Background: The purpose of our study was to elucidate the joint effects of combined smoking and alcohol intake on esophageal cancer mortality in Japanese men through a large cohort study with a 20-year follow-up period. Materials and Methods: The Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study) was established in the late 1980s, including 46,395 men and 64,190 women aged 40 years and older and younger than 80. Follow-up of these participants was conducted until 2009. We used the Cox proportional hazards model to analyze data for 42,408 people excluding female participants, 411 people with histories of malignant neoplasms, and 3,576 with unclear smoking and drinking data. Results: The joint effects of age at start of smoking and amount of alcohol consumed per day were compared with non-smokers and non-drinkers or those consuming less than one unit of alcohol per day. The mortality risk was 9.33 (95% confidence interval, 2.55-34.2) for those who started smoking between ages 10 and 19 years and drinking at least three units of alcohol per day. Regarding the joint effects of cumulative amount of smoking and alcohol intake, the risk was high when both smoking and alcohol intake were above a certain level. Conclusions: In this Japanese cohort study, increased cancer mortality risks were observed, especially for people who both started smoking early and drank alcohol. Quitting smoking or not starting to smoke at any age and reducing alcohol consumption are important for preventing esophageal cancer in Japan.
This study was conducted to investigate drinking smoking exercise and environmental characteristics and it's risk factors for hypercholesterolemia (HC) in Korean. 344 adult men who took the annual health check-ups at D or J hospitals were participated in this corss-sectional study. The subjects were grouped by plasma total cholesterol level into three groups: normal cholesterolemic(n=139) borderline hyper-cholesterolemic (n=93) and hypercholesterolemic (n-112) groups. The data of plasma cholesterol level in the subjects were collected from medical records. Drinking smoking and exercise habits family and disease history personality type and stress level of subjects were investigated by using questionaries. The subjects with HC had longer drinking duration and drunk more frequently. The proportion of smok-er heavy smoker($\geq$2pack/day) and longer smoker ($\geq$30yrs) showed high in the HC but there were no significancy. The subjects with HC had preference for light exercise and exercised more frequently but there were no significant difference. The family history of cardiovascular diseases was higher in the were not different among the three groups. The relative risks on HC were 1.33 for family history, 1.22 for severe stress 1.06 for smoking and 1.04 for exercise.
The purpose of this study was to develop strategies and policies for smoking prevention that are tailored to the characteristics of different groups of smokers. The structured survey was conducted with regular smokers. The results were as follows: It has been demonstrated that Risk Perception Attitude framework can be used as a major research framework to predict behavioral changes related to the prevention of smoking. The smokers were divided into four attitude groups based on perceived risks and self-efficacy: indifference, proactive, avoidance, and responsive. The smoker groups showed significant differences in information seeking, information avoidance, prevention behavior and addiction degree. Especially, the difference in prevention behavior depended on the self-efficacy when the perceived risk level was high. Information avoidance was the lowest when the perceived risk level was high and the self-efficacy was low. Information seeking was lowest when the perceived risk level was low. When the level of self-efficacy was high, if the perceived risk level was high, prevention behavior was actively performed. Therefore, the self-efficacy was related to preventive behavior, and the perceived low-risk played a role in hindering information seeking. Smoking prevention strategies are important to raise awareness of the risk of smoking and to improve the positive willingness of smokers to quit smoking through self-efficacy.
Objectives : The aim of this study was to evaluate the roles of cigarette smoking, alcohol consumption, tuberculosis, and their interactions in the risk of lung cancer in a Korean cohort. Methods : The study subjects comprised 13,150 males and females aged above 20 years old. During the follow up period from 1993 to 2002, 79 lung cancer cases were identified by the central cancer registry and the national death certificate database. Information on cigarette smoking, alcohol consumption and the history of physician-diagnosed tuberculosis was obtained by interview. Indirect chest X-ray findings were also evaluated to ascertain tuberculosis cases. Cox proportional hazard models were used to estimate relative risks (RR) and 95% confidence intervals (CI) after adjusting for age and gender. Results : Cigarette smoking was statistically significantly associated with an increased risk of lung cancer [for current smokers, RR = 2.33 (95% CI = 1.23 - 4.42) compared to non-smokers]. After further adjustment for cigarette smoking, both alcohol consumption and tuberculosis showed no statistically significant association with the risk of lung cancer [for current drinkers, RR = 0.80 (95% CI = 0.48 - 1.33) compared to non-drinkers] [for tuberculosis cases, RR = 1.17 (95% CI = 0.58 - 2.36) compared to non-cases]. There was no statistically significant interaction between cigarette smoking and alcohol consumption (p-interaction = 0.38), or cigarette smoking and tuberculosis (p-interaction = 0.74). Conclusions : Although cigarette smoking was confirmed as a risk factor of lung cancer in this cohort study, this study suggests that alcohol consumption and tuberculosis may not be associated with the risk of lung cancer.
Cervical cancer is a serious public health problem in Thailand. We investigated possible risk factors for cervical cancer including HPV infection, p53 polymorphism, smoking and reproductive history among women in Northeast Thailand using a case control study with 177 cases and age-matched controls. Among the HPV carriers, a significantly increased risk for cervical cancer with an OR of 36.97(p<0.001) and an adjusted OR of 38.07(p<0.001) were observed. Early age at first sexual exposure, and multiple sexual partners increased the risk of cervical cancer with ORs ranging between 1.73-2.78(p<0.05). The interval between menarche and first sexual intercourse <6 years resulted in a significant increase in the risk for cervical cancer with ORs ranging between 3.32-4.09 and the respective adjusted OR range for the 4-5 and 2-3 year-old groups were 4.09 and 2.92. A higher risk was observed among subjects whose partner had smoking habits, whether currently or formerly; with respective ORs of 3.36(P<0.001) and 2.17(p<0.05); and respective adjusted ORs of 2.90(p<0.05) and 3.55(p<0.05). Other smoking characteristics of the partners including smoking duration ${\geq}20$ years, number of cigarettes smokes ${\geq}20$ pack-years and exposure time of the subject to passive smoking ${\geq}5$ hrs per day were found to be statistically significant risks for cervical cancer with adjusted ORs of 3.75, 4.04 and 11.8, respectively. Our data suggest that the risk of cervical cancer in Thai women is substantially associated with smoking characteristics of the partner(s), the interval between menarche and first sexual intercourse as well as some other aspects of sexual behavior.
We evaluated cigarette smoking as a risk factor for prostate cancer in a prospective, population-based cohort study. The subjects were 14,450 males among the participants in the Seoul Male Cancer Cohort Study who had at least 1-year follow-up. They were followed up between 1993 and 2008. During the 16-year follow-up period, 87 cases of prostate cancer occurred over the 207,326 person-years of the study. The age-adjusted relative risks of past and current smokers at entry were 0.60 (95%CI: 0.34-1.06) and 0.70 (95%CI: 0.43-1.13), respectively, suggesting that cigarette smoking may not be a risk factor for prostate cancer. The relationship between prostate cancer and other modifiable factors, such as Westernized diet, should be studied with the goal of establishing prevention programs for prostate cancer.
Background: Despite anti-smoking campaigns, smoking prevalence among Thai males aged 30 or older is high, at around 50%. The purpose of this study was to determine the relationship between smoking and mortality in a rural Thai community. Materials and Methods: Subjects enrolled into the Khon Kaen cohort study between 1990 and 2001 were followed up for their vital status until $16^{th}$ March 2012. The death resource was from the Bureau of Policy and Strategy, Ministry of Interior, Thailand. A Cox proportional hazards model was used to analyse the association between smoking and death, controlling for age, education level and alcohol drinking, and confidence intervals were calculated using the floating risk method. Results: The study recruited 5,962 male subjects, of whom 1,396 died during a median 13.5 years of follow-up. Current smokers were more likely to die than never smokers after controlling for age, education level and alcohol drinking (HR, 95%CI: 1.41, 1.32-1.51), and the excess mortality was greatest for lung cancer (HR, 95%CI: 3.51, 2.65-4.66). However, there was no increased risk with increasing dose of tobacco, and no difference in risk between smokers of yamuan (hand-rolled cigarettes) and manufactured tobacco. Conclusion: Mortality from cancer, particularly lung cancer, and from all causes combined is dependent on smoking status among men in rural Thailand, but the relative risks are lower than have been reported from studies in high income countries, where the tobacco epidemic is more established.
Background: Tobacco smoking is a major cause of preventable disease and death worldwide. Kreteks are clove-flavored cigarettes made from a combination of tobacco and ground-clove mixed with a sauce, smoked widely in Indonesia. Because health and social consequences of kretek smoking are potentially as great as those of traditional cigarettes, this study examines the prevalence of kretek smoking in Indonesia and associated risk factors. Materials and Methods: The study used nationally representative Indonesia Global Adult Tobacco Survey data. Multiple logistic regression analysis was employed to identify correlates of kretek smoking. Results: One-third of Indonesian adults smoked tobacco of which about 90.0% smoked kreteks. Prevalence of kretek smoking among men (60.9%) was more than 25 times the rate among women (2.3%). Overall, the highest prevalence of kretek use was in the age group 45-54 years (36.5%), followed by 34-44 (35.1%), 25-34 (34.2 %), and 55-64 years (32.8%). By wealth index, prevalence of kreteks smoking among those in the middle index was almost 50% above the rate for the wealthiest group (36.4% vs 24.8% respectively). Logistic regression results showed that being male, being older, having less education, and being less wealthy were significant predictors of kretek smoking, while urban vs rural residence was not. Conclusions: Kretek smoking is common in Indonesia and is entrenched in the sociocultural fabric of the country. However, potential consequences of kretek smoking, particularly as risks for noncommunicable diseases, underscore the importance of a comprehensive approach to tobacco control as outlined in the World Health Organization's MPOWER strategies.
Purpose: This study is based on an experimental research program designed to evaluate the before and after states of a control group that undertook a series of smoking prevention education sessions. Methods: The research was undertaken between June 2 and July 22, 2008. Students from two public elementary schools in Uiwang City took part in the study. 76 students from one of the schools (School 'W') were designated as the experimental group and 89 students from the other school (School 'O') were allotted to the control group. During the research period, the experimental group held 10, 40 minute discussions on the subject of smoking prevention. The control group had no such sessions and no information was given. The data was collected in 3 stages, firstly after initial study preparation, secondly after five sessions and thirdly after ten sessions. The data was analysed using the SPSS/WIN 12.0 program. Results: First, there was a presumption that the experiment group would have a greater knowledge about the effects of smoking than the control group. This was supported by the data analysis results (F=41.79, p =.000). Second it was presumed that the experiment group would have a more informed attitude to smoking than the control group. This was supported by the data analysis results (F=6.917, p =.009). Third, there was the presumption that the experiment group would have a greater knowledge of the effects of smoking after ten sessions than they would five sessions. This was supported by the data analysis results (F=56.911, p =.000, Scheffe=3rd> 2nd>1st). Fourth, the presumption held that the experimental group would have a more informed attitude to the effects of smoking after ten sessions than they did five. This was supported by the data analysis results (F=14.607, p =000, Scheffe=3rd>2nd>1st). Conclusion: The results appear to show that the elementary school students who participated in the smoking prevention sessions had an increased knowledge of the risks and had also formed a more negative attitude towards smoking. On the basis of the findings of this study, I would suggest that there are benefits in developing learner-centered smoking prevention programs and other related media. Also, smoking prevention discussions should be included in the regular curricula relating to health education.
Passive exposure to tobacco smoke significantly contributes to morbidity and mortality in children. Children, in particular, seem to be the most susceptible population to the harmful effects of environmental tobacco smoke (ETS). Paternal smoking inside the home leads to significant maternal and fetal exposure to ETS and may subsequently affect fetal health. ETS has been associated with adverse effects on pediatric health, including preterm birth, intrauterine growth retardation, perinatal mortality, respiratory illness, neurobehavioral problems, and decreased performance in school. A valid estimation of the risks associated with tobacco exposure depends on accurate measurement. Nicotine and its major metabolite, cotinine, are commonly used as smoking biomarkers, and their levels can be determined in various biological specimens such as blood, saliva, and urine. Recently, hair analysis was found to be a convenient, noninvasive technique for detecting the presence of nicotine exposure. Because nicotine/cotinine accumulates in hair during hair growth, it is a unique measure of longterm, cumulative exposure to tobacco smoke. Although smoking ban policies result in considerable reductions in ETS exposure, children are still exposed significantly to tobacco smoke not only in their homes but also in schools, restaurants, child-care settings, cars, buses, and other public places. Therefore, more effective strategies and public policies to protect preschool children from ETS should be consolidated.
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