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Thursday, February 14, 2008

Smokers Might Benefit From Earlier Colon Cancer Screening

New evidence suggests screening for colorectal cancer, which is now recommended to begin at age 50 for most people, should start five to 10 years earlier for individuals with a significant lifetime exposure to tobacco smoke, a University of Rochester Medical Center study said.

An examination of 3,450 cases found that current smokers were diagnosed with colon cancer approximately seven years earlier than people who never smoked. The study is also one of the first to link exposure to second-hand smoke, especially early in life, with a younger age for colon cancer onset.

The article appears online in the Journal of Cancer Research and Clinical Oncology.

“The message for physicians and patients is clear: When making decisions about colon cancer screening you should take into account smoking history as well as family history of disease and age,” said lead author Luke J. Peppone, Ph.D., research assistant professor of Radiation Oncology at the James P. Wilmot Cancer Center at the University of Rochester.

Peppone’s group examined data from patients diagnosed with colorectal cancer between 1957 and 1997 at Roswell Park Cancer Institute in Buffalo. (Peppone joined the University of Rochester in 2007, coming from RPCI. Co-authors are from RPCI.)

Over the 40-year period smoking habits changed, with a decrease in the percentage of current or active smokers and an increase in the percentage of former smokers. Still, the age at colon cancer diagnosis was 6.8 years younger among current smokers and 4.3 years younger for former smokers who quit less than five years ago, the results showed. People who quit more than five years ago had no significant increased risk.

However, people who reported they began smoking as young teens (before age 17) or who smoked heavily (1 pack a day or more) were the most likely to be diagnosed with cancer much younger than their never-smoking counterparts. Past exposure to second-hand-smoke was an additional, significant risk factor, compared to never smoking. In fact, when active smokers and passive smoking were combined into one subgroup, the age at cancer diagnosis was nearly 10 years earlier, Peppone said.

Although smoking is a well-known risk factor for many cancers, only recent studies have suggested that cigarettes may cause colon cancer.

The biological reasons for the cigarette smoke-colon cancer risk are unclear. However, researchers believe that cigarette smoke reduces the body’s resistance to malignancies, just as smoking can depress immune function in general, impairing the ability to fight off infections and viruses. Carcinogens from smoke reach the bowel through direct circulation or by swallowing smoke and passing it through the intestines.

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Tuesday, November 06, 2007

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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Sunday, July 08, 2007

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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Saturday, May 12, 2007

Spiritual Beliefs, Practices May Help Smokers Quit


Unlike many traditional alcohol and drug dependence treatment programs, mainstream smoking cessation programs generally exclude spiritual practice and beliefs from the treatment process. But a study by Oregon Health & Science University Smoking Cessation Center researchers reveals many smokers are receptive to and may benefit from their own spiritual resources, when attempting to quit.

The study, believed to be the first to look at the potential use of spiritual resources for quitting in adult smokers, recently was published in Nicotine & Tobacco Research.

For decades, the OHSU research team encountered some patients in clinical practice who reported that in addition to the treatments provided by the team, they used personal spiritual beliefs and practices in their quit attempts. This led the team to question why spiritual resources were not part of mainstream tobacco dependence treatment programs.


"We theorized the absence of spiritual resources in smoking cessation programs may be due to perceived resistance from smokers or, until recently, the social acceptance of smoking, which may have prevented patients and providers from considering the health effects of tobacco dependence as life-threatening," says David Gonzales, principal investigator of the study, and co-director, OHSU Smoking Cessation Center, OHSU School of Medicine. "We know that smoking cessation medications coupled with behavioral interventions increase quit rates, but quitting is still difficult and some smokers need more support in order to quit successfully. We may be missing opportunities to assist these smokers."

Gonzales and colleagues discovered that women were more likely to report a spiritual practice or belief compared with men, but smokers of both sexes who smoked more than 15 cigarettes per day were more likely to be open to having their health care provider encourage them to use their own (the patient's) spiritual practice to assist in a quit attempt.

"Our findings suggest that although not all clinicians want to talk about spirituality with their patients, those who do feel comfortable doing so will likely find most patients who smoke are receptive. Asking smoking patients if they have a spiritual practice or belief may be important to their care," Gonzales explains.

Patient spirituality is becoming more mainstream in medicine and is accepted as integral to the treatment of many medical conditions, especially cancer, Gonzales says. Surveys show patients would like their providers to discuss spirituality related to their health care. Along with this opportunity there is a challenge for health care providers to respect spiritual beliefs and practices that may be different from their own. Further investigation and program development on how to include spirituality in mainstream tobacco dependence treatment is warranted, he and his team concluded.

To conduct this research, Gonzales and colleagues surveyed 104 current smokers, aged 18 or older and not attempting to quit, in smoking areas outside building on the OHSU Marquam Hill Campus. Study participants were equally male and female, on average 38 years old, and had smoked about 17 cigarettes a day for approximately 21 years. The anonymous surveys included questions about smoking behaviors, and spiritual practices and beliefs.

Of the 104 participants, 92 had some history of using spiritual resources, and of those, 78 percent believed that using those resources when making a quit attempt could be helpful.

Seventy-seven percent believed having treatment staff encourage the use of spiritual resources to help them quit could be beneficial.


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Monday, April 30, 2007

Study Shows Smoking Common During Pregnancy


While pregnancy may be considered an effective motivator for smoking cessation, results of a new study by researchers at the Mailman School of Public Health indicate that pregnant U.S. women commonly smoke, placing themselves and their unborn children at risk for health and developmental complications. The research also finds a significant association between cigarette use, nicotine dependence, and the presence of mental disorders among pregnant women.

The data show that almost 22 percent of these women smoked cigarettes and more than 10 percent were nicotine dependent. The results also indicate that approximately 30 percent of pregnant women who used cigarettes had a mental disorder, with personality disorders, major depressive disorder, and specific phobia among the most common psychological ailments.

Mental disorders were even more common among pregnant women with nicotine dependence, affecting more than 57 percent. In terms of specific disorders, the strongest associations with nicotine dependence were seen for prolonged depression, panic disorder, and major depressive disorder.

"Our research shows that prenatal smoking appears to be more common in pregnant women who are already vulnerable—those who are unmarried, have less than high school education, and have lower personal incomes," says Renee Goodwin, assistant professor of Epidemiology at the Mailman School, and lead scientist. "They also are likely to have limited access to health care services, which may contribute to a lower likelihood of some women quitting smoking upon becoming pregnant."

The study included 1,516 pregnant women at least 18 years old who took part in the 2001–2002 National Epidemiologic Survey of Alcohol and Related Conditions, a nationally representative survey of more than 43,000 U.S. adults administered by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Mental disorders and nicotine dependence were diagnosed through use of the NIAAA Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV.

The findings were published in the April issue of Obstetrics and Gynecology. The study was supported in part by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.


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Saturday, February 17, 2007

Studies Identify DNA Regions Linked to Nicotine Dependence


Americans are bombarded with antismoking messages, yet at least 65 million continue to light up. Genetic factors play an important role in this continuing addiction to cigarettes, suggest scientists at Washington University School of Medicine in St. Louis.

In two studies in the January 2007 issue of Human Molecular Genetics, the scientists show that certain genetic variations can influence smoking behaviors and contribute to a person's risk for nicotine dependence.

The smoking-related genes identified normally facilitate communication between nerve cells in the brain. One gene in particular, the alpha-5 nicotinic cholinergic receptor (CHRNA5) gene, was a very strong indicator of risk for nicotine dependence. Individuals with a specific variation in the gene seemed to have a two-fold increase of developing nicotine dependence once exposed to cigarette smoking. CHRNA5 is from a class of receptors that plays a role in dopamine pathways in the brain, which are linked to a person's experience of pleasure.

The researchers also identified genes related to gamma aminobutyric acid (GABA) receptors, another set of proteins vital to nerve cell function. Both GABA and nicotinic receptors had been suspected of involvement in nicotine addiction, but these findings strengthen those suspicions.

The studies also identified a gene not previously known to be involved with nicotine dependence. Called the Neurexin 1 (NRXN1) gene, it helps regulate the balance between excitatory mechanisms — those that increase communication between nerve cells — and inhibitory mechanisms — those that slow firing between nerve cells.

"An imbalance between excitatory and inhibitory activity in the brain may predispose people to addiction, such as alcoholism, drug dependence or nicotine dependence," says Laura Jean Bierut, M.D., associate professor of psychiatry and principal investigator of both studies. "The Neurexin gene we've identified is really a key factor in the balance between inhibition and excitatory activity in neurons."

Bierut suspects a large number of genes are involved in nicotine dependence, and she says understanding how they work may make it possible to develop new treatments for smoking cessation.

The research team analyzed data from almost 2,000 participants in two ongoing studies. One, called the Collaborative Genetic Study of Nicotine Dependence, is a U.S.-based sample that includes both addicted smokers and "social" smokers from St. Louis, Minneapolis and Detroit. The other is an Australian study of smokers of European ancestry called the Nicotine Addiction Genetics study.

The scientists combined two approaches for analyzing genetic information. One approach scanned the entire human genome for suspicious areas of DNA while the second approach closely examined specific target genes.

"The combination of these two approaches represents the most powerful and extensive study on nicotine dependence to date and is an important step in a large-scale, genetic examination of nicotine dependence," says Elias A. Zerhouni, M.D., the director of the National Institutes of Health, which funded the studies. "As more genomic variations are discovered that are associated with substance abuse, we can better understand addictive disorders."

The researchers identified an area of DNA variation that seems to alter the function of a nicotinic receptor protein. That small variation makes a big difference in risk for nicotine dependence.

Current drug treatments for nicotine dependence continue to be only marginally successful, and Bierut believes using information about genetic traits to tailor medications to individuals could make them significantly more effective. "The type of variant you have at this particular receptor — the alpha-5 nicotinic receptor — may actually predict whether or not you will do well on nicotine replacement therapy," she says.

<---Anyone who's been or is a smoker, knows how hard it is to quit cigarettes. Even after we hear again and agian the risk of lung cancer for some reason we pick up a cigarette, ignoring the cancer statistics. Smokefree seems far away. But eventually, there is a point when quitting smoking makes the most sense.The effect of smoking takes too much of a toll.--->

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