To Quit Smoking, Try Eating More Veggies and Fruits

If you're trying to quit smoking, eating more fruits and vegetables may help you quit and stay tobacco-free for longer, according to a new study published online by University at Buffalo public health researchers.

If you're trying to quit smoking, eating more fruits and vegetables may help you quit and stay tobacco-free for longer [Credit: © taviphoto / Fotolia]

The paper, in the journal Nicotine and Tobacco Research, is the first longitudinal study on the relationship between fruit and vegetable consumption and smoking cessation.

The authors, from UB's School of Public Health and Health Professions, surveyed 1,000 smokers aged 25 and older from around the country, using random-digit dialing telephone interviews. They followed up with the respondents fourteen months later, asking them if they had abstained from tobacco use during the previous month.

"Other studies have taken a snapshot approach, asking smokers and nonsmokers about their diets," says Gary A. Giovino, PhD, chair of the Department of Community Health and Health Behavior at UB. "We knew from our previous work that people who were abstinent from cigarettes for less than six months consumed more fruits and vegetables than those who still smoked. What we didn't know was whether recent quitters increased their fruit and vegetable consumption or if smokers who ate more fruits and vegetables were more likely to quit."

The UB study found that smokers who consumed the most fruit and vegetables were three times more likely to be tobacco-free for at least 30 days at follow-up 14 months later than those consuming the lowest amount of fruits and vegetables. These findings persisted even when adjustments were made to take into account age, gender, race/ethnicity, education, household income and health orientation.

They also found that smokers with higher fruit and vegetable consumption smoked fewer cigarettes per day, waited longer to smoke their first cigarette of the day and scored lower on a common test of nicotine dependence.

"We may have identified a new tool that can help people quit smoking," says Jeffrey P. Haibach, MPH, first author on the paper and graduate research assistant in the UB Department of Community Health and Health Behavior. "Granted, this is just an observational study, but improving one's diet may facilitate quitting."

Several explanations are possible, such as less nicotine dependence for people who consume a lot of fruits and vegetables or the fact that higher fiber consumption from fruits and vegetables make people feel fuller.

"It is also possible that fruits and vegetables give people more of a feeling of satiety or fullness so that they feel less of a need to smoke, since smokers sometimes confuse hunger with an urge to smoke," explains Haibach.

And unlike some foods which are known to enhance the taste of tobacco, such as meats, caffeinated beverages and alcohol, fruits and vegetables do not enhance the taste of tobacco.

"Foods like fruit and vegetables may actually worsen the taste of cigarettes," says Haibach.

While smoking rates in the U.S. continue to decline, Giovino notes, the rate of that decline has slowed during the past decade or so. "Nineteen percent of Americans still smoke cigarettes, but most of them want to quit," he says.

Haibach adds: "It's possible that an improved diet could be an important item to add to the list of measures to help smokers quit. We certainly need to continue efforts to encourage people to quit and help them succeed, including proven approaches like quitlines, policies such as tobacco tax increases and smoke-free laws, and effective media campaigns."

The UB researchers caution that more research is needed to determine if these findings replicate and if they do, to identify the mechanisms that explain how fruit and vegetable consumption may help smokers quit. They also see a need for research on other dietary components and smoking cessation.

Gregory G. Homish, PhD, assistant professor in the UB Department of Community Health and Health Behavior, also is a co-author.

Funding was provided by the Robert Wood Johnson Foundation and LegacyA®.

Source: University at Buffalo [June 06, 2012]

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Smoking Zaps Healthy Bacteria In the Mouth

According to a new study, smoking causes the body to turn against its own helpful bacteria, leaving smokers more vulnerable to disease. 

Despite the daily disturbance of brushing and flossing, the mouth of a healthy person contains a stable ecosystem of healthy bacteria. New research shows that the mouth of a smoker is a much more chaotic, diverse ecosystem -- and is much more susceptible to invasion by harmful bacteria. 

As a group, smokers suffer from higher rates of oral diseases -- especially gum disease -- than do nonsmokers, which is a challenge for dentists, according to Purnima Kumar, assistant professor of periodontology at Ohio State University. She and her colleagues are involved in a multi-study investigation of the role the body's microbial communities play in preventing oral disease. 

"The smoker's mouth kicks out the good bacteria, and the pathogens are called in," said Kumar. "So they're allowed to proliferate much more quickly than they would in a non-smoking environment." 

The results suggest that dentists may have to offer more aggressive treatment for smokers and would have good reason to suggest quitting smoking, Kumar said. 

"A few hours after you're born, bacteria start forming communities called biofilms in your mouth," said Kumar. "Your body learns to live with them, because for most people, healthy biofilms keep the bad bacteria away." 

She likens a healthy biofilm to a lush, green lawn of grass. "When you change the dynamics of what goes into the lawn, like too much water or too little fertilizer," she said, "you get some of the grass dying, and weeds moving in." For smokers, the "weeds" are problem bacteria known to cause disease. 

In a new study, Kumar's team looked at how these bacterial ecosystems regrow after being wiped away. For 15 healthy nonsmokers and 15 healthy smokers, the researchers took samples of oral biofilms one, two, four and seven days after professional cleaning. 

The researchers were looking for two things when they swabbed subjects' gums. First, they wanted to see which bacteria were present by analyzing DNA signatures found in dental plaque. They also monitored whether the subjects' bodies were treating the bacteria as a threat. If so, the swab would show higher levels of cytokines, compounds the body produces to fight infection. 

The results of the study were published in the journal Infection and Immunity. 

"When you compare a smoker and nonsmoker, there's a distinct difference," said Kumar. "The first thing you notice is that the basic 'lawn,' which would normally contain thriving populations made of a just few types of helpful bacteria, is absent in smokers." 

The team found that for nonsmokers, bacterial communities regain a similar balance of species to the communities that were scraped away during cleaning. Disease-associated bacteria are largely absent, and low levels of cytokines show that the body is not treating the helpful biofilms as a threat. 

"By contrast," said Kumar, "smokers start getting colonized by pathogens -- bacteria that we know are harmful -- within 24 hours. It takes longer for smokers to form a stable microbial community, and when they do, it's a pathogen-rich community." 

Smokers also have higher levels of cytokines, indicating that the body is mounting defenses against infection. Clinically, this immune response takes the form of red, swollen gums -- called gingivitis -- that can lead to the irreversible bone loss of periodontitis. 

In smokers, however, the body is not just trying to fight off harmful bacteria. The types of cytokines in smokers' gum swabs showed the researchers that smokers' bodies were treating even healthy bacteria as threatening. 

Although they do not yet understand the mechanisms behind these results, Kumar and her team suspect that smoking is confusing the normal communication that goes on between healthy bacterial communities and their human hosts. 

Practically speaking, these findings have clear implications for patient care, according to Kumar. 

"It has to drive how we treat the smoking population," she said. "They need a more aggressive form of treatment, because even after a professional cleaning, they're still at a very high risk for getting these pathogens back in their mouths right away. 

"Dentists don't often talk to their patients about smoking cessation," she continued. "These results show that dentists should take a really active role in helping patients to get the support they need to quit." 

For Kumar, who is a practicing periodontist as well as a teaching professor, doing research has changed how she treats her patients. "I tell them about our studies, about the bacteria and the host response, and I say, 'Hey -- I'm really scared for you.' Patients have been more willing to listen, and two actually quit." 

Kumar's collaborators include Chad Matthews and Vinayak Joshi of Ohio State's College of Dentistry as well as Marko de Jager and Marcelo Aspiras of Philips Oral Healthcare. The research was sponsored by a grant from Philips Oral Healthcare. 

Author: Maureen Langlois | Source: Ohio State University [February 15, 2012]

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Researchers Create Healthier Cigarette

From a health care perspective, the best cigarette is no cigarette, but for the millions of people who try to quit smoking every year, researchers from Cornell University may have found a way to make cigarette smoking less toxic. 

Using natural antioxidant extracts in cigarette filters, the researchers were able to demonstrate that lycopene and grape seed extract drastically reduced the amount of cancer-causing free radicals passing through the filter. The research will be the 1500th article published in the ground-breaking Journal of Visualized Experiments (JoVE), the only peer-reviewed, PubMed indexed video-journal. 

"The implications of this technique can help reduce the hazardous effects of tobacco smoke," said Dr. Boris Dzilkovski, who co-authored the paper, "because free radicals are a major group of carcinogens." 

Scientists have tried to make safer cigarettes in the past. Haemoglobin (which transports oxygen in red blood cells) and activated carbon have been shown to reduce free-radicals in cigarette smoke by up to 90 percent, but because of the cost, the combination has not been successfully introduced to the market. 

JoVE Content Director, Dr. Aaron Kolski-Andreaco, is very excited to be publishing this article as the journal’s landmark 1500th article. 

"Practically, this research could lead to an alternative type of cigarette filter with a free radical scavenging additive," said Kolski-Andreaco. "It could lead to a less harmful cigarette." 

To watch the full video article, please click here: http://www.jove.com/video/3406/a-protocol-for-detecting-and-scavenging-gas-phase-free-radicals-in-mainstream-cigarette-smoke. 

Source: Journal of Visualized Experiments [January 01, 2012]

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Making Big Tobacco pay smokers' health bills: lessons from the United States

Reports that Nicola Roxon plans to encourage state governments to consider legal action to recover around A$31 billion in smoking-related health-care costs from the tobacco industry highlight the incoming attorney-general’s commendable commitment to reducing the impact of smoking-related illness and mortality. 

The legacy of the US Master Settlement Agreement holds significant lessons for policy makers in Australia [Credit: Razvan Caliman]

Such litigation is a potentially powerful way of countering the tobacco industry, but has been largely limited to the United States to date. As part of preliminary work on the proposal, Roxon has brought Matthew Myers, president of the leading US tobacco control organisation, Campaign for Tobacco-Free Kids, to Australia to discuss litigation with state officials. 

Myers, as The Australian points out, advised US attorneys-general during litigation against the tobacco industry in the late 1990s, and played a key role in negotiations that resulted in the controversial 1998 Master Settlement Agreement (MSA). 

While a spokeswoman for Roxon stated that Myers had been brought in to “share his extensive experience in tobacco-related litigation” and that the minister was “heartened by the support of such an esteemed anti-tobacco expert", the MSA has, in fact, had limited impact on the tobacco industry and effectively split the tobacco control community in the United States. 

Probably best known for its requirement that Philip Morris and other leading tobacco corporations make payments of US$246 billion to those states party to the settlement over a 25-year period, the MSA remains controversial within US tobacco control and broader public health circles, and it’s imperative that Australian officials consider the circumstances surrounding its progress carefully. 

The US Master Settlement Agreement 

The MSA was the result of secret negotiations between the tobacco industry, and attorneys-general and members of the tobacco control community including Myers. Critics of the negotiations claim the tobacco industry was on the defensive in the late 1990s – facing a combination of dozens of state lawsuits, damaging insights into its long-standing knowledge of the harms of smoking, and falling stock prices – and that state lawsuits should have been allowed to go to trial. In effect, the negotiations let the industry off the ropes. 

Under the terms of the MSA, the tobacco industry paid US$246 billion, agreed to fund a national initiative to reduce smoking and accepted limited restrictions on advertising. In return, outstanding litigation was dropped by the 46 states party to the settlement, and future state-level litigation was pre-empted. 

The final terms have been described by Allan Brandt, professor of history of medicine at Harvard Medical School and author of the book The Cigarette Century, as “a pale reflection” of earlier proposed settlements. As many had predicted, tobacco corporations passed the costs of the MSA on to consumers through sharp price hikes essentially making the agreement, Brandt contends, little more than a new excise tax on cigarettes. 

Settlement results 

Ostensible marketing restrictions in the agreement contained so many loopholes that spending on cigarette advertising and promotion has, in fact, increased dramatically in the United States since 1998. Not only has the MSA had virtually no impact on tobacco industry income or marketing practice, signatory states have realised little benefit from it. 

And while it may appear impressive, the agreed multi-billion dollar payment was insufficient to cover the costs of treating smoking-related illnesses and, more significantly, there were no assurances included in the settlement that monies received by the states would be dedicated to health-care and tobacco control programs. 

In many cases these funds have disappeared into general revenues, making state politicians reliant on this unexpected income, and effectively making the states partners of the tobacco industry. As Brandt argues, any new legal challenges to the industry have become “threats to the states' cash flow”. 

Australia’s tobacco control legislation is considerably more advanced than that in the United States, so concerns that the MSA does little to curtail industry advertising are largely irrelevant here. But the legacy of the MSA does hold significant lessons for policy makers in this country assessing the advisability of mounting legal action to secure compensation for smoking-related health-care costs. 

Most importantly, the MSA demonstrates that litigation, once launched, will have to be pursued diligently and without recourse to negotiated settlements with the industry. 

The experience of US states also underlines the importance of installing a regulatory mechanism that ensures any monies recovered from the industry are used to underwrite health costs related to tobacco use. Given his central role in the MSA negotiations, Myers' best advice to Australian policy makers may well be about what not to do in future litigation. 

Author: Ross MacKenzie | Source: The Conversation [December 16, 2011]

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Research reveals when and why students smoke

Discovering when and why students smoke might lead to the development of better intervention methods, according to researchers at the University of Missouri. In an article published in the journal Substance Use & Misuse, the researchers showed that partying, drinking and work prompted college students to recall their smoking experience, and that smoking occurred most often at the start of the semester and on weekends. 

"Students are using social events and work as cues to remind them about smoking," said Nikole Cronk, PhD, assistant professor of family and community medicine at MU and lead author of the article. "This research is important for those working with college students to recognize when smoking is happening at its highest levels. Targeting interventions during those periods and prior to frequent smoking events would have the maximum impact on student smoking prevention." 

Nearly a half million deaths are attributed to smoking annually, costing nearly $200 billion in health care costs and lost productivity in the United States. Though cigarette smoking remains the leading cause of preventable deaths in the country, more than 20 percent of the population smokes. Every day, another 1,000 young people become new smokers.  

"We know that college is a time where we see initiation of smoking," Cronk said. "If you ask college students, many will tell you it's something they don't intend to do after they're out of school, but a significant number do continue smoking. What we know is there's no safe level of smoking and no way to know that once you start you'll be able to easily quit." 

Among college students, the rate of reported smokers spikes to nearly 30 percent. Since research shows that the majority of lifelong smokers begin smoking before the age of 24, targeting college student smokers with intervention and prevention efforts might help reduce those figures dramatically. 

"In our study, smoking rates were higher at the start of the semester and on weekends," Cronk said. "Targeting smoking prevention efforts immediately after students arrive on campus and throughout the semester in student email messages just prior to the weekend would be the most effective times to reach students." 

Partying, work, drinking, fraternity and sorority events, and vacation were among the top cues for recall of past smoking among students in social fraternities and sororities who participated in the study from 2006 to 2008. MU researchers believe their study is the first to examine smoking habits among this population. 

Cronk's study is part of a larger research project published in Preventive Medicine. The project focuses on a behavioral intervention approach known as motivational interviewing. In the approach, a clinician interviews a participant to discover what's important to that individual and how a behavior, such as smoking, might fit with that person's goals and values. Opposed to a traditional intervention approach that tells participants how to behave, motivational interviewing elicits motivation from participants to help them decide on their own whether to continue a behavior. 

"The key for intervention using that approach is identifying an individual's motivation for smoking," Cronk said. "Helping people understand why they are engaging in a behavior has much more promise for getting that person to address a behavior."  

Source: University of Missouri [November 06, 2011]

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Your stroke risk profile may also help predict your risk of memory problems

A new study shows a person's stroke risk profile, which includes high blood pressure, smoking, and diabetes, may also be helpful in predicting whether a person will develop memory and thinking problems later in the life. The research is published in the Nov. 8, 2011, issue of Neurology®, the medical journal of the American Academy of Neurology. 

Researchers in the REGARDS study followed 23,752 people with an average age of 64 who were free of stroke and cognitive problems at the start of the study. Participants underwent a Framingham Stroke Risk Profile, which is used to determine a person's risk of stroke by measuring their age, blood pressure, education level, history of heart disease, smoking and diabetes status, and whether they have left ventricular hypertrophy (a thickening of the heart muscle) and an abnormal heart rhythm. 

After an average of four years of follow-up, 1,907 people had developed memory and thinking problems. 

The study found the higher a person's score on the Stroke Risk Profile, the greater the chance of developing cognitive problems four years later. Fifteen percent of people who scored among the highest 25 percent on the Stroke Risk Profile test (greater than 11.99 points) had cognitive problems compared to three percent of those who scored among the bottom 25 percent with a score below 3.4 points. 

"Overall, it appears that the total Stroke Risk Profile score, while initially created to predict stroke, is also useful in determining the risk of cognitive problems," said study author Frederick Unverzagt, PhD, of Indiana University School of Medicine in Indianapolis. 

The study found older age and the presence of thickening in the heart muscle, which is a result of long-term high blood pressure, were the only Stroke Risk Profile factors independently associated with future cognitive problems. This association remained even after controlling for age, sex, race, where a person lived and education. In addition, the study also found high systolic blood pressure was related to cognitive problems in people without a thickening of the heart muscle. 

"Our findings suggest that elevated blood pressure and thickening of the heart muscle may provide a simple way for doctors to identify people at risk for memory and thinking problems," said Unverzagt. "Increased focus on preventing and treating high blood pressure may be needed to preserve cognitive health." 

Source: American Academy of Neurology [November 07, 2011]

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Influencing craving for cigarettes by stimulating the brain

Targeted brain stimulation increases cigarette cravings, a new study in Biological Psychiatry has found, which may ultimately lead to new treatments that reverse these effects. Cues associated with cigarette smoking, such as watching someone else smoke, elicit craving and may provoke relapse when smokers are attempting to quit. 

There are many methods that smokers use in an attempt to reduce their craving for cigarettes, including efficacious pharmacologic treatments such as nicotine patches, and alternative approaches such as hypnosis and acupuncture. Scientists have long suspected that these diverse approaches might work through a common mechanism -- the reduction of activity in a brain circuit that is responsible for cigarette craving. 

This hypothesis is supported by human functional brain imaging studies, which consistently report the activation of several brain regions during craving that involve regions in the cerebral cortex as well as the limbic system, a brain circuit involved in emotion. 

Building on these brain imaging studies, scientists at the Center for Nicotine and Smoking Cessation Research at Duke University Medical Center manipulated this ‘craving circuit’ activity using transcranial magnetic stimulation (TMS), a non-invasive technique that uses electromagnetic currents to target specific or general areas of the brain. Depending upon the frequency used, it can either stimulate or depress brain activity. 

The researchers found that the delivery of repeated TMS to the superior frontal gyrus at high frequency (10 Hz) increased craving for cigarettes. 

“We directly stimulated a frontal brain region using magnetic fields and showed that it exaggerated smokers’ craving for cigarettes when they viewed smoking related cues. By gaining a better understanding of how the brain influences craving responses, strategies for blocking these responses can be devised and ultimately more effective smoking cessation treatments may be developed,” explained Dr. Jed Rose, one of the study authors. 

However, they did not find that low frequency (1 Hz) stimulation reduced craving. Thus, a potential intervention that may have reduced the activation within this circuit did not produce the opposite effect. 

Nonetheless, the high frequency stimulation reduced craving when participants were viewing nonsmoking cues. Moreover, the ability of smoking to satisfy craving, a rewarding effect that helps keep smokers “hooked,” was partially blocked by high frequency stimulation. These effects need to be explored for potential therapeutic applications. 

“This elegant study implicates the superior frontal gyrus in controlling the activity of the craving circuit,” commented Dr. John Krystal, Editor of Biological Psychiatry. “Additional research will be needed to determine the potential value of repetitive TMS as a treatment for smoking.”   

Source: Elsevier [October 31, 2011]

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Computer-based tool to improve diagnosis and prognosis for cancer patients

A computer-based tool could help GPs to speed up the diagnosis and treatment of patients suffering from two of the most common forms of cancer, potentially saving thousands of lives every year. 

Researchers at The University of Nottingham and ClinRisk Ltd have shown that the algorithm is successful in identifying those suffering with gastro-oesophageal cancer and lung cancer at an earlier stage by 'red-flagging' potentially worrying combinations of symptoms and risk factors. 

Their results, published in the British Journal of General Practice on Monday October 31, showed that the 10 per cent of the patients that the algorithm predicted as most at risk of developing one of the two diseases accounted for 77 per cent of all the gastro-oesophageal and lung cancers diagnosed over the following two years. 

The research was led by Professor Julia Hippisley-Cox, in the University's Division of Primary Care. She said: "Earlier diagnosis of cancer is a major challenge and we hope this new research will help doctors identify patients for earlier referral and investigation." 

The tool could help GPs to improve their record on early diagnosis in line with current Government policy and the National Awareness and Early Diagnosis Initiative (NAEDI) — a public sector/third sector partnership between the Department of Health, National Cancer Action Team, and Cancer Research UK. Evidence suggests that simply raising awareness of symptoms and speeding up diagnosis could save 5,000 lives a year without any new advances in medicine. 

Two simple web calculators have been produced — one for lung cancer (www.qcancer/lung) and the other for gastro-oesophageal cancer (http://www.qcancer.org/gastro-oesophageal) — which are designed for use by doctors but a simpler version could also be made available on the internet to raise awareness among the general public and to prompt patients with high risk factors or symptoms to seek advice from their doctor. 

Lung cancer is the most common cancer worldwide, with 1.3 million new cases diagnosed every year. It has one of the lowest survival rates because two-thirds of patients are diagnosed too late to be successfully treated. 

It presents a huge challenge for family physicians because the symptoms can be common and non-specific. While smoking is a well-known risk factor, evidence suggests that other factors including age, social deprivation, and chronic obstructive airways disease also have an important part to play. 

The presence of the disease can be indicated by 'red flag' symptoms such as new onset of coughing, coughing up blood (haemotypsis), weight loss, loss of appetite and anaemia. Currently, doctors focusing on just one of these symptoms without taking into account other risk factors are likely to miss 80 per cent of current lung cancer cases. 

Similarly, gastro-oesophageal cancer is one of the most common cancers worldwide and earlier diagnosis could improve treatment options and improve five-year survival. 

Alarm symptoms for gastro-oesophageal cancer include vomiting blood (haematemesis), difficulty swallowing (dysphagia), appetite loss, weight loss, or abdominal pain but focusing on one symptom alone in diagnosis can mean that up to 40 per cent of cases are missed. Other underlying factors which could also alert doctors to patients at risk include heavy smoking. 

The study aimed to develop and test the success of a computer algorithm that would incorporate both the symptoms and underlying risk factors of patients to flag those in need of urgent investigation or referral. 

It used 375 general practices in the UK already using the QResearch® database system — a not-for-profit partnership between The University of Nottingham and leading GP systems supplier EMIS — to collect anonymised patient information. 

It included patients aged 30 to 84 years who were free from a diagnosis of the cancers at the start of the study. For lung cancer it ruled out those patients who had previously seen their GPs within the previous 12 months with symptoms of coughing up blood, loss of appetite or weight loss, while the gastro-oesophageal study looked at those patients at the beginning of the study free from difficulty swallowing, vomiting blood, abdominal pain, appetite loss or weight loss. 

The study then identified those patients with the highest associated risk factors for the cancers to predict which were most likely to develop the disease and then validated their results by looking at which patients had been diagnosed with the cancers at the end of two years. 

The study found that the new algorithm worked so well it could identify 10 per cent of the population in which around 77 per cent of all new cases of cancer arose over the two years. 

The algorithm could be incorporated into existing GP computer records to alert doctors to patients who are potentially at a higher risk of developing the diseases. 

In the case of the lung algorithm, it could also be used to inform National Institute of Clinical Excellence (NICE) guidelines on investigation and referral of patients with suspected cancer. For example, NICE guidance recommends an urgent referral for a chest x-ray for patients with persistent symptoms such as coughing up blood, chest pain, shortness of breath, cough or weight loss but not for appetite loss, despite the fact that the study showed that patients with this symptom is four or five times more likely to develop the cancer. 

Dr Clare Gerada, Chair of the Royal College of General Practitioners that publishes the BJGP, said: "The University of Nottingham studies will create great excitement for those of us working in primary care. Early diagnosis has a huge impact on the treatment and survivorship of patients with lung and stomach-related cancers. Incorporating this simple calculation into the consultation could give GPs a two-year headstart on investigation and treatment, with the potential to save thousands of lives. 

"This is exactly the sort of research that the British Journal of General Practice was set up to highlight — practical measures that GPs can take to improve the care they give to their patients. The publication of these vitally important studies by Professor Julia Hippisley-Cox, Dr Carol Coupland and their colleagues could prove a defining moment for cancer diagnosis. I hope the Department of Health and others will take heed." 

Similar QResearch® tests have already proven effective in previous research in identifying patients at most risk of developing heart disease, fracture, kidney disease and serious blood clots. 

Source: University of Nottingham [October 31, 2011]

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Cigarette smoking's impact lingers after quitting

Cigarette smoking appears to impair pancreatic duct cell function--even for those who quit--putting all smokers at risk of compromised digestive function regardless of age, gender and alcohol intake, according to the results of a study unveiled today at the American College of Gastroenterology's (ACG) 76th Annual Scientific meeting in Washington, DC. 

In a separate smoking-related study also released today, "Smoking Cessation and the Risk for Advanced Neoplasia: Risk for Women Persists Longer than for Men," researchers from the University of Connecticut found that the risk of advanced pre-cancerous tissue changes (neoplasia) was significantly elevated for women —even if they stopped smoking—but not for men--suggesting that the impact of smoking in women has a longer effect than in men. 

In the study, "Cigarette Smoking Impairs Pancreatic Duct Cell Function," researchers from Center for Pancreatic Disease at Brigham and Women's Hospital in Boston assessed pancreatic duct cell function in smokers and non-smokers (current and past). A total of 131 subjects (74 smoked and 57 never smoked) underwent secretin-stimulated endoscopic pancreatic function testing (ePFT), for pancreatic fluid bicarbonate analysis. Cigarette smoking exposure was found to be associated with an abnormal ePFT result, and there was no statistical difference in peak bicarbonate concentration between current and former smokers, according to the results. 

The risk of pancreatic duct cell dysfunction was 56.78 percent in former or current smokers and 26.32 percent in nonsmokers, according to Vivek Kadiyala, MD, who presented the findings. "Our data suggests the risk of duct cell dysfunction was doubled in patients who smoked compared to nonsmokers," said Dr. Kadiyala. 

"These findings indicate that anyone with a history of smoking, either current or past is at greater risk of impaired pancreatic duct cell function," said Dr. Kadiyala. 

"Additionally, the findings underscore the value that early smoking cessation may have for patients with chronic pancreatitis and as a result healthcare providers should advise patients to quit smoking as part of their overall treatment plan." 

Elevated Colorectal Cancer Risk for Women, Even After Smoking Cessation 

Even after women quit smoking they are still at an increased risk for colorectal cancer, according to researchers at the University of Connecticut who examined the risk of advanced neoplasia in 2428 male and female patients over age 45 who have quit smoking. 

The recent ACG colorectal cancer screening guidelines include smoking as a risk factor that should be considered when screening for colorectal cancer. Although the risk for neoplasia increases after 10 pack years of exposure, there is little data regarding the risk for advanced neoplasia after quitting. 

"The risk of advanced neoplasia was significantly elevated for women and men whether they were current smokers and/ or former smokers who quit within five years of screening colonoscopy," said Joseph C. Anderson, MD, FACG, also of the White River Junction VA Medical Center in Vermont, who presented the findings. "The risk was elevated for female smokers who quit six to ten years prior to screening but not for male smokers." 

Dr. Anderson said the data suggests that the impact of smoking has a longer effect in women than in men, and that the data could have an impact on colorectal cancer screening in male versus female smokers. "If smoking is used as a factor for determining when to begin screening, for example, we might have different parameters for men and women." 

Source: American College of Gastroenterology [October 31, 2011]

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