Smoking

From Anvita Health Wiki

Contents 1 Etiology 2 Pathology 3 Genetics 4 Laboratory 5 Complications 6 Management 7 More General Terms 8 Additional Terms 9 References

Etiology

• smoking may be a sign of mental illness [4]

Pathology

• Some known carcinogens in smoke

• polycyclic aromatic hydrocarbons

• benzo[a]pyrene

• aromatic amines

• 4-aminobiphenyl

• nitrosamines

• 4-(methylnitrosoamino)-1-(3-pyridyl)-1-butanone

• benzene & benzene metabolites
• acrylamide
• acrylonitrile

Genetics

• AZGP1 may reduce body fat in smokers

Laboratory

• decrease in HDL cholesterol
• increase in plasma fibrinogen
• decrease in plasma plasminogen
• increase in blood carboxyhemoglobin

Complications

• Increased risk* of:

• chronic obstructive pulmonary disease ( COPD)
• pneumonia
• atherosclerosis

• coronary artery disease ( CAD) [19]

• epicardial coronary endothelial dysfunction [22]

• congestive heart failure secondary to CAD
• abdominal aortic aneurysm

• screening for older men who have ever smoked ( USPSTF)

• ischemic stroke?

• cancer (mostly carcinoma) of the

• lung#
• oral cavity, pharynx, larynx
• esophagus ( squamous cell and adenocarcinoma)
• bladder and renal pelvis
• pancreas
• nasal cavities and nasal sinuses
• stomach
• liver
• kidney ( renal cell carcinoma)
• uterine cervix
• bone marrow - myeloid leukemia

• impotence
• mortality [13,18]
• diabetes mellitus type 2 (see CARDIA study)
• chronic pancreatitis
• birth defects associated with smoking during pregnancy [28]
  

• * Unfiltered high-tar cigarettes associated with greatest risk of tar in filtered cigarettes has little effect on risk [11]
• # 26-fold increase risk of lung cancer for 1 pack/day relative to non-smoker reduction in smoking reduces lung cancer risk [16]
  
• Diseases associated with or aggravated by smoking:

• asthma
• pulmonary fibrosis
• calcification of pleural plaques in asbestosis
• alveolar proteinosis
• Langerhans cell granuloma
• Goodpasteur's syndrome (lung hemorrhage)
  

• Other increased risks:

• infections of the lower respiratory tract

• includes Mycoplasma pneumonia

• fluid collection in the middle ear
• decreased lung function
• increased risk of developing asthma
• cataracts [3]
• increased risk of post-operative complications [6]
  

• Pipe & cigar smoking also associated with COPD [25]
  
• Water pipe smoking with pulmonary effects similar to cigarettes [27]
  
• 2nd hand smoke or passive smoking:

• increases risk of lung cancer (30%)
• increases risk of coronary artery disease (30%)
• increased bronchial hyperreactivity & risk of asthma [5]
• diminishes FEV1 [5]
• may increase risk of sudden infant death syndrome ( SIDS) [8]
• risks may be overestimated [10]
• increases risk of mortality (15%) [12]

Management

• see smoking cessation

More General Terms

• tobaccoism

Additional Terms

• bupropion (Wellbutrin, Wellbutrin SR, Zyban, Aplenzin)
• clonidine (Catapres)
• doxepin (Sinequan, Adapin, Zonalon, Silenor)
• fluoxetine (Prozac, Sarafem)
• nicotine
• nicotine gum (Nicorette)
• nicotine patch (Habitrol, Nicoderm, Nicotrol, ProStep)
• second hand smoke (passive smoking)
• smokeless tobacco
• smoking cessation
• tobacco

References

1. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 738-39
2. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
3. Journal Watch 20(18):144, 2000 Christen WG et al Smoking cessation and risk of age-related cataract in men. JAMA 284:713, 2000 PMID: &dopt=Abstract
4. Journal Watch 21(1):4, 2001 Lasser K et al Smoking and mental illness: A population-based prevalence study. JAMA 284:2606, 2000 PMID: [1]
5. Journal Watch 22(3):24, 2002 Janson C et al Effect of passive smoking on respiratory symptoms, bronchial responsiveness, lung function, and total serum IgE in the European Community Respiratory Health Survey: a cross-sectional study. Lancet 358:2103, 2001 PMID: [2]
6. Journal Watch 22(6):46, 2002 Moller AM et al Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial. Lancet 359:114, 2002 PMID: [3]
7. Journal Watch 22(8):62-63, 2002 Cornuz J et al Efficacy of resident training in smoking cessation: a randomized, controlled trial of a program based on application of behavioral theory and practice with standardized patients. Ann Intern Med 136:429, 2002 PMID: [4]
8. Journal Watch 22(8):62, 2002 McMartin KI Lung tissue concentrations of nicotine in sudden infant death syndrome (SIDS). J Pediatr 140:205, 2002 PMID: &dopt=Abstract
9. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
10. Journal Watch 23(13):106, 2003 Enstrom JE & Kabat GC Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98. BMJ 326:1057, 2003 <PubMed> PMID: [5] <Internet> [6]
    - Davey Smith G Effect of passive smoking on health. BMJ 326:1048, 2003 <PubMed> PMID: [7] <Internet> [8]
11. Journal Watch 24(5):42, 2004 Harris JE et al Cigarette tar yields in relation to mortality from lung cancer in the cancer prevention study II prospective cohort, 1982-8. BMJ 328:72, 2004 <PubMed> PMID: [9] <Internet> [10]
12. Journal Watch 24(12):99, 2004 Hill S, Blakely T, Kawachi I, Woodward A. Mortality among 'never smokers' living with smokers: two cohort studies, 1981-4 and 1996-9. BMJ. 2004 Apr 24;328(7446):988-9. Epub 2004 Apr 05. No abstract available. <PubMed> PMID: &dopt=Abstract <Internet> [11]
13. Journal Watch 24(16):131, 2004 Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ. 2004 Jun 26;328(7455):1519. Epub 2004 Jun 22. <PubMed> PMID: [12] <Internet> [13]
14. Journal Watch 25(6):49, 2005 Anthonisen NR, Skeans MA, Wise RA, Manfreda J, Kanner RE, Connett JE; Lung Health Study Research Group. The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial. Ann Intern Med. 2005 Feb 15;142(4):233-9. Summary for patientsin: Ann Intern Med. 2005 Feb 15;142(4):I12. PMID: [14]
15. Journal Watch 25(13):106, 2005 Chinn S, Jarvis D, Melotti R, Luczynska C, Ackermann- Liebrich U, Anto JM, Cerveri I, de Marco R, Gislason T, Heinrich J, Janson C, Kunzli N, Leynaert B, Neukirch F, Schouten J, Sunyer J, Svanes C, Vermeire P, Wjst M, Burney P. Smoking cessation, lung function, and weight gain: a follow-up study. Lancet. 2005 May 7;365(9471):1629-35; discussion 1600-1. PMID: [15]
    - Colditz GA, Stein C. Smoking cessation, weight gain, and lung function. Lancet. 2005 May 7;365(9471):1600-1. No abstract available. PMID: [16]
16. Godtfredsen NS, Prescott E, Osler M. Effect of smoking reduction on lung cancer risk. JAMA. 2005 Sep 28;294(12):1505-10. PMID: [17]
17. Barnfather KD et al Effect of incorporating a 10 minute point of care test for salivary nicotine metabolites into a general practive based smoking cessation programme: randomized controlled trial. BMJ 331(7533): 999, 2005 PMID: [18]
18. Vollset SE, Tverdal A, Gjessing HK. Smoking and deaths between 40 and 70 years of age in women and men. Ann Intern Med. 2006 Mar 21;144(6):381-9. PMID: [19]
19. Teo KK et al, Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: A case control study. Lancet 2006, 368:647 PMID: [20]
20. Prescriber's Letter 13(12): 2006 Smoking Cessation Drug Therapy Detail-Document#: [21] (subscription needed) [22]
21. Klement E et al, Identification of risk factors for infection in an outbreak of Mycoplasma pneumoniae respiratory tract disease. Clin Infect Dis 2006, 43:1239 PMID: [23]
22. Lavi S, Prasad A, Yang EH, Mathew V, Simari RD, Rihal CS, Lerman LO, Lerman A. Smoking is associated with epicardial coronary endothelial dysfunction and elevated white blood cell count in patients with chest pain and early coronary artery disease. Circulation. 2007 May 22;115(20):2621-7. Epub 2007 May 7. PMID: [24]
23. Prescriber's Letter 15(7): 2008 Comparison of Smoking Cessation Drug Therapy CHART: Comparison of Smoking Cessation Drug Therapy COMMENTARY: Smoking Cessation Drug Therapy: An Update GUIDELINES: Treating Tobacco Use and Dependence: 2008 Update Detail-Document#: [25] (subscription needed) [26]
24. U.S. Preventive Services Task Force. Counseling and interventions to prevent tobacco use and tobacco-caused disease in adults and pregnant women: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med 2009 Apr 21; 150:551 <PubMed> PMID: [27] <Internet> [28]
25. Rodriguez J et al. The association of pipe and cigar use with cotinine levels, lung function, and airflow obstruction: A cross-sectional study. Ann Intern Med 2010 Feb 16; 152:201. PMID: [29]
26. Cote GA et al. Alcohol and smoking as risk factors in an epidemiology study of patients with chronic pancreatitis. Clin Gastroenterol Hepatol 2011 Mar; 9:266 PMID: [30]
27. Raad D et al. Effects of water-pipe smoking on lung function: A systematic review and meta-analysis. Chest 2011 Apr; 139:764 PMID: [31]
    - Hakim F et al. The acute effects of water-pipe smoking on the cardiorespiratory system. Chest 2011 Apr; 139:775. PMID: [32]
28. Hackshaw A et al, Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls Hum. Reprod. Update (2011) Published online: July 11, 2011 <PubMed> PMID: [33] <Internet> [34]
29. Smoking and Your Digestive System [35]
    - Smoking: NIH Institute and Center Resources [36]
30. National Guideline Clearinghouse
    - Smoking cessation in HIV-infected patients. (New York State Department of Health) ngc-guideline: [37]
    - Brief interventions and referral for smoking cessation in primary care and other settings. National Institute for Health and Clinical Excellence ngc-guideline: [38]
    - Workplace health promotion: how to help employees to stop smoking. National Institute for Health and Clinical Excellence ngc-guideline: [39]
    - Varenicline for smoking cessation. National Institute for Health and Clinical Excellence ngc-guideline: [40]
    - Treating tobacco use and dependence: 2008 update. Public Health Service (U.S.) ngc-guideline: [41]
    - Reducing the rate of premature deaths from cardiovascular disease and other smoking-related diseases: finding and supporting those most at risk and improving access to services. National Institute for Health and Clinical Excellence (NICE) ngc-guideline: [42]
    - Counseling and interventions to prevent tobacco use and tobacco-caused disease in adults and pregnant women: U.S. Preventive Services Task Force reaffirmation recommendation statement ngc-guideline: [43]

smoking; cigarette smoking; tobacco smoking