ages 18-34. Cigar use was divided into three groups: ever use of LCCs only, ever use of LCs only, and ever dual users. Multinomial regression was used to determine the differential demographic characteristics and tobacco use behaviors associated with the three cigar-use groups. RESULTS Ever cigar use was reported by 37.9% (n = 1,596) of the young adult cohort. Of the cigar smokers, 21.5% (n = 344) had used only LCCs, 32.3% (n = 515) had used only LCs, and 46.2% (n = 737) were dual users of both. In comparison with LC-only users, LCC-only users were more like to be younger (relative risk ratio [RRR] = 0.40, p < .001 for 25-34 vs. 18-24 years), female (RRR = 4.92, p < .001), non-Hispanic Black (RRR = 2.91, p < .001), and smoke cigarettes daily. Dual users were more likely than LC-only users to be female (RRR = 1.61, p = .03), non-Hispanic Black (RRR = 2.06, p = .04), and use a higher numbers of tobacco products (RRR = 4.44, p < .001). CONCLUSIONS Cigar use is prevalent among young adults with the highest proportion using both LCCs and LCs. Interventions to curb use should consider the differential demographic and tobacco use patterns of cigar users.
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Sterling K, Berg CJ, Thomas AN, Glantz SA, Ahluwalia JS. Factors associated with small cigar use among college students. Am J Health Behav 2013; 37:325-33. [PMID: 23985179 DOI: 10.5993/ajhb.37.3.5] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To assess small cigar use among college students in the southeastern United States. METHODS Data from a 2010 online survey were analyzed to examine small cigar smoking and its sociodemographic and psychosocial correlates among 4388 college students, aged 18-30. RESULTS Small cigar users were more likely to be younger, male, black, and current cigarette, cigar, hookah, or marijuana smokers (p's < .05). They reported lower perceived harm of smoking and greater sensation seeking and perceived stress. Menthol cigarette smokers were more likely to smoke small cigars. CONCLUSIONS Small cigar use and the co-occurrence of other tobacco and substance use should be addressed among college students.
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Affiliation(s)
- Kymberle Sterling
- Institute of Public Health, Georgia State University, Atlanta, GA, USA.
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Schuster RM, Hertel AW, Mermelstein R. Cigar, cigarillo, and little cigar use among current cigarette-smoking adolescents. Nicotine Tob Res 2012; 15:925-31. [PMID: 23072873 DOI: 10.1093/ntr/nts222] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Cigar, cigarillo, and little cigar (CCLC) use is prevalent among adolescents, particularly among those who smoke cigarettes. METHODS Using data from a longitudinal study of smoking patterns among adolescents, we examined differences between CCLC users (ever and past 30 days) and nonusers (never and not in the past 30 days) among adolescents who smoked a cigarette in the last month (n = 486). RESULTS In our sample, 76.7% reported ever trying CCLC and 40.7% reported past month CCLC use. Bivariate analyses showed that CCLC users differed from nonusers in terms of demographics, other forms of tobacco use, other substance use, and mental health. Multivariate logistic regression analyses found that both ever and past 30-day CCLC use were strongly associated with being male and concurrent use of hookah. Ever CCLC use was also strongly associated with recent use of alcohol, and past 30-day CCLC use was strongly associated with antisocial behavior. After controlling for the number of days on which cigarettes were smoked in the past 30 days, past 30-day CCLC use was associated with most other forms of tobacco use, other substance use, and mental health, but not with number of cigarettes smoked in the past month and nicotine dependence. CONCLUSIONS Results suggest that CCLC use is high among adolescent cigarette users and is associated with a variety of negative correlates. Importantly, many of these relationships are not accounted for by the adolescent's level of cigarette use. Further characterizing CCLC use will be important for developing more targeted and tailored interventions.
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Affiliation(s)
- Randi M Schuster
- Department of Psychology, University of Illinois at Chicago, Chicago, IL 60608, USA.
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Lee PN, Forey BA, Coombs KJ. Systematic review with meta-analysis of the epidemiological evidence in the 1900s relating smoking to lung cancer. BMC Cancer 2012; 12:385. [PMID: 22943444 PMCID: PMC3505152 DOI: 10.1186/1471-2407-12-385] [Citation(s) in RCA: 180] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Accepted: 07/18/2012] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Smoking is a known lung cancer cause, but no detailed quantitative systematic review exists. We summarize evidence for various indices. METHODS Papers published before 2000 describing epidemiological studies involving 100+ lung cancer cases were obtained from Medline and other sources. Studies were classified as principal, or subsidiary where cases overlapped with principal studies. Data were extracted on design, exposures, histological types and confounder adjustment. RRs/ORs and 95% CIs were extracted for ever, current and ex smoking of cigarettes, pipes and cigars and indices of cigarette type and dose-response. Meta-analyses and meta-regressions investigated how relationships varied by study and RR characteristics, mainly for outcomes exactly or closely equivalent to all lung cancer, squamous cell carcinoma ("squamous") and adenocarcinoma ("adeno"). RESULTS 287 studies (20 subsidiary) were identified. Although RR estimates were markedly heterogeneous, the meta-analyses demonstrated a relationship of smoking with lung cancer risk, clearly seen for ever smoking (random-effects RR 5.50, CI 5.07-5.96) current smoking (8.43, 7.63-9.31), ex smoking (4.30, 3.93-4.71) and pipe/cigar only smoking (2.92, 2.38-3.57). It was stronger for squamous (current smoking RR 16.91, 13.14-21.76) than adeno (4.21, 3.32-5.34), and evident in both sexes (RRs somewhat higher in males), all continents (RRs highest for North America and lowest for Asia, particularly China), and both study types (RRs higher for prospective studies). Relationships were somewhat stronger in later starting and larger studies. RR estimates were similar in cigarette only and mixed smokers, and similar in smokers of pipes/cigars only, pipes only and cigars only. Exceptionally no increase in adeno risk was seen for pipe/cigar only smokers (0.93, 0.62-1.40). RRs were unrelated to mentholation, and higher for non-filter and handrolled cigarettes. RRs increased with amount smoked, duration, earlier starting age, tar level and fraction smoked and decreased with time quit. Relationships were strongest for small and squamous cell, intermediate for large cell and weakest for adenocarcinoma. Covariate-adjustment little affected RR estimates. CONCLUSIONS The association of lung cancer with smoking is strong, evident for all lung cancer types, dose-related and insensitive to covariate-adjustment. This emphasises the causal nature of the relationship. Our results quantify the relationships more precisely than previously.
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Affiliation(s)
- Peter N Lee
- P N Lee Statistics and Computing Ltd, Sutton, Surrey, United Kingdom
| | - Barbara A Forey
- P N Lee Statistics and Computing Ltd, Sutton, Surrey, United Kingdom
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Abstract
A wide variety of non-cigarette forms of tobacco and nicotine exist, and their use varies regionally and globally. Smoked forms of tobacco such as cigars, bidis, kreteks and waterpipes have high popularity and are often perceived erroneously as less hazardous than cigarettes, when in fact their health burden is similar. Smokeless tobacco products vary widely around the world in form and the health hazards they present, with some clearly toxic forms (eg, in South Asia) and some forms with far fewer hazards (eg, in Sweden). Nicotine delivery systems not directly reliant on tobacco are also emerging (eg, electronic nicotine delivery systems). The presence of such products presents challenges and opportunities for public health. Future regulatory actions such as expansion of smoke-free environments, product health warnings and taxation may serve to increase or decrease the use of non-cigarette forms of tobacco. These regulations may also bring about changes in non-cigarette tobacco products themselves that could impact public health by affecting attractiveness and/or toxicity.
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Leatherdale ST, Rios P, Elton-Marshall T, Burkhalter R. Cigar, cigarillo, and little cigar use among Canadian youth: are we underestimating the magnitude of this problem? J Prim Prev 2012; 32:161-70. [PMID: 21809109 DOI: 10.1007/s10935-011-0248-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Data from 29,296 students in grades 9-12 as part of the 2008-2009 Youth Smoking Survey were used to examine the prevalence of cigar, cigarillo, and little cigar use and factors associated with their use. Among Canadian youth in grades 9-12, 12.9% reported current use of cigarillos or little cigars, and 8.1% reported current use of cigars. The characteristics of youth most likely to use either cigars or cigarillos and little cigars were being male, being in grade 11 or 12, being a daily or occasional cigarette smoker, having more than $20 of weekly spending money, and having ever tried flavored tobacco. Our findings suggest that cigars, cigarillos, and little cigars are used by a substantial number of Canadian youth, many of whom do not smoke cigarettes. As such, current national prevalence estimates of youth smoking may be underestimated, and existing tobacco control prevention programs and policies may be overlooking a large population of at-risk youth.
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Affiliation(s)
- Scott T Leatherdale
- Department of Health Studies and Gerontology, University of Waterloo, 200 University Avenue, Waterloo, ON, N2L 3G1, Canada.
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Richardson A, Xiao H, Vallone DM. Primary and dual users of cigars and cigarettes: profiles, tobacco use patterns and relevance to policy. Nicotine Tob Res 2012; 14:927-32. [PMID: 22259149 DOI: 10.1093/ntr/ntr306] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The Family Smoking Prevention and Tobacco Control Act provides an unprecedented opportunity to regulate tobacco in the United States. However, restrictions on little cigars, cigarillos, and large cigars are notably absent from the Act, which may create a favorable environment for increased dual usage of cigars. The purpose of this study is to examine demographic profiles and tobacco use behaviors of dual, as opposed to primary, users of cigarettes and cigars. METHODS This study used data from a cross-sectional nationally representative survey of 2,649 adult smokers and nonsmokers. Multivariable regression analysis was used to compare the demographic characteristics and tobacco use behaviors of dual users versus cigarette-only smokers. RESULTS Data indicate that 12.5% of cigarette smokers are dual users of cigars. Dual users are more likely to be male, 18-29 years of age, non-Hispanic Black, of lower educational attainment, and either unemployed or out of the work force. Dual users were less likely than cigarette-only smokers to be daily cigarette smokers (odds ratio [OR] = 0.57, 95% CI: 0.32, 1.02), more likely to have made a recent quit attempt (OR = 2.39, 95% CI: 1.44, 3.97), and more likely to have used at least one other alternative product (OR = 2.26, 95% CI: 1.26, 4.05), including snus, e-cigarettes, dissolvables, and chewing tobacco. CONCLUSIONS As greater restrictions on cigarettes become implemented in the United States, it will be critical to monitor increased dual use of cigars, in order to inform prevention and treatment strategies and guide more comprehensive policy efforts.
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Dela Cruz CS, Tanoue LT, Matthay RA. Lung cancer: epidemiology, etiology, and prevention. Clin Chest Med 2011. [PMID: 22054876 DOI: 10.1016/j.ccm.2011.09.001.lung] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Lung cancer is the leading cause of cancer death in the United States and around the world. A vast majority of lung cancer deaths are attributable to cigarette smoking, and curbing the rates of cigarette smoking is imperative. Understanding the epidemiology and causal factors of lung cancer can provide additional foundation for disease prevention. This article focuses on modifiable risk factors, including tobacco smoking, occupational carcinogens, diet, and ionizing radiation. It also discusses briefly the molecular and genetic aspects of lung carcinogenesis.
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Affiliation(s)
- Charles S Dela Cruz
- Pulmonary and Critical Care Medicine Section, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, TAC S441-C, New Haven, CT 06519, USA.
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Abstract
Lung cancer is the leading cause of cancer death in the United States and around the world. A vast majority of lung cancer deaths are attributable to cigarette smoking, and curbing the rates of cigarette smoking is imperative. Understanding the epidemiology and causal factors of lung cancer can provide additional foundation for disease prevention. This article focuses on modifiable risk factors, including tobacco smoking, occupational carcinogens, diet, and ionizing radiation. It also discusses briefly the molecular and genetic aspects of lung carcinogenesis.
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Affiliation(s)
- Charles S Dela Cruz
- Pulmonary and Critical Care Medicine Section, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, TAC S441-C, New Haven, CT 06519, USA.
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Sterling KL, Mermelstein R. Examining hookah smoking among a cohort of adolescent ever smokers. Nicotine Tob Res 2011; 13:1202-9. [PMID: 21896886 DOI: 10.1093/ntr/ntr146] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Evidence suggests that hookah smoking is growing among adolescents, particularly among those with a history of cigarette smoking, and is an emerging public health concern. We examined hookah use and its correlates among a sample of adolescents who have ever smoked and may be considered high risk for hookah use. METHODS We examined differences between hookah users and nonusers among a cohort of 951 adolescents (75.3% of the baseline sample, mean age 17.6 years at 24 months), consisting exclusively of youth who reported ever smoking cigarettes who were participating in a longitudinal study of adolescent smoking predictors and patterns. Ever and 30-day hookah use were assessed at 24 months. RESULTS Of the 951 participants, 58.5% reported ever use and 30.2% reported smoking hookah at least 1 day in the past 30 days. Multivariate logistic regression analyses found that 30-day hookah use was associated with sex (p < .05); race (p < .001); current cigarette (p < .0001), cigar (p < .01), kretek (p < .05), and alcohol use (p < .01); and attending a hookah bar, lounge, or restaurant (p < .001). Participants who were male, White, and were concurrent users of multiple tobacco products and other substances had increased odds of 30-day hookah use. CONCLUSIONS Prevalence of hookah use is high among youth who have already tried cigarette smoking and is associated with a variety of tobacco and other substance use behaviors. Evidence-based programs may be needed to prevent initiation of or reduce Hookah smoking, as well as address cooccurring problem behaviors, to lessen the health risks associated with use among adolescents.
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Affiliation(s)
- Kymberle L Sterling
- Institute of Public Health, Georgia State University, 140 Decatur Street SE, Atlanta, GA 30303, USA.
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Cullen J, Mowery P, Delnevo C, Allen JA, Sokol N, Byron MJ, Thornton-Bullock A. Seven-year patterns in US cigar use epidemiology among young adults aged 18-25 years: a focus on race/ethnicity and brand. Am J Public Health 2011; 101:1955-62. [PMID: 21852638 DOI: 10.2105/ajph.2011.300209] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined patterns in cigar use among young adults, aged 18-25 years, focusing on race/ethnicity and brand. METHODS We conducted a secondary data analysis of cross-sectional waves of the National Survey on Drug Use and Health, 2002-2008, using multivariate logistic regression to assess time trends in past 30 days cigar use, past 30 days use of a "top 5" cigar brand, cigar use intensity, and age at first cigar use. RESULTS Cigar use has increased among White non-Hispanic men aged 18 to 25 years, from 12.0% in 2002 to 12.7% in 2008. Common predictors of all outcomes included male gender and past 30 days use of cigarettes, marijuana, and blunts. Additional predictors of past 30 days cigar and "top 5" brand use included younger age, non-Hispanic Black or White race, lower income, and highest level of risk behavior. College enrollment predicted intensity of use and "top 5" brand use. CONCLUSIONS Recent legislative initiatives have changed how cigars are marketed and may affect consumption. National surveys should include measures of cigar brand and little cigar and cigarillo use to improve cigar use estimates.
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Affiliation(s)
- Jennifer Cullen
- Research and Evaluation Department, American Legacy Foundation, Washington, DC, USA.
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Chéron-Launay M, Le Faou AL, Sévilla-Dedieu C, Gilbert F, Kovess-Masfety V. Smoking and the consumption of antidepressants, anxiolytics and hypnotic drugs: results of a large, French epidemiological study in 2005. Addict Behav 2011; 36:743-8. [PMID: 21420792 DOI: 10.1016/j.addbeh.2011.02.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Revised: 12/16/2010] [Accepted: 02/21/2011] [Indexed: 11/26/2022]
Abstract
The aim of this study was to describe and analyse the links between the consumption of psychotropic drugs and smoking, based on data from individuals subscribing to a health insurance organisation (a mutuelle) in France in 2005. Data on smoking status, depression, anxiety and alcohol consumption from a large transversal epidemiological study carried out in 2005 were analysed in parallel to individual data concerning the reimbursement of medical prescriptions for psychotropic drugs. We compared reimbursement data for psychotropic drugs between individuals who had smoked for at least 15 years and continued to smoke and individuals who had stopped smoking after at least 15 years of smoking. This group of ex-smokers was subdivided into three subgroups on the basis of the number of years elapsed since the time point at which the individual had been smoking for 15 years: 1 to 9 years, 10 to 19 years and 20 years or more. "Ex-smoker" status was associated with a lower risk of psychotropic drug prescription than "current smoker" status (OR=0.81 for anxiolytics, OR=0.74 for antidepressants). Analysis of the subgroups of smokers and ex-smokers also showed that mean annual consumption of antidepressants and anxiolytics was significantly lower for individuals who had stopped smoking after at least 15 years of the habit than for those who continued to smoke (respectively 1.34 versus 0.65 for anxiolytics, and 1.17 versus 0.62 for antidepressants). Our findings suggest that stopping smoking is associated with a decrease in the consumption of psychotropic drugs. They highlight the need to evaluate the medium- and long-term effects of stopping smoking on psychotropic drug consumption in more detail, taking into account the anxious and depressive disorders to which smokers are particularly prone.
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Trapl ES, Terchek JJ, Danosky L, Cofie L, Brooks-Russell A, Frank SH. Complexity of measuring "cigar use" in adolescents: results from a split sample experiment. Nicotine Tob Res 2011; 13:291-5. [PMID: 21330280 DOI: 10.1093/ntr/ntq247] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Inclusion of brand-specific examples (BE) in health surveys assessing lifetime and current cigar use has been shown to impact response rates. A split sample experimental design was used to investigate whether these rates are consistent by race, gender, and geographic locale. METHODS The 2009 Cuyahoga County Youth Risk Behavior Survey was conducted among 20 randomly selected high schools. Two versions of the survey were created; the first included items assessing lifetime and current cigar use with no brand-specific examples (NBE) while the second included BE in the items assessing cigar use. Both survey versions were distributed randomly within selected classrooms in participating schools. RESULTS Within the City, both White and Black BE respondents reported higher lifetime cigar product use prevalence and current cigar product use compared to the NBE group; however, the difference was only significant among Black respondents (odds ratio [OR] = 1.45, 95% CI 1.02-2.06). In the Outer Ring, White BE respondents were significantly less likely to report lifetime cigar use (OR = 0.73, 95% CI: 0.54 - 0.98) and current cigar use (OR = 0.66, 95% CI: 0.44-0.99) when compared with White NBE respondents. CONCLUSIONS Inclusion of BE in current measures of cigar product use may improve product use estimates in at-risk groups. However, better estimation of cigar product use may be accomplished by creating additional items to assess the use of subtypes of cigars.
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Affiliation(s)
- Erika S Trapl
- Department of Epidemiology and Biostatistics, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4945, USA.
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Vaccarezza GF, Antunes JLF, Michaluart-Júnior P. Recurrent sores by ill-fitting dentures and intra-oral squamous cell carcinoma in smokers. J Public Health Dent 2010; 70:52-7. [PMID: 19694933 DOI: 10.1111/j.1752-7325.2009.00143.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine whether denture use and recurrent sores caused by ill-fitting dentures are associated with intra-oral squamous cell carcinoma (IO-SCC) in individuals exposed to tobacco. METHODS We conducted a hospital-based case-control study. The study population 124 patients wi th IO-SCC and the same number of controls (individually paired according to gender and age) recruited from outpatient units of the same hospital. Conditional logistic regression analysis assessed the effect of denture use and recurrent oral sores by ill-fitting dentures, adjusted by covariates on the lifetime exposure to alcohol and tobacco, socioeconomic standings, and dietary patterns. RESULTS The use of dentures showed no association with IO-SCC [adjusted odds ratio (OR) 1.40, 95 percent confidence interval 0.51-3.87, P = 0.513] in an assessment controlled by socioeconomic position, lifetime exposure to alcohol and tobacco, and dietary patterns. However, the report of recurrent sores caused by ill-fitting dentures showed significant association with the disease (adjusted OR 4.58, 95 percent confidence interval 1.52-13.76, P = 0.007). CONCLUSIONS The association between recurrent oral sores caused by ill-fitting dentures and squamous cell carcinoma of the mouth in smokers is in agreement with the hypothesis that the chronic physical irritation of oral mucosa contributes to the topical carcinogenic effect of tobacco, which must be taken into careful consideration in the planning of dental services for adults and the elderly.
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Lee YCA, Marron M, Benhamou S, Bouchardy C, Ahrens W, Pohlabeln H, Lagiou P, Trichopoulos D, Agudo A, Castellsague X, Bencko V, Holcatova I, Kjaerheim K, Merletti F, Richiardi L, Macfarlane GJ, Macfarlane TV, Talamini R, Barzan L, Canova C, Simonato L, Conway DI, McKinney PA, Lowry RJ, Sneddon L, Znaor A, Healy CM, McCartan BE, Brennan P, Hashibe M. Active and involuntary tobacco smoking and upper aerodigestive tract cancer risks in a multicenter case-control study. Cancer Epidemiol Biomarkers Prev 2010; 18:3353-61. [PMID: 19959682 DOI: 10.1158/1055-9965.epi-09-0910] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Several important issues for the established association between tobacco smoking and upper aerodigestive tract (UADT) cancer risks include the associations with smoking by cancer subsite, by type of tobacco, and among never alcohol drinkers and the associations with involuntary smoking among nonsmokers. Our aim was to examine these specific issues in a large-scale case-control study in Europe. METHODS Analysis was done on 2,103 UADT squamous cell carcinoma cases and 2,221 controls in the Alcohol-Related Cancers and Genetic Susceptibility in Europe project, a multicenter case-control study in 10 European countries. Unconditional logistic regression was done to obtain odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS Compared with never tobacco smoking, current smoking was associated with UADT cancer risks (OR, 6.72; 95% CI, 5.45-8.30 for overall; OR, 5.83; 95% CI, 4.50-7.54 for oral cavity and oropharynx; OR, 12.19; 95% CI, 8.29-17.92 for hypopharynx and larynx; and OR, 4.17; 95% CI, 2.45-7.10 for esophagus). Among never drinkers, dose-response relationships with tobacco smoking pack-years were observed for hypopharyngeal and laryngeal cancers (P(trend) = 0.010) but not for oral cavity and oropharyngeal cancers (P(trend) = 0.282). Among never smokers, ever exposure to involuntary smoking was associated with an increased risk of UADT cancers (OR, 1.60; 95% CI, 1.04-2.46). CONCLUSION Our results corroborate that tobacco smoking may play a stronger role in the development of hypopharyngeal and laryngeal cancers than that of oral cavity and oropharyngeal cancers among never drinkers and that involuntary smoking is an important risk factor for UADT cancers. Public health interventions to reduce involuntary smoking exposure could help reduce UADT cancer incidence.
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Rodriguez J, Jiang R, Johnson WC, MacKenzie BA, Smith LJ, Barr RG. The association of pipe and cigar use with cotinine levels, lung function, and airflow obstruction: a cross-sectional study. Ann Intern Med 2010; 152:201-10. [PMID: 20157134 PMCID: PMC2906916 DOI: 10.7326/0003-4819-152-4-201002160-00004] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cigarette smoking is the major cause of chronic obstructive pulmonary disease, but studies on the contribution of other smoking techniques are sparse. OBJECTIVE To determine whether pipe and cigar smoking was associated with elevated cotinine levels, decrements in lung function, and increased odds of airflow obstruction. DESIGN Cross-sectional study. SETTING Population-based sample from 6 U.S. communities. PARTICIPANTS Men and women aged 48 to 90 years without clinical cardiovascular disease at enrollment who were part of MESA (Multi-Ethnic Study of Atherosclerosis). MEASUREMENTS The MESA Lung Study measured spirometry according to American Thoracic Society guidelines and urine cotinine levels by immunoassay on a subsample of MESA. Pipe-years and cigar-years were calculated as years from self-reported age of starting to age of quitting (or to current age in current users) multiplied by pipe-bowls or cigars per day. RESULTS Of 3528 participants, 9% reported pipe smoking (median, 15 pipe-years), 11% reported cigar smoking (median, 6 cigar-years), and 52% reported cigarette smoking (median, 18 pack-years). Self-reported current pipe and cigar smokers had elevated urine cotinine levels compared with never-smokers. Pipe-years were associated with decrements in FEV(1), and cigar-years were associated with decrements in the FEV(1)-FVC ratio. Participants who smoked pipes or cigars had increased odds of airflow obstruction whether they had also smoked cigarettes (odds ratio, 3.43 [95% CI, 1.75 to 6.71]; P < 0.001) or not (odds ratio, 2.31 [CI, 1.04 to 5.11]; P = 0.039) compared with participants with no smoking history. LIMITATION Cross-sectional design. CONCLUSION Pipe and cigar smoking increased urine cotinine levels and was associated with decreased lung function and increased odds of airflow obstruction, even in participants who had never smoked cigarettes. PRIMARY FUNDING SOURCE National Heart, Lung, and Blood Institute, National Institutes of Health.
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Affiliation(s)
- Josanna Rodriguez
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Rui Jiang
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, N.Y
| | - W. Craig Johnson
- Department of Biostatistics, University of Washington, Seattle, WA
| | | | - Lewis J. Smith
- Department of Medicine, Northwestern University, Chicago, IL
| | - R. Graham Barr
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, N.Y
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Launay M, Le Faou AL, Sevilla-Dedieu C, Pitrou I, Gilbert F, Kovess-Masfety V. Prevalence of tobacco smoking in teachers following anti-smoking policies: results from two French surveys (1999 and 2005). Eur J Public Health 2009; 20:151-6. [DOI: 10.1093/eurpub/ckp149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
There are many preparations for tobacco use, which can be classified as smoking or smokeless tobacco. Among the noncigarette preparations that produce smoke, we cite cigars, pipes and narghiles. Smokeless tobacco can be found in preparations for chewing or for being absorbed by nasal and oral mucosae (snuff). However, all tobacco products deliver nicotine to the central nervous system and there is a confirmed risk of dependence. In addition, there is no safe form of tobacco use, and tobacco users have a significantly increased risk of morbidity and premature mortality due to tobacco-related diseases.
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Hassan MM, Spitz MR, Thomas MB, El-Deeb AS, Glover KY, Nguyen NT, Chan W, Kaseb A, Curley SA, Vauthey JN, Ellis LM, Abdalla E, Lozano RD, Patt YZ, Brown TD, Abbruzzese JL, Li D. Effect of different types of smoking and synergism with hepatitis C virus on risk of hepatocellular carcinoma in American men and women: case-control study. Int J Cancer 2008; 123:1883-91. [PMID: 18688864 PMCID: PMC2673571 DOI: 10.1002/ijc.23730] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The International Agency for Research on Cancer has declared smoking to be a risk factor for hepatocellular carcinoma (HCC). However, passive exposure to cigarette smoke and use of noncigarette tobacco products on the risk of HCC has not been examined. Therefore, we evaluated the independent effects of different types of smoking exposure along with multiple risk factors for HCC and determined whether the magnitude of smoking was modified by other risk factors in men and women. We conducted a case-control study at The University of Texas M. D. Anderson Cancer Center where 319 HCC patients and 1,061 healthy control subjects were personally interviewed for several HCC risk factors. Multivariate logistic regression analysis was performed to estimate the adjusted odds ratio (AOR) and 95% confidence interval (CI) for each potential risk factor. Use of smokeless tobacco (chewing tobacco and snuff), cigars, pipes and passive smoking exposure were not related to HCC among noncigarette smokers. However, regular cigarette smoking was associated with HCC in men: AOR, 1.9 (95% CI, 1.1-3.1). Heavy alcohol consumption was associated with HCC in women: AOR, 7.7 (95% CI, 2.3-25.1). Cigarette smoking interacted synergistically with chronic infection of hepatitis C virus in men: AOR, 136.3 (95% CI, 43.2-429.6) and with heavy alcohol consumption in women: AOR, 13.7 (95% CI, 3.2-57.9). We conclude that sex differences were observed in HCC relationship with cigarette smoking and alcohol consumption. Controlling for smoking exposure might be a prudent approach to the prevention of HCC, especially in patients with chronic viral hepatitis infections.
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Affiliation(s)
- Manal M Hassan
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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46
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Kozlowski LT, Dollar KM, Giovino GA. Cigar/cigarillo surveillance: limitations of the U.S. Department of Agriculture system. Am J Prev Med 2008; 34:424-6. [PMID: 18407010 DOI: 10.1016/j.amepre.2007.12.025] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2007] [Revised: 10/25/2007] [Accepted: 12/26/2007] [Indexed: 11/29/2022]
Abstract
BACKGROUND The U.S. Department of Agriculture (USDA) reports data on cigar sales in two categories: little cigars (weighing less than 3 lbs. per thousand) and large cigars and cigarillos (weighing more than 10 lbs. per thousand). A rise in the sales of little cigars in recent years is a cause for concern. The capacious second category could be obscuring the growth of sales in cigarillos. METHODS Trends in cigar use were analyzed in May 2007 using (1) the standard USDA two-level system and (2) data from the Maxwell Report that provides information on cigarillos as a separate category. The intercorrelations among cigar use trends in the three areas were also explored. RESULTS From 1993 to 2006, unit sales of little cigars increased from 37% to 47% of the cigar market, cigarillos increased from 25% to 32%, and large cigars dropped from 37% to 22%. From 1976 to 2006, cigarillo sales were strongly related to sales of little cigars (r=0.93; 95% CI=0.86-0.97), while sales of large cigars and cigarillos were modestly related (r=0.42; 95% CI=0.08-0.57). CONCLUSIONS Analyses show strong correlations between cigarillo and little cigar sales and argue for more detailed reporting of cigar sales as a function of cigar size. Tobacco surveillance should at minimum be watching the same trends as the tobacco industry. The sales of little cigars, cigarillos, and large cigars should be monitored, and the measuring of cigarillo sales in 3-5 subcategories according to size is encouraged.
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Affiliation(s)
- Lynn T Kozlowski
- Department of Health Behavior, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY 14214, USA.
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Vander Weg MW, Peterson AL, Ebbert JO, DeBon M, Klesges RC, Haddock CK. Prevalence of alternative forms of tobacco use in a population of young adult military recruits. Addict Behav 2008; 33:69-82. [PMID: 17706889 PMCID: PMC2101765 DOI: 10.1016/j.addbeh.2007.07.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2007] [Revised: 05/14/2007] [Accepted: 07/04/2007] [Indexed: 11/21/2022]
Abstract
Recent evidence suggests that the popularity of certain alternative forms of tobacco may be increasing in adolescents. Little is known, however, about the use of these products among young adults. This study examined the use of alternative tobacco products including bidis, cigars, kreteks (clove cigarettes), pipes, and smokeless tobacco in a large sample of young adult military recruits (N=31107). Overall, 18.5% of participants were using some form of alternative tobacco product prior to entry into Basic Military Training. Results revealed a relatively high prevalence of cigar (12.3%) and smokeless tobacco use (6.7%). Use of other products was less common, including 1.1% for pipes, 2.0% for bidis, and 3.0% for kreteks. With the exception of kreteks, which did not differ by gender, the prevalence of use of alternative tobacco products was greater for males than for females (p<.001). Patterns of use also differed according to other demographic characteristics including race, ethnicity, age, and income. Implications for surveillance and tobacco control efforts are discussed.
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Affiliation(s)
- Mark W. Vander Weg
- Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP), VA Medical Center, 601 Highway 6 West, Mail Stop 152, Iowa City, IA 52246, United States
- University of Iowa Carver College of Medicine, Department of Internal Medicine, 200 Hawkins Drive, Iowa City, IA 52242, United States
- * Corresponding author. VA Medical Center, 601 Highway 6 West, Mail Stop 152, Iowa City, IA 52246, United States. Tel.: +1 319 338 0581x7717; fax: +1 319 887 4932
| | - Alan L. Peterson
- University of Texas Health Sciences Center at San Antonio, Department of Psychiatry, 7703 Floyd Curl Drive, San Antonio, Texas 78229, United States
- Wilford Hall Medical Center, 59th Medical Wing, 2200 Bergquist Dr. Suite 1, Lackland AFB, TX 78236, United States
| | - Jon O. Ebbert
- Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, United States
| | - Margaret DeBon
- University of Tennessee Health Science Center, 66 N. Pauline Street, Suite 633, Memphis, Tennessee 38163, United States
| | - Robert C. Klesges
- University of Tennessee Health Science Center, 66 N. Pauline Street, Suite 633, Memphis, Tennessee 38163, United States
- St. Jude Children's Research Hospital, 332 N. Lauderdale Memphis, TN 38105, United States
| | - C. Keith Haddock
- University of Missouri — Kansas City, Department of Informatic Medicine and Personalized Health, Western Missouri Mental Health Center, 1000 East 24th Street, Kansas City, MO 64108, United States
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Alberg AJ, Ford JG, Samet JM. Epidemiology of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 2007; 132:29S-55S. [PMID: 17873159 DOI: 10.1378/chest.07-1347] [Citation(s) in RCA: 421] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The objective of this study was to summarize the published literature concerning the epidemiology of lung cancer. METHODS A narrative review of published evidence was conducted, identifying and summarizing key reports that describe the occurrence of lung cancer in populations and factors that affect lung cancer risk. RESULTS In the United States, lung cancer remains the leading cause of cancer death in both men and women, even though an extensive list of modifiable risk factors has long been identified. The predominant cause of lung cancer is exposure to tobacco smoke, with active smoking causing most cases but passive smoking also contributing to the lung cancer burden. CONCLUSIONS The reductions in smoking prevalence in men that occurred in the late 1960s through the 1980s will continue to drive lung cancer mortality rates downward in men during the first portion of this century, but rates in women have not yet begun to decrease. Fortunately, exposures to major occupational respiratory carcinogens have largely been controlled, but the population is still exposed to environmental causes of lung cancer, including radon, the second leading cause of lung cancer death.
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Affiliation(s)
- Anthony J Alberg
- Hollings Cancer Center, Medical University of South Carolina, 86 Jonathan Lucas St, PO Box 250955, Charleston, SC 29425, USA.
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Sartor SG, Eluf-Neto J, Travier N, Wünsch Filho V, Arcuri ASA, Kowalski LP, Boffetta P. Riscos ocupacionais para o câncer de laringe: um estudo caso-controle. CAD SAUDE PUBLICA 2007; 23:1473-81. [PMID: 17546338 DOI: 10.1590/s0102-311x2007000600022] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2006] [Accepted: 01/11/2007] [Indexed: 11/21/2022] Open
Abstract
O tabagismo e o consumo de álcool são os fatores de risco mais bem estabelecidos para o câncer de laringe. Com relação aos fatores ocupacionais, o único carcinógeno estabelecido é a exposição a névoas de ácidos inorgânicos fortes. Entretanto, asbesto, pesticidas, tintas, gases de combustão de gasolina e diesel e poeiras, entre outros, aparecem na literatura como agentes ocupacionais que aumentam o risco de câncer de laringe. Um estudo caso-controle de base hospitalar foi conduzido para investigar fatores de risco ocupacionais para câncer de laringe. Foram coletadas informações detalhadas sobre tabagismo, consumo de álcool e história ocupacional de 122 casos de câncer de laringe e 187 controles pareados por freqüência (segundo sexo e idade). Encontrou-se risco aumentado de câncer de laringe nos indivíduos com exposição à sílica cristalina livre respirável (OR = 1,83; IC95%: 1,00-3,36), à fuligem (de carvão mineral, coque, madeira, óleo combustível) (OR = 1,78; IC95%: 1,03-3,03), a fumos em geral (OR = 2,55; IC95%: 1,14-5,67) e a animais vivos (OR = 1,80; IC95%: 1,02-3,19).
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Affiliation(s)
- Sergio Guerra Sartor
- Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Arnaldo 455, São Paulo, SP 01246-903, Brazil.
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Randi G, Scotti L, Bosetti C, Talamini R, Negri E, Levi F, Franceschi S, La Vecchia C. Pipe smoking and cancers of the upper digestive tract. Int J Cancer 2007; 121:2049-2051. [PMID: 17631642 DOI: 10.1002/ijc.22791] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Pipe smoking has been related to the risk of cancers of the upper digestive and respiratory tract, but quantification of the risk for exclusive pipe smokers is still limited. To analyse the association between exclusive pipe smoking and cancers of the upper digestive tract, we used data from a series of case-control studies conducted in Italy and Switzerland between 1984 and 1999. After excluding cigarette and cigar smokers, 41 male oral and pharyngeal cancer cases, 52 male oesophageal cancer cases and 1,032 male controls were included in the present analysis. Odds ratios (OR) of cancers were estimated by the mean of unconditional multivariate logistic regression, including terms for age, study centre, education, body mass index, and alcohol drinking. Compared to never smokers, exclusive pipe smokers had an OR of 8.7 [95% confidence intervals (CI): 4.0-18.9] of all upper digestive tract cancers. The OR was 12.6 for oral and pharyngeal and 7.2 for oesophageal cancer. Pipe smokers who were also heavy alcohol drinkers had an OR of 38.8 (95% CI: 13.6-110.9) as compared to never smokers and light drinkers. Thus, pipe smoking and heavy alcohol drinking appears to interact at least on a multiplicative model.
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Affiliation(s)
- Giorgia Randi
- Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
- Istituto di Statistica Medica e Biometria "G.A. Maccacaro", Università degli Studi di Milano, Milan, Italy
| | - Lorenza Scotti
- Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - Cristina Bosetti
- Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - Renato Talamini
- Servizio di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Aviano, Italy
| | - Eva Negri
- Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - Fabio Levi
- Unité d'épidémiologie du cancer, Institut Universitaire de Médicine Sociale et Préventive, Université de Lausanne, Lausanne, Switzerland
| | | | - Carlo La Vecchia
- Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
- Istituto di Statistica Medica e Biometria "G.A. Maccacaro", Università degli Studi di Milano, Milan, Italy
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