Life's Tough on North American Smokers

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Cigarette Smoke And Alcohol Damage Hearts Worse As Combo

Tobacco smoke-filled air is bad for cardiovascular health, and drinking alcohol at the same time only makes it worse, according to researchers at the University of Alabama at Birmingham (UAB).

Testing the theory that moderate alcohol consumption provides some heart-protection benefits, the UAB team said it wanted to take the idea further and look at the effects of smoking and breathing second-hand smoke along with drinking.

They reported that mice exposed to smoky air in a laboratory enclosure and fed a liquid diet containing ethanol, the intoxicating ingredient in alcohol, had a 4.7-fold increase in artery lesions. That compares to mice who breathed filtered air and ate a normal solid diet.

Artery lesions are a common problem in heavy smokers and a key sign of advancing
cardiovascular disease. The results are published in the journal Free Radical Biology & Medicine.
The researchers reported mice solely exposed to the smoky air had a 2.3-fold increase in artery lesions when compared to mice who breathed filtered air. Mice solely fed a liquid diet containing ethanol had a 3.5-fold increase in artery lesions when compared to mice fed a normal diet.
The study points to a greater need to understand the negative biological impact of single or multiple risky behaviors, and the compounding effect of environmental hazards such as second-hand smoke, says Scott Ballinger, an associate professor in the UAB Department of Pathology and lead author on the study.

“Our study shows that exposure to cigarette smoke when combined with alcohol consumption caused the greatest degree of cardiovascular disease development compared to either action or exposure alone,” Ballinger says.

“Because moderate alcohol consumption is commonly thought to be cardioprotective, these findings are important for smokers and non-smokers alike in terms of what you should and should not do to protect their health,” says Shannon Bailey, an associate professor in the UAB Department of Environmental Health Sciences and a co-investigator on the study.

The mice experiments were performed over a five-week period. Blood-alcohol concentrations reached the equivalent of a 150-pound adult consuming 2 drinks per hour. Cigarette smoke exposure was similar to being in an automobile with a chain smoker with the windows closed.
In addition to measuring artery lesions in the study mice, the UAB team looked at other signs of advancing cardiovascular disease like DNA damage and oxidative stress in key heart tissues.

Like the artery lesions, these added measurements showed that taking in both smoky air and ethanol had the effect of basically nullifying any potential heart benefit from drinking alcohol by itself.

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Is Fear of Weight Gain Keeping Many Women From Trying to Quit Smoking?

Is a fear of getting fatter partly to blame for the fact that nearly one in five American women still smokes, and many don’t try to quit?

Although there are many possible reasons for the stubborn persistence of smoking, fear of weight gain is high on the list for many women, says a University of Michigan Health System researcher who has devoted much of her career to studying this issue.

Several years ago, she and her team reported that 75 percent of all women smokers say they would be unwilling to gain more than five pounds if they were to quit smoking, and nearly half said they would not tolerate any weight gain. In fact, many women started smoking in the first place because they thought it might help them stay slim.

Now, new U-M research findings published in the October issue of Addictive Behaviors show that women who smoke tend to be further from their ideal body image, and more prone to dieting and bingeing, than those who don’t smoke.

Cigarettes are well known to suppress appetite and weight, says Cindy Pomerleau, director of the U-M Nicotine Research Laboratory. “So it’s hardly surprising that women who have trouble managing their weight or are dissatisfied with their bodies are drawn to smoking,” she says.

In another recent study, published in August, the U-M team found that overweight women smokers who were overweight as children were far more likely to have started smoking in their early teens than women whose weight problems started later in life. They also had worse withdrawal symptoms when they tried to quit.

Once they make a serious attempt to quit, evidence suggests that most weight-concerned smokers can be just as successful in kicking the habit as others.

“The problem here is getting women who are concerned about their weight to be willing to try to make a quit attempt,” says Pomerleau, “and then helping them gain a sense of control over their weight.”

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Girls Who Begin Dieting Twice as Likely to Start Smoking

Starting to diet seems to double the odds a teenage girl will begin smoking, a University of Florida study has found.

UF researchers, who analyzed the dieting and smoking practices of 8,000 adolescents, did not find the same link in boys, who were also less likely than girls to diet, according to findings released Friday in the American Journal of Health Promotion.

“Dieting was a significant predictor of initiation of regular smoking among females,” says Mildred Maldonado-Molina, a UF assistant professor of epidemiology and health policy research and lead author of the study. “We were expecting that this relationship was going to be stronger among females. That has been well-documented, especially because (nicotine) can suppress your appetite.

“In boys we found something we don’t understand yet,” she says. “We found that those who were inactive dieters, those who first started dieting and then stopped, were more likely to engage in smoking behaviors.”

The researchers derived their findings from the answers of 7,795 adolescents who were surveyed during the first two waves of the National Longitudinal Study of Adolescent Health, completed in 1994 and 1996. The teens were in seventh, eighth and ninth grade when surveyed.
UF researchers included the answers of adolescents who said they were trying to lose weight and divided the group into four units: non-dieters, new dieters, former dieters and consistent dieters, who said they were dieting both times they were surveyed. They excluded teens who were already smokers and those who admitted to taking diet pills, vomiting and using other unhealthy weight-loss tactics.

“That group (of teens who were beginning to diet) was the one we were most interested in, seeing how the start of one behavior related to initiation of smoking,” Maldonado-Molina says.
Researchers also found that girls who consistently dieted were more likely to smoke.

Still, the number of children smoking in the United States has dropped in the 10 years since the first two waves of the survey were completed. In 1995, about 35 percent of high school students smoked regularly, according to the Centers for Disease Control and Prevention. Now about 23 percent of high-school age children reportedly smoke and 8 percent of middle school students do. The percentage of girls who smoke is slightly higher in both age groups, according to a 2006 CDC report on tobacco use among youth.

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Inhaling From Just 1 Cigarette Can Lead To Nicotine Addiction

A new study published in the Archives of Pediatric and Adolescent Medicine shows that 10 percent of youth who become hooked on cigarettes are addicted within two days of first inhaling from a cigarette, and 25 percent are addicted within a month. The study found that adolescents who smoke even just a few cigarettes per month suffer withdrawal symptoms when deprived of nicotine, a startling finding that is contrary to long-held beliefs that only people with established smoking habits of at least five cigarettes per day experience such symptoms.

The study monitored 1,246 sixth-grade students in six Massachusetts communities over four years. Students were interviewed frequently about smoking and symptoms of addiction, such as difficulty quitting, strong urges to smoke, or nicotine withdrawal symptoms such as cravings, restlessness, irritability, and trouble concentrating. Of those who were hooked, half were already addicted by the time they were smoking seven cigarettes per month. As amazing as it may seem, some youth find they are unable to quit smoking after just a few cigarettes. This confirms an earlier study by the same researchers.

Recent research has revealed that the nicotine from one cigarette is enough to saturate the nicotine receptors in the human brain. “Laboratory experiments confirm that nicotine alters the structure and function of the brain within a day of the very first dose. In humans, nicotine-induced alterations in the brain can trigger addiction with the first cigarette,” comments

Joseph R. DiFranza, MD, professor of family medicine & community health at the University of Massachusetts Medical School and leader of the UMMS research team. “Nobody expects to get addicted from smoking one cigarette.” Many smokers struggle for a lifetime trying to overcome nicotine addiction. The National Institutes of Health estimates that as many as 6.4 million children who are living today will die prematurely as adults because they began to smoke cigarettes during adolescence.

“While smoking one cigarette will keep withdrawal symptoms away for less than an hour in long-time smokers, novice smokers find that one cigarette suppresses withdrawal for weeks at a time,” explains Dr. DiFranza. “One dose of nicotine affects brain function long after the nicotine is gone from the body. The important lesson here is that youth have all the same symptoms of nicotine addiction as adults do, even though they may be smoking only a few cigarettes per

month.”

Symptoms of nicotine addiction can appear when youth are smoking as little as one cigarette per month. At first, one cigarette will relieve the craving produced by nicotine withdrawal for weeks, but as tolerance to nicotine builds, the smoker finds that he or she must smoke ever more frequently to cope with withdrawal.

According to DiFranza, the addiction-related changes in the brain caused by nicotine are permanent and remain years after a smoker has quit. This explains why one cigarette can trigger an immediate relapse in an ex-smoker. It also explains why an ex-smoker who relapses after many years of abstinence cannot keep the craving away by smoking one cigarette per month. Unlike the newly addicted novice smoker, a newly relapsed smoker must smoke several cigarettes each day to cope with the craving.

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