The benefits of cessation of smoking

Using the Law to Protect Health: The Frustrating Case of Smoking

It is Recommended … That it be recognized by all organizations and associations concerned with smoking and health that the campaign against smoking is political and economic in character and requires decisions based on political and economic factors.

The only way we know today to stop cancer is to stop smoking. …

Cancer morbidity of professional emergency responders in Korea

BACKGROUND

Many professional emergency responders (ERs) who belong to the Korean National Emergency Management Agency (NEMA) have been cross-trained and serve multiple roles. As such, firefighters and other ERs in Korea are exposed to similar occupational hazards. This study was conducted to estimate cancer morbidity in male ERs and compare that with Korean men.

METHODS

The cohort was comprised of 33,416 male ERs working between 1980 and 2007, who were alive on December 31, 1995. Work histories were merged with the Korea National Central Cancer Registry (KNCCR) to assess cancer morbidity between 1996 and 2007. Standardized incidence ratios (SIRs) with reference to Korean men were analyzed.

RESULTS

SIRs with reference to national cancer rates were not significantly decreased for overall cancer (SIR = 0.97, 95% CI = 0.90-1.08) in all ERs. However, colorectal (SIR = 1.35, 95% CI = 1.07-1.67), kidney (SIR = 1.59, 95% CI = 1.00-2.41), and bladder (SIR = 1.77, 95% CI = 1.08-2.73) cancer, and non-Hodgkin's lymphoma (SIR = 1.81, 95% CI = 1.12-2.76) morbidities were significantly increased among all ERs. In firefighters, significantly increased cancer types were as same as those of all ERs. In non-firefighter ERs, colorectal (SIR = 2.51, 95% CI = 1.20-4.61) and bone and articular cartilage cancers (SIR = 9.53, 95% CI = 1.07-34.41) were significantly higher than those of Korean men.

CONCLUSIONS

Korean firefighters showed excess morbidity in several cancer types, including colorectal and urologic cancers, and non-Hodgkin's lymphoma, demonstrating similar trends to previous studies for firefighters conducted in other countries. Increased incidence in these cancer types suggests occupational exposure to carcinogens and shift work.

Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, November 1986

Chronic obstructive pulmonary disease (COPD) and asthma are the major causes of pulmonary disability in the United States, with at least 10 million Americans suffering form COPD and up to 5% of the population afflicted with asthma. Over the past 20 years, major strides have been made in our understanding of the pathophysiology of these disorders, although there are still large gaps in our knowledge. While a number of position papers and statements have been promulgated by the American Thoracic Society concerning various aspects of the diagnosis and treatment of COPD and asthma, it was felt that a review of the overall topic was timely. This statement represents the combined efforts of a Task Group appointed by the Scientific Assemble of Clinical Problems of the American Thoracic Society to accomplish this task. Clearly, we could not cover every aspect of this broad topic nor even provide a detailed review of those areas addressed. We elected instead to concentrate on clinically relevant topics and to provide sufficient data to be useful as a guide as well as to include selected, but in no was exhaustive, references. The first two chapters define the entities and set forth recommendations for diagnosis, hospital admission, and discharge. The remaining four chapters critically review the various facets of therapy. We have noted controversial areas and those were conclusive experimental data are not yet available. In these situations, the committee often decided to take a position on one side or the other based upon the best available information.

Smoking cessation among coal miners as predicted by baseline respiratory function and symptoms: a 5-year prospective study

A prospective analysis was used to test whether respiratory impairment or the presence of respiratory symptoms predicts 5-year cigarette smoking cessation in a sample of 1,118 U.S. white, male, underground coal miners. Miners were examined in 1977 and re-examined in 1982 by NIOSH, and all miners with test abnormalities were so informed by letter. Respiratory impairment was measured by an index of airways obstruction combining the spirometric measures of Forced Vital Capacity (FVC) and Forced Expiratory Volume in 1 sec (FEV1). Bronchitis symptoms were measured by an index that combined chronic cough (3+ months/year) and chronic phlegm (3 + months/year). Among these coal miners, the presence of chronic respiratory symptoms initially was inversely associated with cigarette smoking cessation. Respiratory impairment, however, was positively associated with cigarette smoking cessation but did not reach statistical significance.

Chronic respiratory effects of exposure to diesel emissions in coal mines

A 5-yr prospective design was employed to test the hypothesis that exposure to diesel emissions leads to chronic respiratory effects among underground coal miners. Changes in respiratory function and development of chronic respiratory symptoms were measured during a 5-yr study period (i.e., 1977 to 1982) in 280 diesel-exposed and 838 control miners from Eastern and Western United States underground coal mines. Spirometry measures of respiratory function included forced expiratory volume in 1 sec (FEV1.0), forced vital capacity (FVC), and forced expiratory flow rate at 50% of FVC (FEF50). Chronic respiratory symptom measures, which included chronic cough, chronic phlegm, and breathlessness, were obtained by questionnaires, as were smoking status and occupational history. Based upon these data, the pattern of evidence did not support the hypothesis either in an age-adjusted comparison of diesel vs. nondiesel miners or in an internal analysis by cumulative years of diesel exposure.

Worksite smoking cessation initiatives: review and recommendations

Offering health lifestyle change assistance in the workplace represents a major challenge for behavioral scientists and behavior therapists in the 1980's. Business and industry are showing special interest in employee smoking cessation. This paper reviews a wide range of worksite smoking cessation activities and related research. Six types of intervention are discussed: educational campaigns; policies restricting workplace smoking; self-help programs; physical examination and physician advice; incentive programs; and actual smoking cessation services. Existing research is critically reviewed. Practical recommendations for improving and systematically evaluating worksite quit smoking initiatives are presented.

Coronary artery bypass surgery; a stimulus to modify existing risk factors?

Coronary arterial atherosclerosis is known to be associated with the risk factors of a positive family history, smoking, systemic hypertension, diabetes mellitus, and elevated serum cholesterol levels. Modification of these risk factors, where possible, is prudent. The risk factor data of 226 (212 men, 14 women) subjects who underwent coronary artery bypass surgery for symptomatic obstructive coronary artery disease are presented. Prior to surgery, an attempt was made to educate the subjects in regard to the risk factors and they were urged to modify these factors. All underwent repeat evaluation one year after operation. Although over half of the subjects had had a prior myocardial infarction and all had had aortocoronary bypass surgery, strong stimuli to modify risk factors, there was little modification of the risk factors of smoking and serum cholesterol. There was some modification of the hypertension risk factor. This study documents the need for a very early approach in life to prevent acquiring risk factors and the need for more research into better methods of behavior modification in the adult population.

Smoking habits and carboxyhaemoglobin. A cross-sectional study of an urban population of middle-aged men

In this cross-sectional population study we report on the distribution of carboxyhaemoglobin concentrations in the morning, before smoking, in an urban population of 1037 men born in 1931. The median concentration was the same in non-smokers as in ex-smokers: 0.5%. It increased with increasing daily tobacco consumption. But when carboxyhaemoglobin concentrations are measured in reasonably well-standardised circumstances there are large variations between individuals, even in those who smoke equal amounts of tobacco a day. This makes it difficult to predict the concentration in the individual smoker when only his daily tobacco consumption is known. Measurements of carboxyhaemoglobin concentration should be a valuable complement to smoking history to identify the smoker at high risk of cardiovascular disease, to provide an extra argument to make the patient give up the habit, and to reinforce the efforts of those who try to do so.

Behavioral approaches to smoking cessation--II. Topical bibliography 1969-1979

This topical bibliography covers that past decade of research into behavioral approaches to smoking cessation. Using multiple sources, including Psychological Abstracts, 335 reference were compiled from over 50 psychology, medicine, and related behavioral science journals. All references were comprehensively coded for each of 28 topical area of interest to behavioral researchers and clinicians. Topics include specific behavioral smoking cessation techniques (e.g. aversive smoking, relaxation techniques, stimulus control), treatment problems (e.g. maintenance problems and procedures, physiological correlates of smoking behavior, therapist and treatment factors influencing outcome). An index defining each topical and listing by number all articles related to each topic is included with the bibliography (Tables 1 and 2). With this index, users with specialized interests can quickly locate all citations concerning a particular topic or combination of topics. The preceding article (Orleans et al., 1981) gives guidelines for expanding this bibliography for personal reference use.