Tobacco.org

A prospective study of smoking, caffeine, and alcohol as risk factors for seizures or epilepsy in young adult women: Data from the Nurses' Health Study II  

Results: Compared with never smoking, current cigarette smoking was associated with an increased risk of seizure (RR 2.60, 95% CI 1.53–4.42), after adjustment for stroke and other potential confounding factors. Past smoking was not associated with risk of seizure, but was associated with modestly increased risk of epilepsy (RR 1.46, 95% CI 1.01–2.12). Long-term caffeine and moderate alcohol intake were not associated with seizure or epilepsy.

Discussion: Cigarette smoking may be associated with increased risk of seizure. More prospective studies are needed to investigate potential factors to ultimately prevent the development of seizures or epilepsy.

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• Nonsmokers Top Smokers in Well-Being Across All Incomes 

Smokers trail nonsmokers in well-being, regardless of income bracket, according to Gallup-Healthways Well-Being Index data collected in 2008 and 2009. In every income group, smokers are less likely than nonsmokers to be "thriving" by at least 12 percentage points. . . .

In the case of emotional health, the connection between smoking and low well-being is especially pronounced for low-income respondents. While the emotional health gap between smokers and nonsmokers is 4 points for the highest income group, the gap for the lowest income group is 10 points.

The differences in the size of the smoking gap across income groups could mean that the emotional consequences of smoking are less pronounced for people in the higher income group. Another possibility is that people in different income groups smoke for different emotional reasons. . . .

Self-reported smoking status is, in fact, strongly linked to depression. . . .

Across all income groups, smokers also fare worse than nonsmokers in physical health as reflected in lower scores on the Physical Health Index. Consistent with medical research connecting smoking to premature mortality, people who are 85 years old or older are unlikely to be smokers.

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Smoking may be considered an established risk factor for sporadic ALS 

Conclusions: Smoking may be considered an established risk factor for sporadic amyotrophic lateral sclerosis (ALS) (level A rating; 3 class II studies, 1 class III study). Evidence-based analysis of epidemiologic data shows concordance among results of better-designed studies linking smoking to ALS, and lets those results drive the conclusions.

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A prospective study of smoking, caffeine, and alcohol as risk factors for seizures or epilepsy in young adult women: Data from the Nurses' Health Study II 

Discussion: Cigarette smoking may be associated with increased risk of seizure. More prospective studies are needed to investigate potential factors to ultimately prevent the development of seizures or epilepsy

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• New dementia risk factors study findings reported from University of Minnesota 

Fresh data on dementia are presented in the report 'Risk of dementia hospitalisation associated with cardiovascular risk factors in midlife and older age: the Atherosclerosis Risk in Communities (ARIC) study.' According to recent research published in the Journal of Neurology, Neurosurgery, and Psychiatry, "Cardiovascular risk factors are associated with a higher risk of developing dementia. Studies in older populations, however, have often failed to show this relationship."

"We assessed the association between cardiovascular risk factors measured in midlife and risk of being hospitalised with dementia and determined whether this association was modified by age and ethnicity. We studied 11 151 participants in the population-based Atherosclerosis Risk in Communities cohort, aged 46-70 (23% African-Americans) in 1990-2, when participants underwent a physical exam and cognitive testing. Hospitalisations with dementia were ascertained through December 2004. During follow-up, 203 cases of hospitalisation with dementia were identified. Smoking (hazard ratio (HR), 95% CI 1.7, 1.2 to 2.5), hypertension (HR, 95% CI 1.6, 1.2 to 2.2) and diabetes (HR, 95% CI 2.2, 1.6 to 3.0) were strongly associated with dementia, in Caucasians and African-Americans. . . .

The researchers concluded: "Our results emphasise the importance of early lifestyle modification and risk factor treatment to prevent dementia."

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Smoking May Now Be Considered An Established Risk Factor For ALS 

While previous studies have indicated a "probable" connection between smoking and ALS, a new study published in the Nov. 17, 2009 issue of Neurology®, the medical journal of the American Academy of Neurology, states that smoking may now be considered an "established" risk factor for Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig's disease.

The findings come from Baystate Medical Center neurologist Dr. Carmel Armon, an ALS researcher and neuroepidemiologist, who came to this conclusion using evidence-based methods to perform a rigorous analysis of studies examining the link between smoking and developing ALS -- a fatal neurodegenerative disease affecting the motor nerves and the voluntary muscles.

"Application of evidence-based methods separates better-designed studies from studies with limitations that may not be relied on. The better-designed studies show consistently that smoking increases the risk of developing ALS, with some findings suggesting that smoking may be implicated directly in causing the disease," said Dr. Armon, a professor of neurology at Tufts University School of Medicine and chief of neurology at Baystate Medical Center in Springfield. He is also a fellow of the American Academy of Neurology.

According to Dr. Armon, identifying smoking as an established risk factor for ALS has three implications.

"First and foremost the findings provide a link between the environment and the occurrence of ALS, where none had been previously identified with this level of certainty," said Dr. Armon.

"Additional implications are that since smoking has no redeeming features, avoidance of smoking may reduce the occurrence of ALS in the future, and since some of the mechanisms by which smoking causes other diseases in humans are understood fairly well, recognizing its role in the occurrence of ALS may help pinpoint the biological processes that initiate the disease," added the researcher.

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• Current cigarette smokers at increased risk of seizures 

A recent study determined there is a significant risk of seizure for individuals who currently smoke cigarettes. Boston-based researchers from Brigham and Women's Hospital and Harvard Medical School also found that long-term, moderate intake of caffeine or alcohol does not increase the chance of having a seizure or developing epilepsy. This is the first prospective study to examine the potential risks associated with cigarette smoking, caffeine intake, and alcohol consumption as they independently relate to epilepsy. Full findings of this study are currently available online and will appear in the February 2010 issue of Epilepsia, a journal published by Wiley-Blackwell on behalf of the International League Against Epilepsy. . . .

Barbara A. Dworetzky, M.D., and colleagues used data obtained from the Nurses' Health Study II, a group of 116,608 female registered nurses, aged 25-42 years old who returned mailed questionnaires on their lifestyle and medical history including epilepsy and seizure activity. In the analysis for cigarette smoking, researchers accrued 246 cases and 1,778,307 person-years of follow-up among 116,363 participants. For the analyses of caffeine intake, there were 201 cases and 1,440,850 person-years of follow-up among 105,941 participants, and for the alcohol consumption analyses, 198 cases and 1,427,348 person-years of follow-up among 104,934 participants. The data used in this study were obtained from 1989 through May 31, 2005.

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Psychologists Welcome Tobacco Curbs In New Health Act 

The British Psychological Society welcomes the passage of measures protecting young people from harm caused by tobacco into law in the Health Act 2009.

The President of the Society, Sue Gardner, says: "We regard the protection of children and young people from smoking as an extremely high priority. All the available evidence suggests that the earlier young people start to smoke the more difficult they will find it to quit."

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• Researchers Study PTSD, Smoking Link For Soldiers 

A new University of Wisconsin study set to begin in January is aiming to help troops coping with post-traumatic stress disorder to overcome smoking when they return home.

The study by the UW Center for Tobacco Research and Intervention has a goal of helping soldiers kick their smoking habit.

"A lot of time that you were exhausted and you needed to have some time out," said veteran Deeann Hansen. "We were on a road march and when we were told to stop we were allowed to take a break, and the comment was made to us that, 'Smoke 'em if you got 'em,' and if you don't they told us to pick up cigarette butts and trash."

Studies show Hansen isn't the only one to leave the military addicted to tobacco. It's something she blamed on the high stress load of life in the services.

Around 7 million U.S. vets suffer from PTSD and more than half smoke -- and that statistic is sparking some research.

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• The Geography of Smoking  

One in five Americans continue to smoke cigarettes, according to a new survey by the Centers for Disease Control and Prevention. The smoking rate varies from low of 9.2 percent in Utah to a high of 26.6 percent in West Virginia. The map below, from the Wall Street Journal, shows the smoking rate by state.

The data are interesting and they allow us to look at the extent to which smoking is associated with all sorts of things, from more obvious ones like cancer and heart disease to the economic and demographic characteristics of states with higher or lower levels of smoking and even the relationship between smoking and happiness. With a helpful analytical assist from my colleague Charlotta Mellander, we decided to take a quick look. We ran some simple correlations and scatter-plots between state smoking rates and these factors. As usual, we point out that correlation does not imply causality, but simply points to associations between variables. Still, a number of interesting things stand out.

It will come as little surprise that states with higher levels of smoking have significantly higher rates of death from cancer, heart disease, and cerebrovascular diseases like hypertension. There is a significant correlation between state smoking rates and death rates from cancer (.75), heart disease (.67), and cerebrovascular disease (.59). . . .

Smoking is negatively associated with state happiness (with a correlation of -44.71). Since these correlations only reflect associations between variables and not causality, it's hard to say whether this reflects the fact that happier people smoke less or unhappier ones smoke more, or that both smoking and happiness levels reflect something else. . . .

That said, smoking rate is associated with concentrations of artists, musicians, and entertainers. Contrary to the stereotypical image of cigarette-puffing bohemians or hipsters, smoking is less prevalent in states with more of these artistic types: The correlation is negative (-.450), and about the same as for education.

Lastly, smoking is negatively correlated with larger concentrations of gays and lesbians, as well as immigrants

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• Smoking Tied to Suicide Risk in Bipolar Disorder  

People with bipolar disorder who smoke appear to have a heightened risk of suicidal behavior -- possibly because they are generally prone to impulsive acts, a new study suggests.

Bipolar disorder, also known as manic depression, is marked by dramatic swings in mood -- ranging from episodes of debilitating depression to periods of euphoric recklessness. Previous studies have found that bipolar patients who smoke have a higher suicide risk than their non-smoking counterparts, but the reasons have not been clear.

The new findings suggest that high levels of impulsivity -- one of the symptoms of bipolar disorder -- may draw some patients to both smoking and suicidal behavior.

Dr. Michael J. Ostacher and colleagues at Massachusetts General Hospital in Boston found that among 116 bipolar patients they followed, current smokers generally scored higher on a standard measure of suicidal thoughts and behaviors.

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• State bans smoking in mental hospitals 

The Atlanta Journal-Constitution has learned that the state plans to ban smoking in the seven state mental hospitals on Jan. 5, a steep challenge considering the high percentage of smokers among those with mental illness.

But Tom Wilson, spokesman for the state Department of Behavioral Health and Developmental Disabilities, said the measure will make the patients and facilities healthier. He also said the ban could advance patients' treatment, helping them to give up an often addictive habit.

Wilson acknowledged the challenges, pointing to national statistics that show 75 percent of people with mental illness or addictions smoke, and that nearly half of the cigarettes consumed in the country are smoked by people with mental illness.

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New research discovers link between smoking and brain damage 

New research which suggests a direct link between smoking and brain damage will be published in the July issue of the Journal of Neurochemistry. Researchers, led by Debapriya Ghosh and Dr Anirban Basu from the Indian National Brain Research Center (NBRC), have found that a compound in tobacco provokes white blood cells in the central nervous system to attack healthy cells, leading to severe neurological damage.

The research centers on a compound known as NNK, which is common in tobacco. NNK is a procarinogen, a chemical substance which becomes carcinogenic when it is altered by the metabolic process of the body.

Unlike alcohol or drug abuse NNK does not appear to harm brain cells directly, however, the research team believe it may cause neuroinflamation, a condition which leads to disorders such as Multiple Sclerosis.

"Considering the extreme economical and disease burden of neuroinflammation related disorders, it is extremely important from a medical, social and economic point of view to discover if NNK in tobacco causes neuroinflammation" said Ghosh.

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Advocates Call for Treating Tobacco Dependence in Psychiatric Patients 

Smoking cessation services should be integrated into substance use disorder treatment programs, according to David Kalman, MD, Department of Psychiatry, University of Massachusetts, and colleagues, in their recent review of tobacco dependency among patients who sought treatment for alcoholism.1

"Clearly there exist many barriers to simultaneous treatment of tobacco dependence and other substance use disorders," the investigators observe. "However, most alcoholics in treatment are concerned about their smoking and the preponderance of evidence indicates that trying to quit during substance use disorder treatment does not interfere with sobriety and, in fact, appears to be associated with better alcohol and other drug use outcomes." Kalman and colleagues are among a growing number of clinicians and researchers calling for the recognition of (and interventions for) tobacco dependence as a common comorbidity with other substance use and psychiatric disorders.

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Smoking mums have 'problem kids' 

Smoking during pregnancy significantly increases the risk of having a child with behavioural problems, according to UK and US researchers.

Writing in the Journal of Epidemiology and Community Health, they say the problems can be evident in children as young as three years old.

They believe smoking in pregnancy may damage the developing structure of the baby's brain.

One expert said it was another strong reason for mothers to give up smoking.

The researchers from the universities of York, Hull and Illinois looked at more than 14,000 mother and child pairs who were taking part in the Millennium Cohort Study.

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