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Just one cigarette a day can lead to heart disease

by UNTV News   |   Posted on Tuesday, February 6th, 2018

FILE PHOTO: A man smokes a cigarette along a road in Mumbai, India, October 26, 2016. REUTERS/Danish Siddiqui/File Photo

(Reuters Health) – Smoking just one cigarette a day carries half the risk for cardiovascular disease and stroke as a pack-a-day habit, according to research that concludes there is no safe level of smoking.

The study team analyzed data from 141 smaller studies to assess the risk of heart disease and stroke for people who smoked one, five or 20 cigarettes a day. Men who smoked one cigarette a day were 74 percent more likely to have heart disease and 30 percent more likely to have a stroke than men who never smoked at all, they report in The BMJ.

Women who smoked one cigarette daily were more than twice as likely to develop heart disease and 46 percent more likely to have a stroke than women who didn’t smoke.

“People who have always been light smokers will have a higher risk of cardiovascular disease than many of them expect,” said lead study author Allan Hackshaw of the Cancer Institute at University College London in the UK.

While their risk is still lower than for heavy smokers, the results should offer fresh motivation for light smokers to quit altogether, Hackshaw said by email. Heavy smokers, meanwhile, can benefit from cutting back even if they can’t quit.

“Cutting down is certainly better than smoking the same high amount,” Hackshaw advised. “And cutting down has significant reductions in the risk of cancer and other disorders; hence, it is absolutely important that people try this if they find it too difficult to stop completely.”

For example, men who smoked about a pack a day had more than twice the risk of heart disease as non-smokers, while the risk was 58 percent higher than nonsmokers’ for men who smoked five cigarettes a day and 48 percent higher for men who smoked just one.

Similarly, women who smoked five cigarettes daily had 43 percent of the excess of heart disease associated with a pack-a-day habit, while women who smoked one cigarette a day had 31 percent of the excess risk.

Compared to nonsmokers, men who smoked 20 cigarettes a day were 64 percent more likely to have a stroke and women had more than twice the risk for stroke.

The study wasn’t a controlled experiment designed to prove whether or how the number of cigarettes people smoke on a typical day might impact their risk of heart disease or stroke.

Another limitation of the analysis is that researchers lacked data on individual patient characteristics from many of the smaller studies, making it impossible to assess whether the study results might be explained by factors that can independently lead to stroke and heart disease and stroke such as obesity and diabetes.

Even so, the findings should serve as a reminder that no amount of smoking is safe, said Kenneth Johnson of the School of Epidemiology and Public Health at the University of Ottawa in Canada, who wasn’t involved in the study.

That’s because smoking can lead to an irregular heart beat, blood clots too well, thickening and stiffening of the artery walls and increased blood pressure, Johnson, author of an accompanying editorial, said by email.

“With regard to the number of cigarettes, it’s a little like with matches, you only need one – not the whole box – to start a fire,” Johnson said. “Even secondhand smoke appears to trigger these damaging processes, resulting in 80 to 90 percent of the effect associated with active smoking.”

SOURCES: bit.ly/2DE8ytj and bit.ly/2E5tmcf BMJ, online January 24, 2018.

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Smokers more likely to need spinal surgery

by UNTV News   |   Posted on Tuesday, January 9th, 2018

FILE PHOTO: A man smokes in Budapest, Hungary, May 12, 2017. REUTERS/Laszlo Balogh

(Reuters Health) — Smoking increases the risk of lower back pain that needs to be fixed by spinal surgery, a Swedish study suggests.

Researchers focused on a common cause of lower back pain known as lumbar spinal stenosis, which occurs when the spinal canal narrows, putting pressure on the spinal cord and nerves. The condition often develops as people age, but nicotine’s constriction of blood flow and promotion of inflammation are believed to contribute to the process, the study authors write.

The researchers examined data on 331,941 construction workers who were part of a nationwide occupational health registry in Sweden. Workers were followed for an average of more than three decades, starting when they were typically in their 30s, and 1,623 of them eventually had surgery for lumbar spinal stenosis.

Compared to people who never smoked, heavy smokers who went through at least 15 cigarettes a day were 46 percent more likely to have this spinal surgery, the study found. For moderate smokers who had up to 14 cigarettes a day, the increased risk was 31 percent, while ex-smokers had 13 percent higher odds of surgery.

“Smoking appears to be a risk factor for developing lower spine space narrowing that can lead to surgical treatment,” said senior study author Dr. Arkan Sayed-Noor, a researcher at Umea University.

“Quitting smoking can reduce the risk,” Sayed-Noor said by email.

While some previous research has linked smoking to worse outcomes from spinal surgery, the current study offers fresh evidence that it can also increase the odds that back pain will require surgery, Sayed-Noor added.

Overall, 44 percent of the study participants were non-smokers. Another 16 percent were former smokers, while 26 percent were moderate smokers and 14 percent were heavy smokers.

The connection between smoking and spinal surgery persisted even after researchers accounted for other factors that can increase the odds of lower back pain such as aging and obesity.

Smoking damages the spine in several ways, researchers note in The Spine Journal. Nicotine can damage spinal tissue, weaken bones and make back pain worse.

Heavy smoking is also often accompanied by a sedentary lifestyle that may lead to muscle weakness and increase strain on the lower back.

One limitation of the study is that researchers lacked data on exercise habits, the authors note. Most of the construction workers in the study were men, and the results might be different for women.

Still, the findings add to evidence linking cigarettes to disc damage and back pain, said Dr. Jean Wong, a researcher at the University of Toronto who wasn’t involved in the study.

“There are multiple short and long-term health reasons for smokers to quit, and by quitting smoking, smokers can reduce their risk of back pain due to disc degeneration and spinal stenosis – which can be a debilitating problem in smokers,” Wong said by email. “Although it may take multiple attempts, quitting smoking is the best thing a smoker can do to minimize the risk of spinal stenosis and other health problems.”

SOURCE: bit.ly/2CXnjDL The Spine Journal, online December 12, 2017.

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Cigarette smoking during pregnancy linked to ADHD risk in offspring

by UNTV News   |   Posted on Monday, January 1st, 2018

A woman is silhouetted as she smokes a cigarette in central Sydney August 1, 2013. REUTERS/Daniel Munoz

(Reuters Health) – Children born to women who smoke cigarettes during pregnancy, especially when mothers are heavy smokers, are at an increased risk for attention-deficit/hyperactivity disorder (ADHD), a new review of medical studies confirms.

Mothers who smoked during pregnancy had an overall 60 percent higher risk of having a child with ADHD compared to women who didn’t smoke. For mothers who smoked fewer than 10 cigarettes per day, the risk of having a child who developed ADHD was 54 percent higher than for nonsmoking mothers. For mothers who were heavier smokers, the risk was 75 percent higher than for nonsmokers.

An increased risk of ADHD for children of women who smoke while pregnant has been reported before. What’s new here, the authors say, is that the data have been pooled from studies in multiple countries and time periods, and also that as the daily tally of cigarettes went up, the risk of ADHD went up.

The findings “lend greater strength and credibility and statistical power to previous studies that likewise show that pregnant women who smoke have a greater likelihood of having a child with ADHD,” said Dr. Andrew Adesman, chief, developmental and behavioral pediatrics, Steven and Alexandra Cohen Children’s Medical Center of New York in New Hyde Park.

Adesman, who was not involved in the research, told Reuters Health by phone that the study ”has to be taken seriously. Women who smoke during pregnancy have one more reason to stop.”

According to 2011 Pregnancy Risk Assessment and Monitoring System (PRAMS) data from 24 states, approximately 10 percent of American women reported smoking during the last three months of pregnancy.

Eleven percent of U.S. children ages 4 to 17, or 6.4 million children, have been diagnosed with ADHD based on parent reports, according to the Centers for Disease Control and Prevention. ADHD can affect attention, hyperactivity and self-control, causing difficulty in school and socially.

As reported in Pediatrics, Dr. Dezhi Mu and colleagues at West China Second University Hospital in Chengdu, Sichuan, China, analyzed 20 studies published between 1998 and 2017 that looked at the potential role of smoking during pregnancy and the risk of ADHD in offspring. Altogether, the studies involved nearly 3 million people in Europe, Brazil, Japan, Australia and the U.S.

The team found lower risks for ADHD in children of mothers who smoked in the U.S. and Europe, where more smokers stop smoking when they get pregnant.

“It would be a big leap from that, but if you are a prior smoker and stop during pregnancy, the inference is that the risk of ADHD goes down,” Dr. Jeffrey Newcorn, director, The Center of Excellence in ADHD and Related Disorders, Icahn School of Medicine at Mount Sinai told Reuters Health in a phone interview.

Data from seven studies showed that while mothers’ smoking had a greater effect than fathers’ smoking on ADHD risk, there was still a 20 percent higher risk of ADHD in children born to fathers who smoked.

The new analysis can’t prove that smoking causes ADHD. Among other limitations of the new research are that different criteria were used to diagnose ADHD in the various studies, and tobacco use during pregnancy was self-reported by the mothers.

Newcorn, who was not involved in the research, would like to see more studies on the relationship between genetic and environmental factors in developing ADHD, as well as the role of nicotine exposure.

SOURCE: bit.ly/2liopCy Pediatrics, online December 29, 2017.

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Smoking, drinking worsen prognosis for head and neck cancers

by UNTV News   |   Posted on Monday, December 4th, 2017

FILE PHOTO: A woman lights a cigarette in this illustration picture taken in Paris, October 8, 2014. REUTERS/Christian Hartmann

(Reuters Health) – People with head and neck cancers who smoke and drink are much more likely to die with these tumors than nonsmokers and teetotalers, a recent study suggests.

Researchers studied 463 patients with head and neck squamous cell carcinoma, a common type of cancer that develops in the outer layer of the skin. It is often slow growing and treatable with medication or minor surgery, but some types can be aggressive and deadly.

Roughly half of the patients were monitored for at least seven years. Over the course of the study, 254 people, or 55 percent, died. People who smoked at diagnosis were twice as likely to die as nonsmokers, and people who reported any alcohol use were 68 percent more likely to die, the study found.

“Head and neck cancer patients who smoke and also drink may be creating more problems for themselves than they realize,” lead study author Dr. Nosayaba Osazuwa-Peters of Saint Louis University School of Medicine Osazuwa-Peters said by email.

Worldwide, head and neck squamous cell carcinoma is the seventh most common type of cancer, according to the National Institutes of Health. Each year, 600,000 new cases are diagnosed globally, including about 50,000 in the United States.

These tumors are more common in men and people in their 50s and 60s, but a growing number of cases are being diagnosed in younger patients.

Even though smoking has long been linked to worse survival odds with head and neck squamous cell carcinoma survival, the current study offers fresh evidence of the connection and also suggests one possible explanation: smokers are less likely to be married than nonsmokers.

Unmarried people were 87 percent more likely to die with these tumors than married people, researchers report in JAMA Otolaryngology.

Study participants were diagnosed and treated between 1997 and 2012. Overall, 56 percent were smokers at diagnosis and half of them were married.

About 60 percent of the smokers were unmarried and 64 percent were drinkers, the study found. By contrast, only 40 percent of the nonsmokers were unmarried, and just 38 percent were drinkers.

Roughly half of the smokers survived for at least 7 years after their diagnosis, whereas roughly half of the nonsmokers survived at least 17 years.

The study wasn’t designed to prove whether or how lifestyle decisions like smoking, drinking or getting married might influence the odds of getting squamous cell carcinoma or dying from these tumors.

Researchers also lacked data on how changes in marital status might have influenced shifts in smoking or drinking status. In addition, they weren’t able to distinguish nonsmokers who recently quit from people who never used cigarettes.

Still, said Osazuwa-Peters, “The fact is that smoking and drinking alcohol combined cause more head and neck cancer than smoking or drinking alcohol alone.”

Quitting at any time can improve how people respond to cancer treatment and improve their survival odds, said Dr. Karl Kelsey, director of the Center for Environmental Health and Technology at Brown University in Providence, Rhode Island.

“A patient’s response to this cancer and healing from the very invasive treatment of the disease will be greatly diminished in a patient already compromised by dealing with the untoward effects of smoking,” Kelsey, who wasn’t involved in the study, said by email. “Quitting smoking at any time reduces your risk of poor outcomes.”

With this particular type of cancer, however, a large and growing proportion of cases are caused by the sexually transmitted disease human papilloma virus (HPV), Kelsey noted.

The connection between marriage and cancer risk in the study might be connected to HPV infections, Kelsey said. Marriage is also connected to a variety of other factors that contribute to the risk of developing or dying from cancer such as education, employment, and insurance status.

“Marriage may affect the biology of an individual in ways that we have trouble measuring,” Kelsey said. “Married people may be systematically happier, have more social support, better immune systems, etc.”

SOURCE: bit.ly/2i98x3e JAMA Otolaryngology, online November 9, 2017.

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