Smoking habits and attitude to smoking in the study population of the MONICA Project Augsburg

Application of CE-MS to a metabonomics study of human urine from cigarette smokers and non-smokers

BACKGROUND

Novel biomarkers of exposure and early adverse effects are needed for comparative studies of combustible and non-combustible tobacco products for regulatory authority evaluation. Metabolic biomarkers reflect both gene and environmental effects.

RESULTS

CE-MS has been applied to human urine samples from non-smokers and smokers of cigarettes at two tar levels. Validated chemometric models were able to separate smokers from non-smokers, with discrimination mainly based on the presence of nicotine metabolites. With these removed, it still proved possible to discriminate smokers from non-smokers with models now based on endogenous metabolites. The biochemical relevance of these biomarkers is discussed.

CONCLUSION

This proof-of-principle metabonomics study illustrates the potential of CE-MS to discover novel biomarkers in urine from tobacco users.

Some risk factors for the development of type 2 Diabetes in men and women of Belgrade population

Introduction. In the last two decades there has been an increase in the prevalence of type 2 diabetes in both developed and in developing countries. Objective. To determine whether personal habits like smoking, alcohol and coffee consumption or physical inactivity are different between genders in patients with type 2 diabetes. Methods. The study was conducted in Belgrade, during the period 2007-2008, and included newly diagnosed patients with type 2 diabetes. We included 80 men and 99 women diagnosed with diabetes mellitus type 2, referred to the Primary Health Care Centre 'Savski venac'. A questionnaire was used to collect data on demographic and anthropometric characteristics, as well as data on healthy habits. The ?I test and two-tailed t-test were used for data analysis. Results. The men were significantly more engaged in industry and crafts, while the women worked significantly more frequently in administrative jobs. The men were married significantly more frequently than the women (p<0.05) and had a higher level of education (p<0.05). Regarding to the level of implementation of nutritional and physical activity, there were no significant differences between the genders (p>0.05). The women consumed coffee significantly more frequently than the men (p<0.05), but drank less alcohol (p<0.05). The men were former smokers significantly more frequently (p<0.05) than the women. Conclusion. These results indicate the role of certain personal habits in the development of type 2 diabetes.

Misclassification of smoking in a follow-up population study in southern Germany

Smoking prevalence in southern Germany was studied in 1984-1985 using a representative cohort of 4022 subjects aged 25 to 64 years, with 3753 reinterviewed in 1987-1988. Data were available for analysis from interviews on self-reported smoking behavior and from serum cotinine measurements in both investigations. More men than women reported current smoking, and particularly heavy smoking. Serum cotinine levels increased steadily with the daily number and nicotine yield of cigarettes smoked. Mean cotinine levels in ex-smokers were higher than those in never smokers, suggesting that a higher percentage of current smokers are misclassified as ex-smokers than never smokers. Using cotinine rather than self-reported smoking data increased the proportion of true smokers in the subgroup of self-reported smokers by about 3% in males and by about 1% in females. Data from the reinterviews revealed that reported smoking status confirmed by cotinine measurement in 1987-1988 conflicted in a number of cases with the data obtained in 1984-1985 using the same procedure. For example, 0.1% of those who stated they were current regular smokers, 4.3% of those who stated they were current occasional smokers, and 17.6% of those who stated they were ex-smokers in 1984-1985 claimed in 1987-1988 to have never smoked. This misclassification of ex-smokers was higher in women. Altogether the true proportion of ex-smokers among self-reported never smokers was about 9.7% (17.8% in men and 6.7% in women). The widely variable uptake of tobacco smoke by smokers, as well as the misclassification of true smokers and ex-smokers as never smokers, needs to be considered in epidemiological studies evaluating the health risks from both active and passive smoking.

Cardiovascular risk factors, ECG abnormalities and quality of life in subjects with atrial fibrillation

In Central European regions epidemiologic findings for atrial fibrillation (AF) in a randomly selected population are not available. Therefore, information obtained by a standardized examination procedure including resting 12 lead ECG of 4003 participants (2014 men, 1989 women), aged 25 to 64 years, of the MONICA-Augsburg Survey 1984/85 were analysed. Reexamination of 3753 subjects took place three years later (Follow-up Study 1987/88). Persons with AF in the baseline survey (n = 13) were compared with an age-and sex-matched control group (n = 156) without AF, chosen from the same population sample, with regard to cardiovascular risk factors, associated disease and disturbances in the subjects' general well-being. In 1984/85 thirteen cases with AF (6 males, 7 females) were observed, giving an age-standardized prevalence of AF in males of 0.22% and in females of 0.34%. The age of men with AF ranged between 50 and 63 years and of women between 61 and 64 years. No significant differences were observed in persons with AF compared to the control group in risk factor levels and alcohol consumption; however, significant differences could be seen concerning disturbances in quality of life like self-reported health status (p < 0.001), sleep disturbances (p < 0.05), antihypertensive medication (p < 0.001). AF cases were found to have further ECG abnormalities significantly more often (left anterior hemiblock: p < 0.05; ventricular premature beats: p < 0.05). In all subjects with AF in the initial examination 1984/85 AF was found three years later (chronic AF). Overall 13 new cases (7 men, 6 women) were identified in the 1987/88 follow-up. The prevalence of AF in a South German population is comparable with AF prevalences reported from studies in other populations (e.g.) Framingham 1950, Reykjavik 1967/70). Associated ECG abnormalities were found more frequently in subjects with AF. Cases with AF have considerable disturbances in their general well-being.

[Smoking among children and adolescents: a challenge for primary prevention]

The best way to prevent the deleterious health effects of cigarette smoking is helping children to refrain from starting the habit. As a part of a survey of the prevalence of asthma symptoms in children and adolescents, we investigated the smoking habits of grade seven and eight school children in Bochum, a city of approximately 400,000 people in northwestern Germany. A random sample of 2050 children (93%) answered a confidential questionnaire. Fifty-three percent of the children responded that they had ever smoked cigarettes and 26% indicated that they had smoked during the previous month. 10% of the teenagers smoked daily, and 5% smoked more than 10 cigarettes per day. The prevalence of active smoking during the previous month was more frequent among girls (28%) than among boys (23%), but slightly more boys (5%) than girls (4%) smoked more than 10 cigarettes per day. The prevalence of active smoking was increased among children living in families of lower socio-economic status or in households with smokers. The high prevalence of cigarette smoking among the school children in Bochum, Germany, emphasizes the need to develop and implement effective intervention programs for children and adolescents and to contribute to a social environment which is conductive to refraining from smoking.

Determinants of plasma fibrinogen: relation to body weight, waist-to-hip ratio, smoking, alcohol, age, and sex. Results from the second MONICA Augsburg survey 1989-1990

In the second World Health Organization MONItoring Trends and Determinants in CArdiovascular Disease (MONICA) Augsburg survey in 1989-1990 (n = 4,940), the association between nephelometric plasma fibrinogen level and lifestyle-related potential determinants was assessed in 4,434 subjects aged 25-74 years (89.8% of participants). Irrespective of pregnancy and the use of oral contraceptives, crude fibrinogen values were consistently higher in women than in men of all ages (age-standardized difference, 12.2 mg/dl; 95% confidence interval, 7.0-17.4 mg/dl). Fibrinogen concentrations were positively correlated (p less than or equal to 0.0001) with age, body mass index, and waist-to-hip ratio in both sexes and with cigarette smoking in men and were negatively correlated with alcohol consumption in both sexes. In multiple linear regression analyses using categorized determinants as independent variables, a strongly J-shaped relation for body mass index in women and a linear association for waist-to-hip ratio in men were revealed. Smoking had a dose-dependent effect on fibrinogen concentration in men but a lesser effect in women. For alcohol consumption a U-shaped association was found, particularly in men. The curvilinear relations were confirmed in multiple polynomial regression models using continuous determinant variables. The potential epidemiological impact of a determinant was assessed by calculating differences in adjusted fibrinogen concentrations associated with the 10th and 90th percentile values of the determinant distributions actually observed among the study participants. This impact on the population fibrinogen level was most pronounced for age in both sexes, followed by body mass index, cigarette smoking, and alcohol consumption in women and by smoking, waist-to-hip ratio, and alcohol consumption in men.(ABSTRACT TRUNCATED AT 250 WORDS)

Smoking prohibition in the workplace and smoking cessation in the Federal Republic of Germany

BACKGROUND

The relationship between prohibition of smoking at the workplace and smoking cessation was assessed in a national sample survey conducted in the Federal Republic of Germany in 1987.

METHODS

Four hundred thirty-nine men and women ages 21 to 65, who were actively engaged in the workforce for at least 20 hr per week and were either current or former smokers, were included in the study.

RESULTS

Quit ratios were substantially higher among women who worked at worksites designated as smokefree compared with women who were allowed to smoke at their workplace. Among men, there were only minor differences between both types of worksites. After simultaneously controlling for age, marital status, and level of education by multiple logistic regression, the odds ratio of being a current smoker (vs former smoker) was 0.80 (95% confidence interval, 0.44-1.45) for men and 0.22 (95% confidence interval, 0.09-0.50) for women working at places where smoking was prohibited (compared with men and women who were allowed to smoke at the workplace).

CONCLUSION

These results suggest that prohibition of smoking at the workplace may help a substantial proportion of smokers, particularly female smokers, to quit. Prohibition of smoking at the workplace might therefore be a particularly cost-effective public health measure.