青岛市市区居民对吸烟有害健康的认知及态度调查

①目的了解青岛市市区居民吸烟情况及对吸烟有害健康的认知及态度。②方法采用整群随机抽样和单纯随机抽样相结合方法,对青岛市市区800名居民进行了问卷调查。③结果青岛市市区居民的吸烟率为18．3％,有97．9％的不吸烟居民和96．3％吸烟居民知道吸烟对健康有不同程度的危害,但两组居民对吸烟、被动吸烟对健康危害程度的认知率不同（uc=5．14、4．79,P〈0．01）。70％以上的居民知道吸烟会引起肺癌、慢性支气管炎,但对吸烟会引起高血压、冠心病等的认知率低于35％。计划在未来6个月内戒烟的吸烟者为43．1％。④结论青岛市城市居民缺乏吸烟对健康有害的认知,应在社区中开展健康教育和健康促进,提高社区居民对吸烟有害健康的认知率。     

Cigarette smoking among school children in Singapore. Part III--Knowledge and attitudes towards smoking.

In the third article in this series which mainly assesses the knowledge of school children on the harmful effects of smoking, findings showed that the majority (90%) of school children surveyed were aware of the harmful effects. Current smokers appeared to be the least knowledgeable (69.4%) whilst non-smokers (89.3%) and experimenters (93.7%) were the most knowledgeable. Lung cancer (49%), smoking is bad for health (25%), smoking is bad for passive smokers (7%) and for heart disease (6%) were the most common responses given by the children on the specific ill effects caused by smoking. Smokers and non-smokers alike agreed that smoking is addictive, the proportions agreeing, once again, being lowest among smokers and highest among non-smokers. This trend was also observed when respondents were asked for their attitudes towards smoking--whether cigarette smoking was harmful and whether smoking made a person popular. The majority of respondents felt that a boy or girl who smoked "looked bad"--39% thought so of boys, while a higher proportion (55%), had the same impression of girls. The main reasons for giving up smoking given by ex-smokers were its harmful effects on health (49%), there being no more "kick" to it (16%), peer pressure (13%) and the disapproval of parents and teachers (13%). Among current smokers, at least half stated that they would like to stop smoking. Most of them had tried to kick the habit before but failed in their attempts. Finally, among the non-smokers, only 0.4% of boys and 0.1% of girls indicated that they might smoke in the future.     

吸烟对男性生殖的毒性影响

吸烟是一种广泛存在的社会行为,是影响男性生殖的外环境因素。香烟烟雾中含有多种有害化合物,吸烟既危害身体健康,也危害生殖健康。本文综述了近年来国内外吸烟对睾丸、附睾、精子、性激素以及性功能等方面影响的研究进展,阐述吸烟危害生殖健康,希望引起人们的重视,为进一步研究吸烟的生殖毒性提供参考。     

吸烟与大肠癌的关系:一项回顾性病例-对照研究

目的试图明确吸烟与大肠癌发生之间的关系。方法为回顾性分析病例对照研究,文中病例均来自我院2009-2011年的住院患者,将患者分为两组:大肠癌组计157例,肠道良性疾病组计80例。两组病例在年龄、性别方面匹配良好。分析两组病例中吸烟者所占比例,同时分析吸烟与性别、肿瘤发生部位之间是否存在联系。结果吸烟者(不论戒烟与否)在病例组中所占比率与对照组比较差异无统计学意义(P >0.05),在每日吸烟量、吸烟年限、吸烟指数等指标上,两组差异亦均无统计学意义(P >0.05)。吸烟者(不论戒烟与否)在不同部位的大肠癌患者中所占的比例差异无统计学意义(P >0.05),在每日吸烟量、吸烟年限、吸烟指数等指标上,不同部位肿瘤差异亦均无统计学意义(P >0.05)。结论吸烟并未增加罹患大肠癌的危险,但考虑到吸烟的其他危害,仍应远离烟草,及早戒烟。     

Prevalence and determinants of adolescent cigarette smoking in Mongolia

INTRODUCTION: Cigarette smoking is the single most important risk factor for non-communicable chronic medical conditions. Estimating the prevalence of cigarette smoking and its determinants will aid in the design, implementation and evaluation of public health interventions. This study was conducted to estimate the prevalence and determinants of smoking among school-going adolescents in Mongolia. METHODS: A cross-sectional study using standardised methodology was conducted among school-going adolescents in 2003 in Mongolia. RESULTS: 4,105 adolescents (mean age 14.1 years, standard deviation 0.8 year) participated in the study. Approximately 55 percent were females, 30.4 percent of the study population was 15 years old, 63.5 percent had never smoked and 93.2 percent perceived tobacco as harmful. About 58 percent had parents, and 52 percent had friends, who were smokers. The prevalence of current cigarette smoking was 9.2 percent; 15.4 percent among males versus 4.4 percent among females. Cigarette smoking was associated with the male gender, parental and peer influence and having spending power. The perception that smoking was harmful to health was associated with lower odds of smoking. CONCLUSION: Cigarette smoking is prevalent among school-going adolescents in Mongolia. There is a need to implement public health interventions, with special attention to the determinants of smoking in this age group.     

吸烟致组织移植血循环危象的临床与实验研究

２例足趾移植和１例肌皮瓣在吸烟后发生血循环危象，造成２例手术失败，１例经积极抗凝解痉治疗后成活。实验研究证实吸烟对大鼠血管吻合口内皮细胞愈合过程有不良影响，吸烟组血管吻合后５～１０天，内皮细胞生长率仅占１６％～３２％，血小板吸附占８％～１０％，而正常组分别为７５％－１００％及０％。文章讨论了吸烟引起血循环危象的机制和特点。     

结直肠癌患者术后1年戒烟成功率及复吸的影响因素研究

背景　吸烟是结直肠癌发病的危险因素之一,且与结直肠癌根治术后复发、转移关系密切。目前,吸烟对结直肠癌患者的危害未得到临床上的足够重视,特别是缺乏针对结直肠癌术后患者戒烟成功率及复吸影响因素的研究。目的　调查并分析就诊时尚未戒烟的结直肠癌患者在术后1年内的戒烟成功率、复吸情况及相关影响因素。方法　选取2014年1月—2017年1月在复旦大学附属闵行医院就诊时尚未戒烟且经肠镜及病理证实的结直肠癌患者。患者常规停止吸烟1~2周后接受结直肠癌根治性手术（开腹手术或腹腔镜结直肠癌根治术）,至出院前停止吸烟3~4周,出院时常规宣教。记录患者的一般情况、问卷调查可能影响患者复吸的因素、门诊随访患者复吸情况1年。采用多因素Logistic回归分析探讨结直肠癌患者术后1年复吸的独立影响因素。结果　共收集117例就诊时尚未戒烟的结直肠癌患者,均完成1年随访,70例患者成功戒烟,戒烟成功率为59.8%。复吸47例,复吸率为40.2%。不同性别、文化程度、家庭收入、开始吸烟年龄、烟龄、每日吸烟量、是否晨起5 min内即吸第一支烟、了解与否吸烟有害健康、了解与否吸烟与呼吸系统疾病的关系、术后是否接受常规化疗患者术后1年复吸率比较,差异均无统计学意义（P>0.05）;年龄>55岁患者术后1年复吸率低于≤55岁患者,非独居患者术后1年复吸率低于独居患者,家人朋友反对其吸烟的患者术后1年复吸率低于家人朋友对其吸烟持听之任之态度的患者,了解吸烟与结直肠癌的关系的患者术后1年复吸率低于不了解吸烟与结直肠癌的关系的患者,开腹手术患者术后1年复吸率低于腹腔镜结直肠癌根治术患者,永久性结肠造口患者术后1年复吸率低于非永久性结肠造口患者（P<0.05）。多因素Logistic回归分析结果显示,年龄〔OR=0.276,95%CI（0.104,0.729）〕、独居〔OR=0.190,95%CI（0.044,0.816）〕、家人朋友对其吸烟的态度〔OR=0.279,95%CI（0.108,0.719）〕及是否行永久性结肠造口〔OR=0.162,95%CI（0.032,0.810）〕是结直肠癌患者术后1年复吸的独立影响因素（P<0.05）。结论　结直肠癌术后患者戒烟成功率较低,年龄、是否独居、家人朋友对其吸烟的态度是影响戒烟的主要因素,对于微创手术且未行结肠造口的患者应特别加强控烟教育。     

Effect of cigarette smoking on human health and promising remedy by mangroves

This article reviews the evils of cigarette smoking and the promise of mangroves to cure them.Chemicals in cigarette smoke are leading cause of death to both smokers and nonsmokers.Plant is the potential source to produce medicine for almost all the diseases.Mangroves are promising as a novel source of anti-cancer drugs in regulating the cancer pathways and stimulating immunity in the body system.Research on medicine from mangroves for the treatment of cancer has not only been shown to have an effect on cancer,but also provided important methods for the study of cancer therapy and mechanism.This report may help to explore the medicinal properties of the mangroves.     

Considerations for smoking advice in pregnancy

Cigarette smoking in pregnancy was the single most important preventable factor identified when determinants of birth weight were studied in 375 pregnancies. Current professional intervention was not effective in reducing cigarette consumption in pregnancy in these mothers in Londonderry, of whom only 19 (5%) became ex-smokers. Present health education, which emphasises impaired fetal growth and wellbeing, had its greatest effect amongst primigravid smokers of whom 32% made some reduction in cigarette consumption. Maternal expectation of birth weight differed significantly between non-smokers, light to moderate, and heavy smokers (8.2 lb, 7.9 lb, 7.3 lb respectively). 54% of multiparous smokers expected the birth weight to be similar to the birth weight in previous pregnancies. Of the women who reduced smoking, 57% did so for the baby, 23% because they found the habit less pleasurable during pregnancy and 13% because of professional advice. Maternal expectation of birth weight is one factor which negates the slant of current health education advice in pregnancy. An anti-smoking programme aimed at protecting the fetus from the harmful effects of cigarettes may produce optimal results when targeted at primary school-aged children in whom the smoking habit is less firmly established.     

Smoking and death rates: report on forty-four months of follow-up of 187,783 men. 2. Death rates by cause

Information was gathered on the smoking habits of 187,783 white men between the ages of 50 and 69 between January 1 and May 31, 1952. The men were subsequently traced through October 31, 1955. 11,870 men died during this period. The total experience covered 667,753 man years. For microscopically proved cases of cancer and for the total cases reported as cancer it was found that the death rates were higher among regular cigarette smokers than among men who never smoked, that the mortality ratio increased with the number of cigarettes smoked each day, and that the death rates were higher among pipe and cigar smokers than among men who never smoked. 7316 deaths occurred among regular cigarette smokers; this was an excess of 2665 over the 4651 deaths that would have occurred had the age-specific death rates for smokers been equal to that for nonsmokers. Coronary disease accounted for 52.1% of the excess; lung cancer accounted for 13.5% of the excess; and cancer of other sites accounted for 13.5% of the excess. An extremely high association between cigarette smoking and death rates for men with lung cancer was found in both rural areas and large cities. Only 338 deaths were ascribed to pulmonary diseases other than lung cancer. Only 1120 (9.4%) of the 11,870 deaths were attributed to diseases other than cancer, cardiac, circulatory, and pulmonary diseases and accidents, violence, and suicide. Only 3 of the specific disease entities - gastric and duodenal ulcers and cirrhosis of the liver - showed a statistically significant degree of association with smoking habits. The most important finding of this study was the high degree of association between cigarette smoking and the total death rate.     

长期吸烟对健康成人血脂和血糖的影响

为探讨长期吸烟对空腹血脂、血糖、胰岛素及胰岛素敏感性指标的影响及其变化规律,在８２例健康成人通过多元逐步回归分析,探讨长期吸烟对血脂、血糖、胰岛素及胰岛素敏感性指标影响的显著性及影响程度;并以协方差分析校正其它影响因素后,对比分析长期吸烟者与不吸烟者血脂、血糖、胰岛素及胰岛素敏感性指标的差异程度。结果：长期吸烟者伴随有糖代谢及脂代谢指标异常变化。并与吸烟程度有显著性相关关系。校正其它可能影响的因素     

赣州市中学生的吸烟现状及其认识的调查分析

目的：了解赣州市中学生的吸烟情况及对吸烟行为的认知和态度。方法：采用分层整群抽样的方法，于2003年对赣州市1395名中学生进行了调查。结果：赣州市中学生的总吸烟率为8．75％，其中男性吸烟率为12．60％，女性吸烟率为2．73％；开始吸烟的平均年龄为14岁，最小为11岁；吸烟的主要动机是好奇和社会交往；中学生吸烟与学校类型和家庭收入等因素有关。本次调查还发现，80％以上的学生认为吸烟有害健康，但仍有一些模糊的认识；学生对控烟措施的有关知识有所了解，但仍处于较低的水平。结论：有效控烟应采取创造无烟环境，开展健康教育，增加控烟的有关知识等干预措施。     

Cigarette smoking and invasive cervical cancer

A case-control study of 480 patients with invasive cervical cancer and 797 population controls, conducted in five geographic areas in the United States, included an evaluation of the relationship of several cigarette smoking variables to cervical cancer risk. Although smoking was correlated with both age at first intercourse and number of sexual partners, a significant smoking-related risk persisted for squamous cell carcinoma after adjustment for these factors (relative risk, 1.5). The risk of squamous cell cancers increased significantly with intensity and duration of smoking. Twofold excess risks were seen for those smoking 40 or more cigarettes per day and those smoking for 40 or more years. In addition, users of nonfilter cigarettes were at particularly high risk. Increased risks, however, were observed only among recent and continuous smokers. In contrast to squamous cell cancer, no relationship was observed between smoking and risk of adenocarcinoma or adenosquamous carcinoma (n = 63). These results suggest a causal relationship between cigarette smoking and invasive squamous cell cervical cancer, perhaps through a late-stage or promotional event, although the mechanisms of action require further elucidation.     

Studies in the distribution of body fat. III. Effects of cigarette smoking

Cross-sectional associations between smoking habits, body mass index, and waist-hip ratio (WHR) were examined in 1122 men aged 19 to 102 years. Weight and body mass index were significantly lower in cigarette smokers than in nonsmokers when age was taken into account. The WHR in smokers was significantly higher than in nonsmokers. A graded dose-response relationship was found between the number of cigarettes smoked and the WHR. Longitudinal associations between changes in smoking habits and changes in the WHR were examined during follow-up visits. In the period between these pairs of visits, weight increased when subjects quit smoking and decreased when they started smoking, as expected. The increase in WHR among those who quit smoking was, however, significantly less than the expected increase if smoking had continued. The WHR in those who started smoking actually increased despite their loss of weight. These paradoxical changes in WHR indicate that there are harmful effects of cigarette smoking on the pattern of distribution of body fat. These facts introduce still another reason to suggest that the decision to initiate or to continue smoking to control body weight is unwise.     

The Effect of Cigarette Smoking on Bladder Carcinogens in Man

In the metabolism of the amino acid, tryptophan, certain products with the orthoaminophenol configuration are believed to act as topical carcinogens in the urinary bladder. In addition, a statistical relationship between cigarette smoking and bladder cancer has been established in recent years.

Thirty metabolic studies are reported on six healthy male subjects when smoking and not smoking. Results revealed a consistent rise in carcinogenic metabolites of tryptophan when smoking (+ 50%), with a reciprocal fall in the end product, N'-methylnicotinamide (- 34%). Carcinogens fell and N'-methylnicotinamide rose when subjects stopped smoking. These metabolic studies confirm the statistical relationship between smoking and bladder cancer, and suggest that cigarette smoking blocks the normal metabolism of tryptophan, leading to the accumulation of carcinogenic metabolites.

     

Trends in mortality among California physicians after giving up smoking: 1950-79

A study was conducted to assess how lung cancer and other mortality trends among California physicians had been influenced by the high proportion who had given up smoking since 1950. Several sample surveys indicated that the proportion of California physicians who currently smoked cigarettes had declined dramatically from about 53% in 1950 to about 10% in 1980. During the same period the proportion of other American men who smoked cigarettes had declined only modestly, from about 53% to 38%. Using the 1950 American Medical Directory a cohort of 10 130 California male physicians was established and followed up for mortality till the end of 1979, during which time 5090 died. The information from follow up and death certification was exceptionally good. The standardised mortality ratio for lung cancer among California male physicians relative to American white men declined from 62 in 1950-9 to 30 in 1970-9. The corresponding decline in standardised mortality ratio was from 100 to 63 for other smoking related cancer, from 106 to 71 for ischaemic heart disease, and from 62 to 35 for bronchitis, emphysema, and asthma. The standardised mortality ratio remained relatively constant for other causes of death not strongly related to smoking. The overall ratio declined in all age groups at a rate of about 1% a year. The total death rate among all physicians converged towards the rate among non-smoking physicians. By the end of the study period physicians had a cancer rate and total death rate similar to or less than those among typical United States non-smokers. This "natural experiment" shows that lung cancer became relatively less common on substantial elimination of the primary causal factor, cigarette smoking. Other smoking related diseases also became relatively less common, though factors other than cigarette smoking may have contributed to this change.     

Nicotine replacement in smoking cessation. Absorption of nicotine vapor from smoke-free cigarettes

Nicotine replacement is a promising new approach to aid smoking cessation, and various methods of delivery are being developed. One new device is a smoke-free cigarette (Favor) that has been test-marketed in several US states. Without lighting up, it delivers nicotine vapor and is free of other harmful products of tobacco smoke. To examine its therapeutic potential, we measured plasma nicotine concentrations before, during, and after its use in eight male subjects. Very little nicotine was absorbed when it was puffed like a conventional cigarette. However, with an intensive schedule of puffing at four further smoke-free cigarettes over a 20-minute period, plasma nicotine concentrations were increased by an average of 17.3 ng/mL (107.3 nmol/L) (range, 10.9 to 30.4 ng/mL [67.6 to 188.5 nmol/L]). Heart rate and blood pressure also increased significantly. The rate of nicotine absorption was slow and resembled that obtained from nicotine chewing gum, suggesting that most of the nicotine was deposited in the mouth, throat, and large airways and did not reach the lung alveoli. Despite the slow absorption, the plasma nicotine levels produced could be of therapeutic value as an aid to smoking cessation.     

Cigarette smoking among school teachers in Tobago

Tobago, until lately, was considered a society with a low prevalence of cigarette smoking. Recent surveys, however, showed an increasing smoking prevalence among school children. To assess whether teachers in Tobago can be credible role models for their pupils, we carried out a cross-sectional survey on their smoking-related attitudes and behaviour in 2002. We distributed anonymous, structured questionnaires to teachers of all 52 primary and secondary schools in the island and conducted structured observations in schools. Of 579 teachers present during the survey, 559 (97%) returned a completed questionnaire; 8.6% of the male and 2.4% of the female teachers reported to be current cigarette smokers; slightly higher proportions had ever been daily smokers. Teachers were well aware of the harmful effects of smoking. Significantly more non-smokers than current smokers were in favour of strict school smoking regulations. The vast majority of the teachers perceived anti-smoking education as their duty. None of the schools had dedicated smoking rooms for teachers, and we found no cigarette butts in or around teachers' rooms. In Tobago, teachers have a lower reported prevalence of cigarette smoking than their pupils. Thus, most teachers can be credible role models with regard to smoking prevention and should be encouraged to become more active in school-based preventive activities.     

Laryngeal cancer and alcohol consumption in Australia.

Whereas lung cancer is strongly associated with cigarette smoking, and upper alimentary tract cancers with both alcohol and cigarettes, the situation has been less clear-cut for laryngeal cancer. This century's time trends in laryngeal cancer death rates in Australia follow those of oesophageal cancer rather than lung cancer. Further, the trends correlate with those for alcohol consumption rather than cigarette consumption. The separate analyses of trends in age-specific death rates for men and women reveal a pattern of laryngeal cancer risk variation between successive generations which is consistent with a causal role of alcohol consumption. Biological mechanisms, and synergism, between alcohol and cigarette consumption are discussed.     

孕期吸烟与被动吸烟影响妊娠结局的研究进展

吸烟会带来一系列的健康问题,而孕期吸烟或者被动吸烟的危害更大。国内外的专家采用了多种研究方法,证实烟草中的化合物对孕妇和胎儿均有害。接触烟雾的孕妇在妊娠期间早产、流产和死胎的风险及各种并发症的风险将大大增加,且对妊娠结局产生较大影响。今后应加强针对孕妇的有关香烟烟雾危害的健康教育工作,从而使孕妇最终能够有效回避香烟烟雾的危害。