Tobacco Induced Diseases - Most accessed articles

Destructive effects of smoking on molecular and genetic factors of periodontal disease

Miki Ojima — 2010-02-20T00:00:00Z

Many epidemiological evidences have proven the association between smoking and periodontal disease. The causality can be further established by linking findings of traditional epidemiological studies with the developments in molecular techniques that occurred in the last decade. The present article reviews recent studies that address the effect of smoking on molecular and genetic factors in periodontal disease. Most findings support the fact that tobacco smoking modulates destruction of the periodontium through different pathways: microcirculatory and host immune systems, connective tissue, and bone metabolism. Although smokers experience an increased burden of inflammatory responses to microbial challenges compared to non-smokers, understanding the association between smoking and periodontal diseases involves substantial problems with respect to accuracy of measurements, and particularly, sampling of many subjects. It remains unclear whether genetic susceptibility to periodontal disease is influenced by exposure to smoking or the effect of smoking on periodontal disease is influenced by genetic susceptibility. Employment of molecular techniques may play a key role in further elucidation of mechanisms linking smoking and periodontal destruction, the direct relationship as environmental factors and indirect relationship through genetic factors.

Analysis of primary risk factors for oral cancer from select US states with increasing rates

Anthony Bunnell — 2010-02-23T00:00:00Z

ObjectivesTo examine the primary risk factor for oral cancer in the US, smoking and tobacco use, among the specific US states that experienced short-term increases in oral cancer incidence and mortality. Methods: Population-based data on oral cancer morbidity and mortality in the US were obtained from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) database for analysis of recent trends. Data were also obtained from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) to measure current and former trends of tobacco usage. To comprehensive measures of previous state tobacco use and tobacco-related policies, the Initial Outcomes Index (IOI, 1992-1993) and the Strength of Tobacco Control index (SoTC, 1999-2000) were also used for evaluation and comparison. Results: Analysis of the NCI-SEER data confirmed a previous report of geographic increases in oral cancer and demonstrated these were state-specific, were not regional, and were unrelated to previously observed increases among females and minorities. Analysis of the CDC-BRFSS data revealed these states had relatively higher percentages of smokers currently, as well as historically. In addition, analysis of the IOI and SoTC indexes suggest that many factors, including cigarette pricing, taxes and home or workplace bans, may have had significant influence on smoking prevalence in these areas. Trend analysis of these data uncovered a recent and significant reversal in smoking rates that suggest oral cancer incidence and mortality may also begin to decline in the near future. Conclusion: Due to the rising costs of health care in the US and the limited resources available for health prevention efforts, it is essential to organize and direct more effective efforts by public health officials and epidemiologists, as well as funding from local, state and federal governments, to reduce and eliminate identified health disparities. This study provides evidence how these efforts may be directed to specific geographic areas, and towards the white males, previously thought to be unaffected by the increases in oral cancer among females and minorities.

Perceptions of hookah smoking harmfulness: predictors and characteristics among current hookah users

Khaled Aljarrah — 2009-12-18T00:00:00Z

IntroductionTobacco cigarette smoking a well-known cause of cancer and other diseases. Hookah smoking is another form of tobacco use that has rapidly spread in the United State and Europe. This study assessed beliefs about the harmfulness of smoking hookah. Methods: We surveyed hookah users in all cafes that provided hookah to its customers in downtown San Diego, California and nearby areas. A total of 235 hookah users participated in this study. Results: Average age of study participants was 22 years, 57% were males, and 72% were not cigarette smokers. Whites were more likely to use hookah than the other ethnic groups (33%), older hookah users (26-35 years) were mostly males, and mint flavor of hookah tobacco was the most popular among a wide variety of flavors (23%). There was no significant difference in gender in relation to the wrong perception that hookah is less harmful than cigarettes, but those of Asian ethnicity were much less likely than other ethnic groups to believe that hookah is less harmful than cigarettes. More frequent users of hookah were more likely to believe that hookah is less harmful than cigarettes. The majority of hookah users (58.3%) believe hookah is less harmful than cigarette smoking.DiscussionCompared to cigarettes, there appears to be a lack of knowledge about the harmfulness of smoking hookah among users regardless of their demographic background. Education about the harmfulness of smoking hookah and policies to limit its use should be implemented to prevent the spread of this new form of tobacco use.

Tobacco use prevalence, knowledge, and attitudes among newly diagnosed tuberculosis patients in Penang State and Wilayah Persekutuan Kuala Lumpur, Malaysia

Ahmed Awaisu — 2010-01-12T00:00:00Z

Background: There is sufficient evidence to conclude that tobacco smoking is strongly linked to tuberculosis (TB) and a large proportion of TB patients may be active smokers. In addition, a previous analysis has suggested that a considerable proportion of the global burden of TB may be attributable to smoking. However, there is paucity of information on the prevalence of tobacco smoking among TB patients in Malaysia. Moreover, the tobacco-related knowledge, attitudes, and behaviors of TB patients who are smokers have not been previously explored. This study aimed to document the prevalence of smoking among newly diagnosed TB patients and to learn about the tobacco use knowledge and attitudes of those who are smokers among this population. Methods: Data were generated on prevalence rates of smoking among newly diagnosed TB patients in the State of Penang from January 2008 to December 2008. The data were obtained based on a review of routinely collated data from the quarterly report on TB case registration. The study setting comprised of five healthcare facilities (TB clinics) located within Penang and Wilayah Persekutuan, Kuala Lumpur health districts in Malaysia, which were involved in a larger project, known as SCIDOTS Project. A 58-item questionnaire was used to assess the tobacco use knowledge, attitudes and behaviors of those TB patients who were smokers. Results: Smoking status was determinant in 817 of 943 new cases of TB from January to December 2008. Of this, it was estimated that the prevalence rates of current- and ex-smoking among the TB patients were 40.27% (329/817) and 13.95% (114/817), respectively. The prevalence of ever-smoking among patients with TB was estimated to be 54,220 per 100,000 population. Of 120 eligible participants for the SCIDOTS Project, 88 responded to the survey (73.3% response rate) and 80 surveys were analyzed (66.7% usable rate). The mean (± SD) total score of tobacco use knowledge items was 4.23 ± 2.66 (maximum possible score=11). More than half of the participants (51.3%) were moderately dependent to nicotine. A moderately large proportion of the respondents (41.2%) reported that they have ever attempted to quit smoking, while more than half (56.3%) have not. Less than half (47.5%) of the study participants had knowledge about the body system on which cigarette smoking has the greatest negative effect. The majority wrongly believed that smokeless tobacco can increase athletic performance (60%) and that it is a safe and harmless product (46.2%). An overwhelming proportion (>80%) of the patients believed that: smoking is a waste of money, tobacco use is very dangerous to health, and that smokers are more likely to die from heart disease when compared with non-smokers. The use of smokeless tobacco was moderately prevalent among the participants with 28.8% reporting ever snuffed, but the use of cigar and pipe was uncommon. Conclusion: Smoking prevalence rate is high among patients with TB in Malaysia. These patients generally had deficiencies in knowledge of tobacco use and its health dangers, but had positive attitudes against tobacco use. Efforts should be geared towards reducing tobacco use among this population due to its negative impact on TB treatment outcomes.

Key points in preventing tobacco use among adolescents

Constantine Vardavas — 2010-01-05T00:00:00Z

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The roll-your-own cigarette market in Canada: a cross-sectional exploratory study

Scott Leatherdale — 2009-03-16T00:00:00Z

Background: Even though the use and prevalence of roll-your-own cigarettes (RYO) has been declining over the past decades, RYO remains important. Given the paucity of research examining RYO use, there is a need to better understand the current and potential future context of RYO use. Methods: Data from the 2002 Canadian Tobacco Use Monitoring Survey (CTUMS) were used to examine RYO tobacco use among 23,341 Canadians aged 15 and older. Logistic regression models were conducted to examine factors which differentiate smokers who smoke RYO tobacco all of the time, most of the time or sometimes from smokers who do not smoke RYO tobacco. Results: We found that 17% (n = 925,000) of current smokers in Canada reported smoking RYO. When compared to manufactured cigarette (MC) smokers, RYO users were heavier smokers, more addicted to nicotine, and less likely to consider quitting smoking. Lower income smokers were more likely to smoke RYO tobacco compared to smokers with high income. Conversely, smokers who had completed secondary school or university were less likely to smoke RYO tobacco compared to smokers who had not completed secondary school. Conclusion: This study demonstrates that RYO tobacco use is not a negligible problem within Canada and provides valuable new insight for developing future tobacco control initiatives for this population of smokers.

Acute effect of smoking on plasma Obestatin levels

Asterios Kukuvitis — 2010-01-07T00:00:00Z

Background: Smoking and smoking cessation are considered to be associated with weight changes. We have recently shown that smoking acutely increases plasma levels of ghrelin, a known orexigenic hormone.Obestatin is a peptide encoded by the ghrelin gene, which opposes ghrelin effects on food intake. We conducted a study in adult volunteers measuring plasma levels of obestatin immediately after initiation of smoking. Methods: 31 volunteers (mean age 32.2 ± 9.2 years and mean BMI 25.7 ± 4.1), 17 smokers and 14 non-smokers, were enrolled in our study. The 2 groups were matched in age and BMI. Plasma obestatin concentrations were determined at baseline (T0), 2 (T2), 5 (T5), 15 (T15), and 60 (T60) minutes after the initiation of smoking. Results: In all 31 subjects, no significant difference in the mean values of plasma obestatin levels was observed from baseline at T2, T5, T15 and T60 after initiation of smoking (overall p = 0.15). However, a trend for higher obestatin levels was noted in smokers vs non-smokers (overall p = 0.069), which was not related to the pack-years. Conclusion: On the contrary with ghrelin's response after smoking initiation, there is no such an acute response of plasma obestatin levels.

Building research capacity for evidence-informed tobacco control in Canada: a case description

Paul McDonald — 2009-08-07T00:00:00Z

Tobacco use remains the leading cause of death and disability in Canada. Insufficient research capacity can inhibit evidence-informed decision making for tobacco control. This paper outlines a Canadian project to build research capacity, defined as a community's ability to produce research that adequately informs practice, policy, and future research in a timely, practical manner. A key component is that individuals and teams within the community must mutually engage around common, collectively negotiated goals to address specific practices, policies or programs of research. An organizing framework, a set of activities to build strategic recruitment, productivity tools, and procedures for enhancing social capital are described. Actions are intended to facilitate better alignment between research and the priorities of policy developers and service providers, enhance the external validity of the work performed, and reduce the time required to inform policy and practice.

School-based smoking prevention programs with the promise of long-term effects

Brian Flay — 2009-03-26T00:00:00Z

I provide a systematic review of trials of school-based smoking prevention programs that had at least 15 sessions, preferably with some in high school, that reported significant short-term effects, and that included long-term follow-up. This is supplemented with a description of some other programs that produce short-term effects that portend large long-term effects. I conclude that school-based programs can have long-term effects of practical importance it they: include 15 or more sessions over multiple years, including some in high school; use the social influence model and interactive delivery methods; include components on norms, commitment not to use, intentions not to use, and training and practice in the use of refusal and other life skills; and use peer leaders in some role. School-based programs of this type can reduce smoking onset by 25–30%, and school plus community programs can reduce smoking onset by 35–40% by the end of high school. Some early childhood programs that do not have smoking prevention as their main aim, including home nursing, the Good Behavior Game, the Positive Action program and others, seem to change the developmental trajectories of children so that they are less likely to engage in multiple problem behaviors, including smoking, as adolescents. This review makes it clear that effective school-based smoking prevention programs exist and can be adopted, adapted and deployed with success – and should be.

Distribution of new graphic warning labels: Are tobacco companies following regulations?

Nick Wilson — 2009-08-25T00:00:00Z

ObjectiveTo test the hypothesis that tobacco companies would not follow a regulation that required seven new graphic health warnings (GHWs) to be evenly distributed on cigarette packs and that they would distribute fewer packs featuring warnings regarded by smokers as being more disturbing. Methods: Cross-sectional survey of purchased packs (n = 168) and street-collected discarded packs (convenience sample of New Zealand cities and towns, n = 1208 packs) with statistical analysis of seven types of new GHWs. A priori warning impact was judged using three criteria, which were tested against data from depth interviews with retailers. Results: The GHWs on the purchased packs and street-collected packs both showed a distribution pattern that was generally consistent with the hypothesis ie, there were disproportionately more packs featuring images judged as "least disturbing" and disproportionately fewer of those with warnings judged "more disturbing". The overall patterns were statistically significant, suggesting an unequal frequency of the different warnings for both purchased (p < 0.0001) and street-collected packs (p = 0.035). One of the least disturbing images (of a "corpse with toe-tag") dominated the distribution in both samples. Further analysis of the street-collected packs revealed that this image appeared disproportionately more frequently on manufactured cigarettes made by each of the three largest New Zealand tobacco companies. Although stock clustering could explain the purchase pack result, there were no obvious reasons why the same uneven warning distribution was also evident among the street-collected packs. Conclusion: These results suggest that tobacco companies are not following the regulations, which requires even distribution of the seven different GHWs on cigarette packs; further monitoring is required to estimate the extent of this non-compliance. As an immediate measure, governments should strictly enforce all regulations applying to health warnings, particularly given that these are an effective tobacco control intervention that cost tax payers nothing.