| Abstracts:
Cigarette smoking and risk of benign proliferative
epithelial disorders of the breast in the Women's Health Initiative.Cancer
Causes Control. 2007 May;18(4):431-8. Epub 2007 Feb 24.
OBJECTIVE: To
investigate the association between cigarette smoking and risk of
benign proliferative epithelial disorders (BPED) of the breast.
METHODS: We used data from an ancillary study of benign breast
disease that is being conducted in the Women's Health Initiative
randomized clinical trials among 68,132 postmenopausal women aged
50-79 at recruitment. After following the trial participants for an
average of 7.8 years, we had ascertained 294 incident cases with
atypical hyperplasia and 1,498 incident cases with non-atypical BPED
of the breast. We used Cox proportional hazards models to estimate
hazard ratios for the association between cigarette smoking and risk
of BPED. RESULTS: Smoking measures, including duration of smoking,
intensity of smoking, pack-years of smoking, age at which smoking
commenced, and years since quitting smoking, were not associated
with risk of BPED overall or by histological subtypes. CONCLUSION:
The null association between cigarette smoking and risk of BPED of
the breast suggests that the carcinogenic and antiestrogenic effects
of cigarette smoking on the breast might counterbalance each other
and that cigarette smoking might have no overall effects on BPED of
the breast among postmenopausal women.
Predictors of postpartum relapse to smoking.Drug
Alcohol Depend. 2007 Apr 30;
Postpartum
relapse is common among women who stop smoking during pregnancy. We
examined predictors of postpartum relapse in 87 women who quit
smoking during pregnancy, 48% of whom relapsed by 6 months
postpartum. We also explored the circumstances surrounding their
first postpartum cigarette. Multivariate analyses revealed that
having more friends/family members who smoke, smoking more heavily
pre-pregnancy, and having higher depression scores and less concern
about weight at the end of pregnancy were associated with increased
risk of relapse postpartum. Most women's first postpartum cigarettes
were unplanned, in the presence of another smoker, and while
experiencing negative affect. The findings suggest targets for
interventions to reduce postpartum relapse.
Maternal smoking is associated with increased
infant oxidative stress at 3 months of age.
Thorax.
2007.Mar.
BACKGROUND:
Cigarette smoke is a major source of free radicals and oxidative
stress. With a significant proportion of women still smoking during
pregnancy, this common and avoidable exposure has the potential to
influence infant oxidative status, which is implicated in the
increased propensity for airway inflammation and asthma. The aim of
this study was to examine the effects of maternal smoking on markers
of infant oxidative stress. METHODS: We compared the level of
oxidative stress (using urinary F2-isoprostanes as a marker of lipid
peroxidation) in infants of smokers (n=33) and non- smokers (n=54)
at 3 months of age. These groups were balanced for maternal atopy
and socioeconomic status. Infant urinary cotinine was also measured
as an indicator of early postnatal cigarette smoke exposure.
RESULTS: Maternal smoking was associated with significantly higher
infant (P=0.002) cotinine levels, despite the fact that most smoking
mothers (83.8%) claimed not to smoke near their baby. Maternal
smoking was associated with significantly higher markers of
oxidative stress (F2-isoprostane) (P=0.015) at 3 months of age.
There was also a positive correlation between urinary
F2-isoprostanes and infant urinary cotinine levels (Kendall's tau b,
0.227; P=0.008). CONCLUSIONS: Although this study does not separate
the pre- and postnatal effects of smoking, these findings indicate
that environmental tobacco smoke in the early postnatal period
adversely effects pro- oxidative/antioxidative status within weeks
of life in very early infancy.
Effects of maternal smoking in pregnancy on
prenatal brain development. The Generation R Study. Eur
J Neurosci. 2007 Feb;25(3):611-7. Epub
2007 Feb 12 .
Nicotine, as
has been shown in animal studies, is a neuroteratogen, even in
concentrations that do not cause growth retardation. In humans,
there is only indirect evidence for negative influences of nicotine
on brain development from studies on the association between
maternal smoking in pregnancy and behavioural and cognitive
development in the offspring. We investigated the associations of
maternal smoking in pregnancy with foetal head growth
characteristics in 7042 pregnant women. This study was embedded in
the Generation R Study, a population-based prospective cohort study
from foetal life until adulthood. Maternal smoking was assessed by
questionnaires in early, mid- and late pregnancy. Head
circumference, biparietal diameter, transcerebellar diameter and
atrial width of lateral ventricles were repeatedly measured by
ultrasound. When mothers continued to smoke during pregnancy, foetal
head circumference showed a growth reduction of 0.13 mm [95%
confidence interval (CI): -0.18, -0.09] per week compared to
foetuses of mothers who never smoked during pregnancy. Biparietal
diameter of foetuses with smoking mothers grew 0.04 mm (95% CI:
-0.05, -0.02) less per week than that of foetuses of nonsmoking
mothers. Atrial width of lateral ventricle was 0.12 mm (95% CI:
-0.22, -0.02) smaller and transcerebellar diameter was 0.08 mm (95%
CI: -0.15, -0.00) smaller if mothers smoked, but growth per week of
these characteristics was not affected by maternal smoking in
pregnancy. In conclusion, continuing to smoke during pregnancy leads
to reduced growth of the foetal head. Further research should focus
on the causal pathway from prenatal cigarette exposure via brain
development to behavioural and cognitive functions.
The effects of
cigarette smoking on circulating maternal leukocytes during
pregnancy.Clin Immunol.
2007 Feb;122(2):214-9. Epub 2006 Dec 11.
During
pregnancy, cigarette smoke exposure, a common environmental insult,
is damaging to both mother and fetus and is associated with
pregnancy loss. The mechanism underlying the pathophysiology of
injury is not understood. We hypothesized that smoking during
pregnancy interferes with the normal physiological adaptation of the
maternal immune system. We used flow cytometry to measure changes in
the distribution of subsets of circulating leukocytes and adhesion
molecule expression in a prospective cohort of 198 women who had 325
blood samples obtained throughout pregnancy. Smoking status was
assessed by plasma cotinine concentration. Smoking increased the
frequency of CD3(+) lymphocytes and decreased CD56(+) cells at 14-20
weeks gestation. Smoking also decreased the expression of CD54 on
monocytes and CD62L on granulocytes throughout pregnancy. Our data
demonstrate that smoking affects several immune parameters,
especially early in pregnancy. These perturbations may play a role
in pregnancy loss in women who smoke.
The combined effect of maternal smoking and
obesity on the risk of preeclampsia.
J Perinat Med. 2007;35(1):28-31.
AIMS: Cigarette
smoking during pregnancy is associated with a lower risk of
preeclampsia, whereas obesity increases the risk of preeclampsia. We
sought to assess the combined effect of smoking and obesity on the
risk of preeclampsia. METHODS: We conducted a population-based
cohort study of 129,674 women who delivered singleton infants during
2000-2001. Data for cigarette use, pre-pregnancy body mass index
(BMI), preeclampsia, and potential confounders were obtained from
birth certificate files. Mantel-Haenszel stratified analysis and
logistic regression were used to analyze the data. RESULTS: The
preeclampsia risk was 3.1, 4.5, 7.6 and 8.8% for normal weight (BMI
18.5-24.9), overweight (25.0-29.9), obese (30.0-39.9) and morbidly
obese (>or=40.0 kg/m2) women, respectively, who smoked cigarettes
while pregnant. The preeclampsia risk was 3.9, 6.2, 9.0 and 12.3%
for the same groups of women, respectively, who did not smoke during
their pregnancy. Compared to non-smokers, the relative risk of
preeclampsia for women who smoked cigarettes was 0.78 (95%
confidence interval 0.73-0.83) before and after adjusting for
pre-pregnancy BMI and other factors associated with preeclampsia.
CONCLUSION: The risk of preeclampsia is lower for women who smoke
cigarettes while pregnant regardless of their pre-pregnancy BMI.
Smoking and environmental iodine as risk factors
for thyroiditis among parous women.
Eur J Epidemiol. 2007 Jun 8;
OBJECTIVE: To
elucidate whether exposure to some environmental factors, i.e.
cigarette smoking and iodine deficiency influence the risk of
thyroiditis. METHODS: We identified a cohort of 874, 507 parous
women with self-reported information on smoking during pregnancy
registered in the Swedish Medical Birth Registry from September 1983
through December 1997. Hospital diagnoses of thyroiditis (n = 286)
and hypothyroidism (n = 690) following entry into the cohort were
identified by record-linkage with the national Inpatient Registry.
The hazard ratio (HR) of smokers compared to non-smokers and the
corresponding 95% confidence limits (CL) were estimated by Cox
regression. RESULTS: Smoking was inversely associated with risk of
overt thyroiditis (adjusted HR = 0.72; CL = 0.54-0.95), even when
diagnoses of primary hypothyroidism were included. However, a
diagnosis of thyroiditis within 6 months from a childbirth was
positively associated with smoking (adjusted HR = 1.88; CL =
0.94-3.76). Being born in areas of endemic goiter was not associated
to hospital admission for thyroiditis. Thyroiditis patients who were
smokers had more often than non-smokers a co-morbidity with other
autoimmune disorders. CONCLUSIONS: Smoking may increase the risk of
thyroiditis occurring in the post-partum period and influence the
clinical expression of other thyroiditis, especially when occurring
as part of a polymorphic autoimmune disease.
Maternal
cigarette smoking during pregnancy and child aggressive behavior.Am
J Addict. 2006 Nov-Dec;15(6):450-6.
This study's
objective was to examine the association between maternal smoking
during pregnancy and childhood aggressive behavior in
African-American and Puerto Rican children, as well as the
relationship between maternal unconventional behavior, low maternal
affection, and offspring aggression. Participants consisted of
African-American and Puerto Rican children (N = 203; mean age = 8.6,
SD = 0.87) and their mothers living in an inner city community. An
interview consisting of a structured questionnaire was administered
to the mothers and their children. Scales with adequate psychometric
properties were adapted from previous validated measures. They
included maternal smoking during pregnancy, maternal education,
unconventionality, and warmth. Controlling for demographic factors,
maternal unconventional behavior, and low maternal warmth, maternal
smoking during pregnancy was associated with having offspring who
were aggressive. Maternal unconventionality and warmth were
independently related to childhood aggression. Although causal
limitations are noted, it may be that a decrease in smoking during
pregnancy is associated with a reduction in aggression in the
offspring.
Meta-analysis of disease risk associated with
smoking, by gender and intensity of smoking.Gend
Med. 2006 Dec;3(4):279-91.
BACKGROUND: The
risks associated with cigarette smoking can be substantial,
particularly for females. In 2000, the mortality rate for lung
cancer among women was higher than that for breast cancer.
OBJECTIVE: To obtain overall risk for intensity of smoking for both
males and females, a meta-analysis was performed on recent studies
that assessed the morbidity and mortality associated with smoking.
METHODS: Using the PubMed database, a literature search was
conducted for cohort and case-control studies on the effect of
smoking on morbidity and mortality. Only studies that had quantified
the risk of disease associated with smoking were included. Nineteen
studies were selected, with data obtained on the disease affected by
smoking, point estimates of risk, 95% CIs, sample size, type of
study, and the number of patients of each sex. Meta-analyses were
performed for low level of use, defined as 1 to 20 cigarettes per
day, and for high level of use, >20 cigarettes per day. RESULTS: For
low level of use, the rate ratio point estimate of 1.77 (95% CI,
1.40-2.24) for females was higher than that of 1.42 (95% CI,
1.23-1.64) for males, indicating a gender effect associated with
smoking as a disease risk. The point estimate for females who smoked
at high levels was 2.75 (95% CI, 2.14-3.52), well beyond the
estimate of 1.95 (95% CI, 1.70-2.24) for males, indicating there was
a substantial gender effect with high-level use. All point estimates
for low and high levels of smoking were significant; those for each
sex at high levels of smoking exceeded those found for low levels.
The increase in risk from low to high levels of smoking was greater
for females than for males. CONCLUSIONS: Few systems in the body
were unaffected by smoking, and intensity was a risk factor for
disease. Results were consistent with and strengthened previous
research demonstrating an increase in overall risk with an increase
in smoking intensity. In addition, gender differences were noted
that may contribute to risk magnitude.
Maternal
cigarette smoking and breastfeeding duration.Acta
Paediatr. 2006 Nov;95(11): 1370-4.
AIM: To examine
the relationship between cigarette smoking and breastfeeding
duration at 2 wk, 6 mo, and longer. METHODS: Design. A 12-mo
longitudinal study. Setting. Two public maternity hospitals in the
Perth metropolitan area (Western Australia). Subjects. Eligible
mothers of healthy newborn infants. Interventions. Participants
completed a self-administered baseline questionnaire while in
hospital or shortly after discharge. All women regardless of their
chosen infant feeding method were followed up by telephone interview
at 4, 10, 16, 22, 32, 40 and 52 wk postpartum. Main outcome
measures. Prevalence of breastfeeding at 2 wk, 2 wk to 6 mo and >6
mo in women who smoked during pregnancy, and breastfeeding duration.
RESULTS: Women who smoked during pregnancy had a lower prevalence
and shorter duration of breastfeeding than non-smoking mothers (28
vs 11 wk, 95% CI 8.3-13.7). This effect remained even after
adjustment for age, education, income, father's smoking status,
mother's country of birth, intended duration of breastfeeding >6 mo
and birthweight (risk ratio 1.59, 95% CI 1.22-2.08). CONCLUSION:
Women who smoke during pregnancy are at greater risk of not
achieving national and international targets for breastfeeding.
Encouraging smoking cessation in the antenatal setting is an area
for considerable public health gain.
Differences in lung cancer risk between men and women: examination
of the evidence. J
Natl Cancer Inst. 1996 Feb 21;88(3-4):183-92.
BACKGROUND:
Lung cancer incidence is gradually leveling off in U.S. men but is
continuing to rise in U.S. women. This increase in U.S. women
exceeds that expected from a slower decline of smoking among women.
Recent epidemiologic and biochemical studies suggest gender
differences in susceptibility to tobacco carcinogens. PURPOSE: We
conducted an up-to-date, more in-depth evaluation of our earlier
observation of a potential gender difference in relative risk (RR)
of lung cancer due to smoking. We added information from several
additional case and control subjects and included more precise
histologic classification of the cancer type, accurate quantitation
of smoke exposure, and adjustments for body size. METHODS: The
present investigation was a part of an ongoing hospital-based,
case-control study by the American Health Foundation. It included
data from 1889 case subjects (1108 males and 781 females) with lung
cancer of squamous/epidermoid, small-cell/oat cell, large-cell, and
adenocarcinoma types and 2070 control subjects (1122 males and 948
females) with diseases unrelated to smoking. The case and control
subjects were admitted to participating hospitals from 1981 to 1994
and were pair-matched by age, sex, hospital, and the time of
hospital admission. Ex-smokers and non-Caucasians were excluded from
analyses to avoid confounding. The RRs and 95% confidence intervals
were estimated from adjusted odds ratios (ORs) by use of
unconditional multiple logistic regression analysis, and statistical
significance was determined by two-sided tests. The ORs for major
histologic types were estimated at increasing levels of exposure to
cigarette smoke. RESULTS: Our results indicated that women were more
likely to be never-smokers than men, particularly those with the
squamous/epidermoid-type cancer (8.3% for women versus 2.9% for men
55 years old or older). Men started smoking earlier, reported
inhaling more deeply, and smoked more cigarettes per day than women.
In contrast, dose-response ORs over cumulative exposure to cigarette
smoking were 1.2-fold to 1.7-fold higher in women than in men for
the three major histologic types; these differences were more
pronounced for small-cell/oat cell carcinomas and adenocarcinomas
than for squamous/epidermoid carcinomas. Adjustments for weight,
height, or body mass index did not alter the ORs. CONCLUSIONS: These
results confirm our earlier finding that the ORs for major lung
cancer types are consistently higher for women than for men at every
level of exposure to cigarette smoke. Furthermore, this gender
difference cannot be explained by differences in base-line exposure,
smoking history, or body size, but it is likely due to the higher
susceptibility to tobacco carcinogens in women.
Sex differences in
lung-cancer risk associated with cigarette smoking.Int
J Cancer. 1993 Apr 22;54(1):44-8.
The importance
of cigarette smoking as a risk factor for specific histologic types
of lung cancer in men and women has been examined in a case-control
analysis of data from the Cancer Surveillance Program of Orange
County, a population-based registry. Smoking habits were abstracted
from medical records for 1153 men and 833 women diagnosed with
primary lung cancer in 1984-1986 and 1851 men and 1656 women aged 30
or older diagnosed with cancers not associated with smoking.
Ninety-six percent of men and 89% of women with lung cancer were
current or former cigarette smokers, as compared with 55% of men and
34% of women with other cancers. The age and ethnicity-adjusted odds
ratios (OR) for ever-smoking were 19.7 for men and 15.0 for women.
Men and women who smoked 2 or more packs per day experienced nearly
equal risks. Comparison of the most common cell types showed that
women smokers had equal or lower ORs for squamous-cell carcinoma and
adenocarcinoma, but higher OR for small-cell carcinoma, as compared
with men smokers. While the smoking-associated OR were equal for
small-cell and squamous-cell carcinomas in men, the OR for women
were significantly higher for small-cell carcinoma than for squamous-cell
carcinoma.
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