Impact of Tobacco Smoking on Health Care Utilization and Medical Costs in Chronic Obstructive Pulmonary Disease,Coronary Heart Disease and Diabetes

Objective To determine the impact of smoking on disease-specific health care utilization and medical costs in patients with chronic non-communicable diseases(NCDs).Methods Participants were middle-aged and elderly adults with chronic NCDs from a prospective cohort in China.Logistic regressions and linear models were used to assess the relationship between tobacco smoking,health care utilization and medical costs.Results Totally,1020 patients with chronic obstructive pulmonary disease(COPD),3144 patients with coronary heart disease(CHD),and 1405 patients with diabetes were included in the analysis.Among patients with COPD,current smokers(β:0.030,95%CI:−0.032-0.092)and former smokers(β:0.072,95%CI:0.014-0.131)had 3.0%and 7.2%higher total medical costs than never smokers.Medical costs of patients who had smoked for 21-40 years(β:0.028,95%CI:−0.038-0.094)and≥41 years(β:0.053,95%CI:−0.004β0.110)were higher than those of never smokers.Patients who smoked≥21 cigarettes(β:0.145,95%CI:0.051-0.239)per day had more inpatient visits than never smokers.The association between smoking and health care utilization and medical costs in people with CHD group was similar to that in people with COPD;however,there were no significant associations in people with diabetes.Conclusion This study reveals that the impact of smoking on health care utilization and medical costs varies among patients with COPD,CHD,and diabetes.Tobacco control might be more effective at reducing the burden of disease for patients with COPD and CHD than for patients with diabetes.

Interaction models of CYP1A1, GSTMl polymorphisms and tobacco smoking in intestinal gastric cancer

AIM： To explore the interaction models of the cytochrome P-450 （CYP） 1A1 Valvariant and glutathione S-transferase （GST） M1 null polymorphisms with tobacco smoking in the occurrence of intestinal gastric cancer. METHODS： A community-based case-control study was conducted in Yangzhong. Subjects included 114 intestinal types of gastric cancer with endoscopic and pathological diagnosis during January 1997 and December 1998, and 693 controls selected from their spouse, siblings or siblingsin-law who had no history of digestive system cancer. Logistic regression was used to estimate the interaction models. RESULTS： The frequency of the CYPIA1 Valvariant allele in cases did not differ from that in controls. The OR of GSTM1 null genotype was 2.0 （95% confidence interval [95%CI]： 1.2-3.1, P〈0.01）. It showed a significant type 2 form of interaction model when both CYPIA1 Valvariant allele and former tobacco smoking existed （i.e., among the multiplicative effects, the disease risk is increased by the tobacco exposure alone but not by the CYPIA1 variant alone）. The interaction index y was 2.8, and OReg （95%CI） was 5.0 （1.9-13.4）. GSTM1 null genctype and former tobacco smoking were significant in a type 4 interaction model （i.e., the disease risk is increased by GSTM1 null genotype or tobacco exposure alone among the multiplicative effects）. The interaction index y and OReg （95%CI） were 3.4 and 8.4 （3.4-20.9）, respectively.CONCLUSION： Different interaction models of CYPIA1 Valvariant allele and GSTM1 null genotype with tobacco smoking will contribute to understanding carcinogenic mechanism, but there is a need to further investigate in larger scale studies.

Reduction of Tobacco Smoking Health Risk Through an Appropriate Media Based Communication Strategy in Uganda

The health impacts of tobacco consumption are well documented and have gained acceptance worldwide. Today, a substantial, preventable burden of tobacco attributable diseases exists in most countries, though in most of the cases, unknown. Smoking accounts for almost half of the deaths in middle age in some regions. In Uganda, translating findings into policy action is slow and involves several stakeholders. It will continue to require support from tobacco control campaign groups. This paper analyses secondary literature on tobacco smoking and later provides an appropriate medium based communication strategy that can be adopted to counteract the persuasive smoking evil adverts of tobacco companies as well as creating awareness among the population of the health impacts caused by smoking.

When smoke meets gut:deciphering the interactions between tobacco smoking and gut microbiota in disease development

Tobacco smoking is a prevalent and detrimental habit practiced worldwide,increasing the risk of various diseases,including chronic obstructive pulmonary disease(COPD),cardiovascular disease,liver disease,and cancer.Although previous research has explored the detrimental health effects of tobacco smoking,recent studies suggest that gut microbiota dysbiosis may play a critical role in these outcomes.Numerous tobacco smoke components,such as nicotine,are found in the gastrointestinal tract and interact with gut microbiota,leading to lasting impacts on host health and diseases.This review delves into the ways tobacco smoking and its various constituents influence gut microbiota composition and functionality.We also summarize recent advancements in understanding how tobacco smoking-induced gut microbiota dysbiosis affects host health.Furthermore,this review introduces a novel perspective on how changes in gut microbiota following smoking cessation may contribute to withdrawal syndrome and the degree of health improvements in smokers.

Prevalence of active and passive tobacco smoking among Beijing residents in 2011

Objectives: This study was aimed to investigate the prevalence of active and passive tobacco smoking among Beijing residents in 2011. Methods: A cross-sectional survey was conducted, using a stratified multistage cluster random sampling method to select a representative sample of 20,242, among Beijing residents aged 18-79 years. Active and passive tobacco smoking information was collected by a standardized and validated questionnaire in a face-to-face interview. All estimates of prevalence and numbers were weighted by the 2010 Beijing Population Census data and the sampling scheme. Results: Among Beijing residents aged 18-79 years, the overall prevalence of ever smokers and current smokers were 33.13%and 30.18%, respectively. The prevalence in males was much higher than that in females (60.75%vs. 3.75%for ever smokers, and 55.53% vs. 3.21% for current smokers, respectively). For overall current smokers, 14.12 cigarettes were consumed per day. However, only 8.91%of ever smokers quitted smoking at the time of the survey, and 2.44%of ever smokers quitted smoking in recent two years. Furthermore, 44.74%of overall nonsmokers and former smokers, with 47.03%of males and 43.63%of females, reported exposure to secondhand smoke for at least 15 minutes per day and at least one day per week. Conclusions: Tobacco smoking prevalence is still extremely high in Beijing. Nonsmokers do still suffer from secondhand smoke critically. Further urgent efforts for tobacco control are warranted in Beijing.

Impact of Village-based Health Education of Tobacco Control on the Current Smoking Rate in Chinese Rural Areas

The number of smokers in Chinese rural areas is more than 200 million, which is twice that in cities. It is very significant to carry out tobacco control interventions in rural areas. We performed this community intervention study to evaluate the efficacy of village-based health education of tobacco control on the male current smoking rate in rural areas. The population of this study was the males above 15 years old from 6 villages in rural areas. The villages were randomly assigned to intervention group or control group（3 villages in each group）. Self-designed smoking questionnaire was applied. The intervention group received the village-based health education of tobacco control for one year. The primary outcome measurement was the male current smoking rate. In the baseline investigation, completed surveys were returned by 814 male residents from the control group and 831 male residents from the intervention group. The male current smoking rate in the control group and the intervention group was 61.2% and 58.5%, respectively, before intervention. There was no significant difference between these two groups（P〉0.05）. After one-year intervention, the current smoking rate in the intervention group（51.2%） was significantly lower than that in the control group（62.8%）（P〈0.001）. Our study suggested that the village-based health education of tobacco control was effective in lowering the male current smoking rate in rural areas, which could be a suitable and feasible way for tobacco control in the Chinese rural areas.

Meta-Analysis of Smoking and the Risk of Gastric Cancer among the Chinese Population

OBJECTIVE To reevaluate the effect of tobacco smoking on therisk of developing gastric cancer among the Chinese population.METHODS Thirty articles from the literature both in Chineseand English from January,1988 to present were identified andfrom which adjusted odd ratios(ORs)or relative risks(RRs)werecombined by meta-analysis.Generalized least squares(GLS)fortrend estimation of summarized dose-response data was carriedout.All the analyses were performed using software of STATAversion 10.0.RESULTS Comparing current smokers with subjects who havenever smoked,the summary effect values on gastric cancer witha 95% confidence interval(CI)were 1.67(1.43-1.96)for case-control studies and 1.52(1.17-1.96)for cohort studies,respectively.The combined effect values with a 95%CI for the comparison ofsmoking quantity of current smokers with the referent groupwere 1.41(1.15-1.72)for case-control studies and 1.24(1.02-1.52)for cohort studies,respectively.The combined effect values witha 95%CI for the comparison of accumulative years smoked ofcurrent smokers with the referent group were 1.07(0.89-1.28)for case-control studies and 1.28(0.95-1.74)for cohort studies,respectively.Dose-response meta-analysis showed that the gastriccancer risk will increase 50%(OR=1.50,95%CI:1.34-1.67)witheach 20 cigarette per day increment and increase 14%(OR=1.14,95%CI:1.10-1.18)with each 10 year increment of smoking.CONCLUSION The gastric cancer risk among the Chinesepopulation is significantly associated with tobacco smoking andthe smoking quantity per day.Smoking cessation should be morestrongly advocated.

Tobacco, air pollution, environmental carcinogenesis, and thoughts on conquering strategies of lung cancer

Each year there will be an estimated 2.1 million new lung cancer cases and 1.8 million lung cancer deaths worldwide.Tobacco smoke is the No.1 risk factors of lung cancer,accounting for>85%lung cancer deaths.Air pollution,or haze,comprises ambient air pollution and household air pollution,which are reported to cause 252,000 and 304,000 lung cancer deaths each year,respectively.Tobacco smoke and haze(hereafter,smohaze)contain fine particles originated from insufficient combustion of biomass or coal,have quite similar carcinogens,and cause similar diseases.Smohaze exert hazardous effects on exposed populations,including induction of a large amount of mutations in the genome,alternative splicing of mRNAs,abnormalities in epigenomics,initiation of tumor-promoting chronic inflammation,and facilitating immune escape of transformed cells.Tackling smohaze and development of multi-targets-based preventive and therapeutic approaches targeting smohaze-induced carcinogenesis are the key to conquer lung cancer in the future.

THE N-NITROSAMINES IN TOBACCO SMOKE AND ITS ADSORPTION AND DEGRADATION

N-nitrosamines are strong carcinogens for humans. This paper gives an overview of the nitrosmaines in cigarette smoke including the formation, the harmfulness, the analytical methods of the nitrosmaines and the adsorptions and degradations of N –nitrosamines.

Ultrastructural changes in embryoic neuroepithelial cells caused by passive smoking in golden hamsters at different periods of pregnancy: A randomized controlled trial

BACKGROUND： Tobacco smoke exposure is recognized as a health risk for pregnant women and it is increasingly evident that tobacco smoke affects the development of brain. Recently, associations between maternal smoking during pregnancy and subsequent mental health problems in offspring have been reported. OBJECTIVE： To observe the effect of passive smoking on the morphology of nerve tissues and the ultrastructure of neuroepithelial cells during embryogenesis in golden hamster at different pregnant period. DESIGN： A randomized control study. SETTING： Department of Histology and embryology, Qingdao University. MATERIALS： Adult golden hamsters, including 40 males and 40 females that had not delivered, weighing （105±5） g, were provided by Shenyang Changsheng Biotechnology, Co.,Ltd. At 20 ： 00 - 21 ： 00, one male and one female were matched in each cage, and their mating was observed. The vaginal swabs were examined the next day and the day of positive sperm was taken as embryonic day 1 （E1）. METHODS： The experiment was completed in the Department of Histology and Embryology of Qingdao University from September 2001 to September 2003. （1） Abnormality caused by smoking, grouping and model establishment： A total of 40 healthy pregnant golden hamsters were randomly divided into control group （n =20） and experimental group （n =20）. The hamsters in the experimental group were exposed to tobacco smoke from embryonic day 4 to 7, 3 times per day, continuously 1 hour per time, 1 cigarette per golden hamster, for 4 consecutive days in the self-made chamber. The animals in the control group were given the same conditions as those in the experimental group except exposure to smoke. （2） Observation with transmission electron microscope： According to different gestational ages, the experimental group and the control group were all divided 4 subgroups （Groups A, B, C and D） respectively, and 5 hamsters in each subgroup. The pregnant golden hamsters were anaesthetized with 1 g/L pentobarbital sodium at 12 ： 00 and 18 ： 00 at E8, 8 ： 00 at E9 and 8 ： 00 at E10, and all the pregnant uteruses were divulsed under the stereomicroscope. The development of the neural plate, neural groove and neural tube were observed. Meanwhile, the amount of normal embryos and abnormal embryos including the neural tube defect ratios were recorded. （3） Electron microscopic specimen preparation and observation： Three embryos of each group ad libtium were fixed. The alternations of neuroepithelial ultrastrnctures were observed with transmission and scanning electron microscopes. MAIN OUTCOME MEASURES： （1） The incidences of abnormality of nervous system development were observed under stereomicroscope and scanning electron microscope in smoking group and the control group; （2） Alternations of neuroepithelial ultrastructures were observed with transmission electron microscope. RESULTS： All the 40 pregnant golden hamsters were involved in the final analysis. （1） Manifestations and incidence of nervous system dysplasia： Passive smoking could induce dymorphogenesis during neurnlation, which mainly presented as growth retardation, spina bifida and failure of formation of neural tubes; The incidences of the nervous system dysplasia in the experimental groups [20%（10/49）, 27%（14/51）, 32% （19/59）, 27% （17/63）] were higher than those in the corresponding control groups [0. 2% （1/57）, 4% （2/53）, 4% （2/52）, P 〈 0.01]. （2） Histomorphological changes at different time points after spermatiation observed with transmission and scanning electron microscopes： In the control group, the embryos formed C-shape columned embryos, anterior and posterior neuropores were all closure at 10 ： 00 on E10; In the experimental group, unfused anterior and posterior neuropores still could be found, and some embryos presented spina bifida at 10 ： 00 on E10. In the control group, neuroepithelial cell arranged tidily and closely, the boundary of the cells was clear, the flee surface of neuroepithelial had a mass of long and regular microvillus, and the surface of mesenchymal cell around the neuroepithelium had many processes which mutually related at 12 ： 00 on E8. In the experimental group, the neuroepithelial cells arranged irregularly and the intercellular spaces became wide at 12 ： 00 on E8. The apical portion of many neuroepithelial cells bulged into the lumen and many microvilli were shorted and swollen. The quantity of the microvillus reduced gradually, evenly disappeared with the increasing of gestational age at 18：00 on E8. Under transmission electron microscope, the neuroepithelial cells in experimental embryos arranged irregularly. There were many visible materials in the intercellular space which increased the breadth and anomaly. It was apparent that passive smoking evoked major alterations in neuroepithelial cytoarchitecture. Junctional complex reduced. Many microvilli were shorted and swollen, even the apical portion of many neuroepithelial cells bulged, and abscised into the lumen. A lot of vacuolation appeared in the cytoplasm of neuroepithelia and mesenchymal cell around the neuroepithelium. The cristae of mitochondria reduced even disappeared, and some mitochondria became elongate. Irregular nuclear, increased heterochromatin and karyopycnosis/karyorrhexis were observed easily. Perinuclear cisternae partially swelled and embraced tangible material （maybe the material from nuclear）. Some death cells separated into a lot of apoptotic bodies. Some apoptotic bodies were found in the cytoplasm of other healthy-looking or healthy cells. CONCLUSION： Passive smoking may induce degeneration, apoptosis, and cells loss in the neural epithelium, thereby result in failure of formation and differentiation of neural tube. It is an important way by which passive smoking caused neural tube defects.

8-Hydroxydeoxyguanosine as a Biomarker of Oxidative DNA Damage Induced by Environmental Tobacco Side-stream Smoke and Its Mechanism

To study the genotoxicity effect of environmental tobacco side-stream smokes (ETSS) on oxidative DNA damage and its molecular mechanism. Methods DNA adduct 8-hydroxydeoxyguanosine (8-OHdG) was used as a biomarker of oxidative DNA damage. The level of 8-OHdG in DNA exposed to ETSS was detected by high performance liquid chromatography with electrochemical detection. Organic and inorganic components in ETSS were analyzed by gas chromatography-mass spectrum and atomic absorption spectrum respectively. Results Particle matters (PMs) and volatile organic compounds (VOCs) in ETSS could directly induce oxidative DNA damage and formation of 8-OHdG. There were 123 and 84 kinds of organic components in PMs and VOCs respectively, and 7 kinds of inorganic components in ETSS. Some components, especially quinones and polyphenols in ETSS, could produce free radicals in vitro by auto-oxidation without any biological activity systems, and with the catalytic reaction of metals, the DNA adduct 8-OHdG was produced. Conclusion ETSS have biological oxidative effect on DNA in vitro and in vivo, and expressed direct genotoxicity. 8-OHdG is a valuable biomarker of oxidative DNA damage.

CONCERNING THE RELATION OF TOBACCOGLYCOPROTEIN TO BUERGER'S DISEASE

Objective To comprehend the reiation of tobacco glycoprotein (TGP) to Buerger,s disease.Metbods TGP was isolated from crude tobacco leaves by basic immunologic techniques. Serum anti- TGPantibodies were tested by Western blot analysis in 11 patients with Buerger,s disease, 15 healthy male smokers and11 nonsmoking healthy male subjects. Results 1. TGP is a dark brown protein of molecular weight 14000. It maybe a subunit of some high molecular weight protein, and exists in crude tobacco leaves. 2. Western blot analysisshowed that 81.81% of patients with Buerger’s disease (9/11), 33.33% of healthy smokers (5/15) and 27.27% ofhealthy nonsmokers (3/11) had serum anti- TGP antibodies. There was significant dtherence between patientswith Buerger,s disease and two control groups (P<0.05), and no signilicant dtherence between both control groups(P>0.05). Conclusion TGP does play an important role in the pathogenesis of Buerger’s disease. As anti - TGPantibodies are also found in some control subjects, it is speculated that other etiologic factors might coordinatelycontribute to the specifc vascular response to TGP in susceptible subjects.

Exploitation of the nicotinic anti-inflammatory pathway for the treatment of epithelial inflammatory diseases

Discoveries in the first few years of the 21st century have led to an understanding of important interactions between the nervous system and the inflammatory response at the molecular level, most notably the acetylcholine （ACh）- triggered,α7-nicotinic acetylcholine receptor （α7nAChR）- dependent nicotinic antinflammatory pathway. Studies using the α7nAChR agonist, nicotine, for the treatment of mucosal inflammation have been undertaken but the efficacy of nicotine as a treatment for inflammatory bowel diseases remains debatable. Further understanding of the nicotinic anti-inflammatory pathway and other endogenous anti-inflammatory mechanisms is required in order to develop refined and specific therapeutic strategies for the treatment of a number of inflammatory diseases and conditions, including periodontitis, psoriasis, sarcoidosis, and ulcerative colitis.

Widening socioeconomic disparity in lung cancer incidence among men in New South Wales, Australia, 1987–2011

Objective：We assessed the trends in lung cancer incidence over a 25-year period by socioeconomic groups for men in New South Wales（NSW）,Australia.Methods：Men diagnosed with lung cancer between 1987 and 2011 were divided into five quintiles according to an Index of Education and Occupation（IEO）.We assessed relative socioeconomic differences over time by calculating age-standardized incidence ratios（SIRs）by 5-year period of diagnosis,and estimated absolute differences by comparing the observed and expected numbers of cases using the highest IEO quintile as the reference.Results：Lung cancer incidence for men decreased from 1987 to 2011 for all IEO quintiles,with a greater rate of decline for men living in the highest IEO areas.Thus,the relative disparity increased significantly over the 25-year period（P=0.0006）.For example,the SIR for the lowest IEO quintile increased from 1.28 during 1987–1991 to 1.74during 2007–2011.Absolute differences also increased with the proportion of＂potentially preventable＂cases doubling from 14.5% in 1987–1991 to 30.2% in 2007–2011.Conclusions：Despite the overall decline in lung cancer incidence among men in NSW over the past 25 years,there was a significant increase in disparity across socioeconomic areas in both relative and absolute terms.

Interaction between ozone and paternal smoking on fetal congenital heart defects among pregnant women at high risk a multicenter maternal-fetal medicine study

Background Evidence remains limited on the association between maternal ozone(O,)exposure and congenital heart defects(CHDs)in offspring,and few studies have investigated the interaction and modification of paternal smoking on this association.Methods Using a sample including pregnant women at high risk of fetal CHD(with metabolic disease,first-trimester viral infection,family history of CHD,etc.)from a maternal-fetal medicine study covering 1313 referral hospitals in China during 2013-2021,we examined the associations between maternal O_(3)exposure during 3-8 weeks of gestational age and fetal CHD in offspring and investigated the interaction and modification of paternal smoking on this association.CHD was diagnosed by fetal echocardiograms,maximum daily 8-hour average O,exposure data at a 10 km×10 km spatial resolution came from the Tracking Air Pollution in China dataset,and paternal smoking was collected using questionnaires.Logistic regression models were used to estimate adjusted odds ratios(ORs)and 95%confidence intervals(CIs).Results Among 27,834 pregnant women at high risk of fetal CHD,17.4%of fetuses were diagnosed with CHD.Each 10μg/m^(3)increase in maternal O_(3)exposure was associated with a 17%increased risk of CHD in offspring(OR=1.17,95%CI=1.14-1.20).Compared with paternal nonsmoking and maternal low O_(3)exposure,the ORs(95%CI)of CHD for smoking and low O_(3)exposure,nonsmoking and high O_(3)exposure,and smoking and high O_(3)exposure were 1.25(1.08-1.45),1.81(1.56-2.08),and 2.23(1.84-2.71),respectively.Paternal smoking cessation seemingly mitigated the increased risk of CHD.Conclusions Maternal O_(3)exposure and paternal smoking were interactively associated with an increased risk of fetal CHD in offspring,which calls for effective measures to decrease maternal exposure to O_(3)pollution and secondhand smoke for CHDprevention.

A Decision Tree Approach for Predicting Smokers’Quit Intentions

This paper presents a decision tree approach for predicting smokers＇ quit intentions using the data from the International Tobacco Control Four Country Survey. Three rule-based classification models are generated from three data sets using attributes in relation to demographics, warning labels, and smokers＇ beliefs. Both demographic attributes and warning label attributes are important in predicting smokers＇ quit intentions. The model＇s ability to predict smokers＇ quit intentions is enhanced, if the attributes regarding smokers＇ internal motivation and beliefs about quitting are included.

Cluster Analysis of Polyphenols and Organic Acids in 11 Different Brand Cigarette Samples at Home and Abroad

The objective of this research was to investigate the differences between local cigarette and foreign cigarette and supplied a base for improving the quality of cigarette. Different kinds of polyphenols and organic acids in 11 different brand cigarette samples at home and abroad were classified by the method of cluster analysis. The results indicated that the 11 samples could be classified into 2 classes. Suyan, Furongwang, Chinese, Baisha, Dihao, Yunyan, Hongtashan belonged to type 1; foreign cigarettes that represented by Marboro, Blue pacific and Brazil cigarette belonged to type 2. The content of malic acid and citric acid in type 1was higher than type 2, the content of malonic acid was higher in type 2, and there is no difference between the type 1 and type 2 about the content of polyphenols. In conclusion, the content of malic acid and citric in Chinese cigarettes was higher than foreign, but the content of malonic acid was lower than foreign. There is no difference between Chinese cigarettes and foreign cigarettes about the content of polyphenols.

An evaluation of mass,number concentration,chemical composition and types of particles in a cafeteria before and after the passage of an antismoking law

This study assessed air quality indicators before and after enactment of the Spanish anti-smoking law. Mass and number concentrations and the chemical composition of particles were evaluated. Microscopy analyses were also conducted. Real time concentrations of PMlo, PM2.s, PM1 and ultrafine particles were measured under ventilated and non-ventilated conditions and PMlo samples were collected for detailed inorganic and organic chemical characterization. Before enactment of the law in 2010, tobacco smoke produced significant indoor ambient particulate matter pollution, with elevated particulate matter mass concentrations （PM10 and PM1 concentrations of 122-220 and 48-85 Dg/m3, respectively） and ultrafine particle numbers （75,000 and 48,000 cm ~ under ventilated and non-ventilated conditions, respectively）. Typical tobacco smoke tracers including iso- and anteiso-alkanes and elements including La and Ce from the ignition of lighters were abundant. Additionally, several toxic substances derived from tobacco smoke, including Cd （3.1 ng/m3） and benzo[a]pyrene （1.0 ng/m3） were present at concentrations approximately 10 times greater than those measured after enactment of the anti-smoking law. The anti-smoking law sig- nificantly reduced exposure to potentially toxic compounds by approximately 90%. This law is expected to have a positive health impact, particularly for people who spend considerable time in affected envi- ronments, such as employees.

A population level study on smoking and radon induced adenocarcinoma and small-cell carcinoma among males and females in Canada

Objective: To assess if there is a relationship between residential radon exposure and two lung cancer histologicaltypes, small-cell carcinoma (diagnosed in people with a smoking history) and adenocarcinoma (the mostcommonly diagnosed histologic type in people who have never smoked) among males and females in Canada.Methods: With survey data of long-term radon measurements in residential homes, long-term averaged tobaccoconsumption rates in the units of cigarettes per day per person and long-term averaged age-standardized lungcancer incidence rates at provincial level, simple linear fitting (ANOVA linear regression) was applied in this studyto determine the effect on lung cancer induction by smoking and exposure to indoor radon, and to assess if there isa relationship between residential radon exposure and lung cancer histological types.Results: Lung cancer incidence rates correlate very well with the tobacco consumption rates (P < 0.05). However,females appear to be more likely than males to develop lung cancer at a given amount of cigarette consumption.For both small-cell carcinoma and adenocarcinoma, a statistically significant correlation between incidence rateand mean radon concentration was observed for females, the correlation was much stronger for adenocarcinoma(P = 0.0057) than small-cell carcinoma (P = 0.0483). However, there was no such correlation for males.Conclusion: It is possible that female non-smokers are more susceptible to radon-induced lung cancer, and the jointeffect of radon exposure and tobacco smoking may be worse in female smokers compared to males, such thathigher incidence rate of adenocarcinoma among females compared to males were observed in recent decades,even though females never smoked more than males.

Current cancer situation in China:good or bad news from the 2018 Global Cancer Statistics?

Cancer is the leading cause of death in China and depicting the cancer pattern of China would provide basic knowhows on how to tackle it more effectively.In this study we have reviewed several reports of cancer burden,including the Global cancer statistics 2018 and Cancer statistics in China,2015,along with the GLOBCAN 2018 online database,to investigate the differences of cancer patterns between China,the United States(USA)and the United Kingdom(UK).An estimated 4.3 million new cancer cases and 2.9 million new cancer deaths occurred in China in 2018.Compared to the USA and UK,China has lower cancer incidence but a 30%and 40%higher cancer mortality than the UK and USA,among which 36.4%of the cancer-related deaths were from the digestive tract cancers(stomach,liver,and esophagus cancer)and have relatively poorer prognoses.In comparison,the digestive cancer deaths only took up≤5%of the total cancer deaths in either USA or UK.Other reasons for the higher mortality in China may be the low rate of early-stage cancers at diagnosis and non-uniformed clinical cancer treatment strategies performed by different regions.China is undergoing the cancer transition stage where the cancer spectrum is changing from developing country to developed country,with a rapidly increase cancer burden of colorectal,prostate,female breast cancers in addition to a high occurrence of infection-related and digestive cancers.The incidence of westernized lifestyle-related cancers in China(i.e.colorectal cancer,prostate,bladder cancer)has risen but the incidence of the digestive cancers has decreased from 2000 to 2011.An estimated 40%of the risk factors can be attributed to environmental and lifestyle factors either in China or other developed countries.Tobacco smoking is the single most important carcinogenic risk factor in China,contributing to~24.5%of cancers in males.Chronic infection is another important preventable cancer contributor which is responsible for~17%of cancers.Comprehensive prevention and control strategies in China should include effective tobacco-control policy,recommendations for healthier lifestyles,along with enlarg-ing the coverage of effective screening,educating,and vaccination programs to better sensitize greater awareness control to the general public.