Tobacco.org

• 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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• Autoimmune Condition, Especially Combined With Smoking And Oral Contraceptive Use, Massively Increases Risk Of Stroke And Heart Attack In Young Women 

The autoimmune condition antiphospholipid syndrome mainly affects young women. An Article published Online First and in the November edition of The Lancet Neurology shows that women with a particular subtype of antibody called lupus anticoagulant (LA) have a more than 40-fold increased risk of stroke and 5-fold increased risk of heart attack compared with the general population (of young women). Smoking and oral contraceptive use increase the risk of these events even more. The Article is written by Dr Rolf Urbanus and Dr Philip de Groot, University Medical Centre Utrecht, Netherlands, together with colleagues from the Leiden University Medical Centre.

Antiphospholipid syndrome occurs when autoantibodies* bind to cell membranes, interfering with the regular clotting mechanism of the blood. Diagnosis occurs when young women (under 50 years) suffer a thrombotic event such as a stroke or heart attack, and antiphospholipid antibodies are tested. Although it is known that this condition causes thrombosis, bleeding, and repeat miscarriage in women, the extent of the increased risk for stroke and heart attack was unknown before this study. . . .

In an accompanying Reflection and Reaction, Dr Kathryn Kirchoff-Torres and Dr Steven R Levine, Stroke Center, Mount Sinai School of Medicine, New York, NY, USA, say that the most important aspect of the study is its conclusion that young women with LA need to be warned about the dangers of smoking and use of oral contraceptives.

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• Use of smokeless tobacco and risk of myocardial infarction and stroke: systematic review with meta-analysis  

In conclusion, in studies carried out in the United States and Sweden we detected an association between use of smokeless tobacco products and risk of fatal myocardial infarction and fatal stroke, which is not readily explained by chance. Confounding and other sources of bias, however, cannot be completely excluded on the basis of available data, although we found no strong evidence for their effect. If the association is real, its public health and clinical implications might be substantial, despite the fact that the magnitude of the excess risk is small. Future research should aim to clarify the mechanisms of effect of smokeless tobacco products on deaths from cardiovascular disease and to elucidate whether a similar effect is present for non-fatal myocardial infarction and non-fatal stroke.

What is already known on this topic Smokeless tobacco products are widely used in many populations An association with risk of cardiovascular disease is plausible

What this study adds This systematic review and meta-analysis provided evidence for an association between use of smokeless products and risk of fatal myocardial infarction and stroke . . .

• Increased Risk Of Heart Attack And Stroke With The Use Of Smokeless Tobacco Products 

Research just published on bmj.com reports that people who use smokeless tobacco products like snus (a moist powder tobacco product) have a slightly higher risk of having a fatal heart attack or stroke.

Over the last couple of decades, there has been an increase in the number of people in Europe and North America using smokeless tobacco. Most new users are aged under 40. According to the study, since these products are being promoted as 'safer' alternatives to smoking cigarettes, the number of individuals using them is expected to increase.

Dr Paolo Boffetta at International Agency for Research on Cancer in France led the research team. They examined the results of 11 studies carried out in Sweden and North America on the use of smokeless tobacco products and the risk of developing or dying from a heart attack or stroke.

In order to reduce partiality, variations in study plan and features were considered.

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• Health research agencies form global alliance to curb humanity's most fatal diseases 

Six of the world's foremost health agencies, collectively managing an estimated 80% of all public health research funding, today announced formation of a landmark alliance to collaborate in the critical battle against chronic, non-communicable diseases: cardiovascular diseases (mainly heart disease and stroke), several cancers, chronic respiratory conditions, and type 2 diabetes.

The health impact and socio-economic cost of these largely-preventable diseases is enormous and rising, potentially derailing efforts at poverty reduction.

The Global Alliance for Chronic Diseases (Alliance) is being created to support clear priorities for a coordinated research effort . . .

The Alliance's charter members are:

* Australia National Health and Medical Research Council;

* Canadian Institutes of Health Research;

* Chinese Academy of Medical Sciences;

* The U.K. Medical Research Council; and

* The U.S. National Institutes of Health, specifically its National Heart, Lung, and Blood Institute (NHLBI), and the Fogarty International Center. . . .

The following research priorities have been proposed by some founding Alliance members, for discussion at their inaugural scientific meetings in November:

* Test ways to prevent cardiovascular diseases and complications of diabetes;

* Identify and promote public health measures for controlling obesity;

* Characterize and quantify the major risk factors for chronic obstructive airways disease (both tobacco and environmental pollution) and the development of control measures; and

* Advance research into the problem of tobacco consumption and its relationship to cancer, cardiovascular disease and other disorders;

* Develop interventions to address the above priorities.

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• Effects of Timing and Extent of Smoking, Type of Cigarettes, and Concomitant Risk Factors on the Association Between Smoking and Subclinical Atherosclerosis  

The purpose of this study was to evaluate the effects of timing and extent of smoking, type of cigarettes, and concomitant vascular risk factors (VRFs) on the association between smoking and carotid intima-media thickness (C-IMT) in a lipid clinic population. . . .

Conclusions-- In the present cross-sectional observational investigation, carried out in a cohort of patients attending a lipid clinic, consumption of light cigarettes does not reduce the atherogenic effect of smoking on C-IMT. The number of pack-years, cigarettes/d, and years of smoking are relevant covariates in evaluating the effects of smoking on vascular health. The presence of diabetes or hypertension strengthens the association between smoking and cardiovascular risk.

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• Why Smoking Increases The Risk Of Heart Disease And Strokes 

Researchers at Charles Drew University of Medicine and Science in Los Angeles and Western University of Health Sciences in Pomona have discovered a reason why smoking increases the risk of heart disease and strokes.

The study, which will be presented June 11 at The Endocrine Society's 91st annual meeting in Washington, D.C., found that nicotine in cigarettes promotes insulin resistance, a pre-diabetic condition that raises blood sugar levels higher than normal. People with pre-diabetes are at greater risk of developing cardiovascular disease.

Theodore Friedman, MD, Ph.D., chief of the endocrinology division at Charles Drew University, said the findings help explain a "paradox" that links smoking to heart disease.

Smokers experience a high degree of cardiovascular deaths, Friedman said. "This is surprising considering both smoking and nicotine may cause weight loss and weight loss should protect against cardiovascular disease."

The researchers studied the effects of twice-daily injections of nicotine on 24 adult mice over two weeks. The nicotine-injected mice ate less food, lost weight and had less fat than control mice that received injections without nicotine.

"Our results in mice show that nicotine administration leads to both weight loss and decreased food intake," Friedman said. "Mice exposed to nicotine have less fat. In spite of this, mice have abnormal glucose tolerance and are insulin resistant (pre-diabetes)."

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• Heart Attack Deaths Drop in U.S. as Smoking, Diet, Drugs Help  

Heart attacks and stroke deaths dropped by a third in 2006 from 1999 as more people stopped smoking, ate better and used medications such as Bristol-Myers Squibb Co.’s Plavix to keep blood flowing freely within arteries.

Heart disease accounted for 1 in 3 U.S. deaths in 2006, the latest year for which data is available, the Dallas-based American Heart Association said in a statement today. Drugs including cholesterol-lowering statins such as Pfizer Inc.’s Lipitor and the Plavix blood-thinner joined with better heart- attack treatment to lower the mortality rate, the health advocacy group said.

The heart association, which includes doctors and consumers in its membership, has lobbied against smoking for years. In 1998, the group set a national goal of reducing heart and stroke deaths 25 percent by 2010. The U.S. hit that mark in 2007, three years early. The change in death rates translates to about 190,000 lives saved in 2006.

“Medical therapy across the board has gotten better,” said Steven Nissen, head of cardiology at the Cleveland Clinic in Ohio. “But at least half of this is lifestyle. Remember that there have been new food labeling laws, laws to restrict trans fats, and smoking has been steadily declining for some time.”

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[A]t least half of this is lifestyle. Remember that there have been new food labeling laws, laws to restrict trans fats, and smoking has been steadily declining for some time.
Steven Nissen, head of cardiology at the Cleveland Clinic, on news that heart attacks and stroke deaths dropped by a third between 1999 and 2006.

• Smokeless tobacco may increase stroke risk 

Results of a new study suggest that the use of oral moist snuff, a type of smokeless tobacco widely used in Sweden that is also known as "snus," may increase the risk of fatal stroke.

Dr. Maria-Pia Hergens, of the Karolinska Institute in Stockholm, and colleagues examined data on Swedish construction workers attending health check-ups between 1978 and 1993 who completed questionnaires that included information on tobacco use.

A total of 118,465 men who had never smoked and had no history of stroke were followed through 2003. The Inpatient Register and Causes of Death Register were used to identify subsequent illness and death from stroke.

During an average of 18 years of follow-up, 3,248 men suffered a stroke. Most of these (70 percent) were "ischemic" strokes due to restricted blood flow ischemic, whereas 17 percent were "hemorrhagic" or bleeding strokes. Thirteen percent of strokes were "unspecified."

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• Women's Peripheral Artery Disease Tied to Secondhand Smoke  

Women exposed to secondhand smoke at home or in the workplace had a 67 percent increased risk of peripheral artery disease (PAD) compared to women who weren't exposed, a new study says.

"This is the first study to show the adverse effects of secondhand smoke on peripheral artery disease in women," lead author Yao He, a professor of epidemiology at the Chinese PLA General Hospital in Beijing, said in an American Heart Association news release.

The researchers, who examined 1,209 Chinese women 60 years and older who'd never smoked

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• Stroke Risk in Women Smokers Goes Up by Each Cigarette  

The risk of stroke for a young woman smoker is directly related to the number of cigarettes she smokes, a new study finds.

While smoking has been clearly established as increasing the risk of stroke, "there is not a lot of data out there on the actual dose response," said Dr. John Cole, the study's corresponding author and an assistant professor of neurology at the University of Maryland School of Medicine in Baltimore.

Cole and his colleagues interviewed 466 women who had had a stroke, and also 604 women who hadn't. All were between the ages of 15 and 49, and were either smokers, non-smokers or former smokers.

Any smoking at all doubles the risk of stroke, the study found. The risk was 2.2 times greater for women smoking one to 10 cigarettes a day . . .

The study findings are published in the Aug. 15 issue of the journal Stroke.

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• Healthy lifestyle cuts stroke risk: study  

A person's odds of suffering a stroke might be significantly reduced by maintaining an overall healthy lifestyle, which includes not smoking, exercising daily, consuming a healthy diet, drinking alcohol in moderation and maintaining a healthy weight, according to a study released today.

In the study, people with these five healthy lifestyle habits had about an 80 percent lower risk of ischemic stroke compared to people with none of the healthy habits. An ischemic stroke occurs when a blood vessel supplying blood to the brain becomes blocked; it is the most common type of stroke.

This study shows that a "low-risk" lifestyle recommended to lower the risk of multiple chronic diseases, such as diabetes, cancer and heart disease, may also help ward off stroke, the study team notes in Circulation: Journal of the American Heart Association.

The National Institutes of Health-funded study, led by Dr. Stephanie E. Chiuve of the Harvard School of Public Health in Boston, involved 43,685 men (average age 54) and 71,243 women (average age 50) - all of whom were participants in the Health Professionals Follow-up Study or the Nurses' Health Study.

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• Stroke risk from smoking partner 

Being married to a smoker will significantly raise your risk of stroke, even if you don't smoke yourself, say researchers.

The Harvard University team looked at records of more than 16,000 people.

The American Journal of Preventative Medicine study found the risk rose by up to 72% for some non-smokers.

The stroke dangers to smokers are well known, but there are fewer studies which have explored the risk from passive smoking. . . .

This advice was echoed by the Stroke Association, which said that passive smokers were nearly twice as likely to have a stroke compared with those not living in a smoky environment.

Joe Korner, from the association, said: "Smoking is a significant risk factor for stroke with a quarter of all strokes being linked to smoking and it can also contribute to high blood pressure which is the single biggest risk factor for stroke.

"We urge people to consider the effects that smoking has on their health and others around them and do all they can to reduce their risk of stroke."

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• Secondhand smoke seen to raise spouse's stroke risk  

Nonsmokers married to smokers have a greatly increased chance of having strokes, according to a U.S. study published on Tuesday showing yet another hazard from secondhand smoke.

Being married to a smoker raised the stroke risk by 42 percent in people who have never smoked compared to those married to someone who never smoked, the researchers said.

This jumped to 72 percent for former smokers married to a current smoker, according to the study published in the American Journal of Preventive Medicine.

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• Smoking Is Major Risk Factor For Stroke In China, Study Shows 

Smoking is a major risk factor for stroke in China, accounting for about one in seven strokes in men, researchers reported in Stroke: Journal of the American Heart Association.

"This study shows that smoking prevention and cessation could be an important approach to reducing the societal burden of stroke," said Jiang He, M.D., Ph.D., senior author of the study.

Many studies in western populations have shown that cigarette smoking is a strong and independent risk factor for stroke. But the relationship between cigarette smoking and stroke hasn't been well-studied in Asian populations -- including China, where stroke is the second leading cause of death.

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