Association between NNAL and Mortality in U.S. Adults, NHANES 2007-2014 with 2015 Mortality Follow-Up

Cigarette smoking is a leading cause of premature mortality, attributable to chronic exposure to toxic compounds in cigarette smoke, including tobacco-specific nitrosamines, which are known carcinogens. This research aims to assess the association between NNAL, a metabolite of the tobacco-specific nitrosamine NNK, and mortality. Data from 14,766 U.S. adults aged 21 - 79 in the National Health and Nutrition Examination Survey (2007-2014) included smoking status and urinary NNAL concentration at the time of examination. These data were linked to participants’ subsequent mortality status as recorded in the public-use Linked Mortality File (through 2015). Cox proportional hazards regression models assessed the relative risk of all-cause, cancer, cardiovascular disease (CVD), and other-causes mortality for increasing levels of natural log (creatinine-adjusted NNAL). In the whole sample, a unit increase in log (NNAL) is associated with a 20% higher risk of all-cause (HR = 1.20;95% CI: 1.16 - 1.24), cancer (HR = 1.20;95% CI: 1.14 - 1.26), CVD (HR = 1.21;95% CI: 1.12 - 1.31) and other-causes (HR = 1.20;95% CI: 1.15 - 1.25) mortality. Among current smokers, a unit increase in log (NNAL) is associated with 44% higher cancer mortality risk (HR = 1.44;95% CI: 1.08 - 1.92) and a 96% higher CVD mortality risk (HR = 1.96;95% CI: 1.20 - 3.20). Risks of all-cause and other-causes mortality, but neither cancer nor CVD mortality, were positively associated with NNAL among never and former smokers. Inferences are limited by the observational nature of the data, and by the focus on a single biomarker of tobacco-related exposure. The findings suggest that urinary NNAL concentration is acting as a proxy for exposure to the toxicants in cigarette smoke rather than as a biomarker of disease-specific mortality risk.

Evidence relating cigarettes,cigars and pipes to cardiovascular disease and stroke:Meta-analysis of recent data from three regions

BACKGROUND More recent data are required relating to disease risk for use of various smoked products and of other products containing nicotine.Earlier we published metaanalyses of recent results for chronic obstructive pulmonary disease and lung cancer on the relative risk(RR)of current compared to never product use for cigarettes,cigars and pipes based on evidence from North America,Europe and Japan.We now report corresponding up-to-date evidence for acute myocardial infarction(AMI),ischaemic heart disease(IHD)and stroke.AIM To estimate,using recent data,AMI,IHD and stroke RRs by region for current smoking of cigarettes,cigars and pipes.METHODS Publications in English from 2015 to 2020 were considered that,based on epidemiological studies in the three regions,estimated the current smoking RR of AMI,IHD or stroke for one or more of the three products.The studies should involve at least 100 cases of stroke or cardiovascular disease(CVD),not be restricted to populations with specific medical conditions,and should be of cohort or nested case-control study design or randomized controlled trials.A literature search was conducted on MEDLINE,examining titles and abstracts initially,and then full texts.Additional papers were sought from reference lists of selected papers,reviews and meta-analyses.For each study identified,we entered the most recent available data on current smoking of each product,as well as the characteristics of the study and the RR estimates.Combined RR estimates were derived using random-effects meta-analysis for stroke and,in the case of CVD,separately for IHD and AMI.For cigarette smoking,where far more data were available,heterogeneity was studied by a wide range of factors.For cigar and pipe smoking,a more limited heterogeneity analysis was carried out.A more limited assessment of variation in risk by daily number of cigarettes smoked was also conducted.RESULTS Current cigarette smoking:Ten studies gave a random-effects RR for AMI of 2.72[95%confidence interval(CI):2.40-3.08],derived from 13 estimates between 1.47 and 4.72.Twenty-three studies gave an IHD RR of 2.01(95%CI:1.84-2.21),using 28 estimates between 0.81 and 4.30.Thirty-one studies gave a stroke RR of 1.62(95%CI:1.48-1.77),using 37 estimates from 0.66 to 2.91.Though heterogeneous,only two of the overall 78 RRs were below 1.0,71 significantly(P<0.05)exceeding 1.0.The heterogeneity was only partly explicable by the factors studied.Estimates were generally higher for females and for later-starting studies.They were significantly higher for North America than Europe for AMI,but not the other diseases.For stroke,the only endpoint with multiple Japanese studies,RRs were lower there than for Western studies.Adjustment for multiple factors tended to increase RRs.Our RR estimates and the variations by sex and region are consistent with earlier meta-analyses.RRs generally increased with amount smoked.Current cigar and pipe smoking:No AMI data were available.One North American study reported reduced IHD risk for non-exclusive cigar or pipe smoking,but considered few cases.Two North American studies found no increased stroke risk with exclusive cigar smoking,one reporting reduced risk for exclusive pipe smoking(RR 0.24,95%CI:0.06-0.91).The cigar results agree with an earlier review showing no clear risk increase for IHD or stroke.CONCLUSION Current cigarette smoking increases risk of AMI,IHD and stroke,RRs being 2.72,2.01 and 1.62.The stroke risk is lower in Japan,no increase was seen for cigars/pipes.

Evidence relating cigarette,cigar and pipe smoking to lung cancer and chronic obstructive pulmonary disease:Meta-analysis of recent data from three regions

BACKGROUND There is a need to have up-to-date information for various diseases on the risk related to the use of different smoked products and the use of other nicotinecontaining products.Here,we contribute to the information pool by presenting up-to-date quantitative evidence for North America,Europe and Japan and for both lung cancer and chronic obstructive pulmonary disease(COPD)on the relative risk(RR)relating to current vs never product use for each of the three smoked tobacco products,cigarettes,cigars and pipes.AIM To estimate lung cancer and COPD current smoking RRs for the three products using recent data for the three regions.METHODS Publications in English from 2010 to 2020 were considered that,based on epidemiological studies in the three regions,estimated the current smoking RR of lung cancer and/or COPD for one or more of the three products.The studies should involve at least 100 cases of the disease considered,not be restricted to specific lung cancer types or populations with specific medical conditions,and should be of cohort or nested case-control study design or randomized controlled trials.Literature searches were conducted on MEDLINE separately for lung cancer and for COPD,examining titles and abstracts initially,and then full texts.Additional papers were sought from reference lists of selected papers,reviews and metaanalyses.For each study identified,the most recent available data on each product were entered on current smoking,as well as on characteristics of the study and the RR estimates.Combined RR estimates were derived using random-effects meta-analysis.For cigarette smoking,where far more data were available,heterogeneity was studied by a wide range of factors.For cigar and pipe smoking,a more limited heterogeneity analysis was carried out.Results were compared with those from previous meta-analyses published since 2000.RESULTS Current cigarette smoking:For lung cancer,44 studies(26 North American,14 European,three Japanese,and one in multiple continents),gave an overall estimate of 12.14[95%confidence interval(CI)10.30-14.30].The estimates were higher(heterogeneity P<0.001)for North American(15.15,CI 12.77-17.96)and European studies(12.30,CI 9.77-15.49)than for Japanese studies(3.61,CI 2.87-4.55),consistent with previous evidence of lower RRs for Asia.RRs were higher(P<0.05)for death(14.85,CI 11.99-18.38)than diagnosis(10.82,CI 8.61-13.60).There was some variation(P<0.05)by study population,with higher RRs for international and regional studies than for national studies and studies of specific populations.RRs were higher in males,as previously reported,the within-study male/female ratio of RRs being 1.52(CI 1.20-1.92).RRs did not vary significantly(P≥0.05)by other factors.For COPD,RR estimates were provided by 18 studies(10 North American,seven European,and one Japanese).The overall estimate of 9.19(CI 6.97-12.13),was based on heterogeneous data(P<0.001),and higher than reported earlier.There was no(P>0.1)variation by sex,region or exclusive use,but limited evidence(0.05<P<0.1)that RR estimates were greater where cases occurring shortly after baseline were ignored;where bronchiectasis was excluded from the COPD definition;and with greater confounder adjustment.Within-study comparisons showed adjusted RRs exceeded unadjusted RRs.Current cigar smoking:Three studies gave an overall lung cancer RR of 2.73(CI 2.36-3.15),with no heterogeneity,lower than the 4.67(CI 3.49-6.25)reported in an earlier review.Only one study gave COPD results,the RR(2.44,CI 0.98-6.05)being imprecise.Current pipe smoking:Four studies gave an overall lung cancer RR of 4.93(CI 1.97-12.32),close to the 5.20(CI 3.50-7.73)given earlier.However,the estimates were heterogeneous,with two above 10,and two below 3.Only one study gave COPD results,the RR(1.12,CI 0.29-4.40),being imprecise.For both diseases,the lower RR estimates for cigars and for pipes than for current smoking of cigarettes aligns with earlier published evidence.CONCLUSION Current cigarette smoking substantially increases lung cancer and COPD risk,more so in North America and Europe than Japan.Limited evidence confirms lower risks for cigars and pipes than cigarettes.

Patients'perspectives on smoking and inflammatory bowel disease:An online survey in collaboration with European Federation of Crohn's and Ulcerative Colitis Associations

BACKGROUNDSmoking has detrimental effects on Crohn’s disease (CD) activity while data onulcerative colitis (UC) are conflicting. Little is known about the use and impact ofalternative smoking products in inflammatory bowel diseases (IBD).AIMTo understand the patients’ perceptions of the impact of smoking on their IBDand to assess differences between CD and UC patients.METHODSThe questionnaire was developed by Philip Morris Products SA in cooperationwith European Federation of Crohn's and Ulcerative Colitis Associations. Thefinal survey questionnaire consisted of 41 questions divided in 8 categories: (1)Subject screener;(2) Smoking history;(3) Background information;(4) IBD diseasebackground;(5) Current disease status;(6) Current therapeutics and medications;and (7) Current nicotine/cigarettes use and awareness of the impacts of smokingon IBD. The questionnaire was submitted online from 4th November 2019 to 11th March 2020 through the European Federation of Crohn's and Ulcerative ColitisAssociations website to IBD patients who were current smokers or had a historyof smoking.RESULTSIn total 1050 IBD patients speaking nine languages participated to the survey.Among them, 807 (76.9%) patients declared to have ever smoked or consumed analternative smoking product, with a higher proportion of current cigarettesmokers among CD patients (CD: 63.1% vs UC: 54.1%, P = 0.012). About twothirdsof the participants declared to have ever stopped cigarette smoking andrestarted (67.0%), with a significantly higher proportion among UC patientscompared to CD patients (73.1% vs 62.0%, P = 0.001). We also found significantdifferences between CD and UC patients in the awareness of the healthconsequences of smoking in their disease and in the perceived impact of smokingon disease activity, for both cigarettes and alternative smoking products.CONCLUSIONThis survey found significant differences between CD and UC patients in bothawareness and perception of the impact of smoking on their disease. Furtherefforts should be done to encourage smoking cessation for all IBD patients,including UC patients.

DNA methylation patterns in alcoholics and family controls

AIM: To assess whether DNA methylation patterns in chronic alcoholics are different from non-alcoholic sibling controls. METHODS: We examined the methylation patterns in DNA samples from 25 chronic alcoholics and 22 matched siblings as controls (one per family). DNA was extracted from peripheral blood and analyzed for differences in the methylation patterns after bisulfite-conversion. We used the Illumina GoldenGate Methylation Cancer Panel I (Illumina, San Diego, CA), which probes the methylation profile at 1505 CpG sites from 807 cancer related genes. We excluded the 84 X-chromosome CpG sites and 134 autosomal CpG sites that failed to show a within sample reliability score of at least 95% for all samples, leaving 1287 autosomal CpG sites (associated with 743 autosomal genes) with reliable signals for all samples. A methylation score was calculated as the average methylation for the 1287 CpG sites examined. Differences were assessed by a two-sample t-test. We also examined the average sib pair differences in methylation scores at each of the 1287 sites. All analyses were performed using SPSS, version 9.0, P < 0.05 was considered significant. RESULTS: Methylation levels at the 1287 CpG sites averaged 28.2% for both alcoholics and controls. The mean difference in methylation scores between alcoholic and non-alcoholic sibs by CpG site was < 1% with small inter-individual variances; and only 5 CpG sites had an average sib difference > 5%. Subgroup analysis showed that methylation scores were significantly lower for the alcoholic-dependent subjects who smoked compared to their non-smoking unaffected siblings. Specifically, among smokers who are alcoholic, global methylation indices were significantly lower than in non-alcoholic sib controls, whereas among non-smoking alcoholics, the global indices were significantly higher (P = 0.008). CONCLUSION: Although we observed no effect of alcoholism alone on DNA methylation, there is a decrease in alcoholics who smoke, suggesting a mechanism for alcohol-tobacco synergy for carcinogenesis.

The Impact of Tobacco Taxation Policy on Slim Cigarette Use and the Growing Popularity of Slim Cigarettes in China Since 2014

Introduction: In 2016, China became the largest market for slim cigarettes in the world, selling 68.945 billion sticks. The purpose of this study is to examine the impact of China’s 2015 tobacco taxation policy on slim cigarette consumption and the product’s market trends. Methods: Monthly data on the market share of slim cigarettes and their average price between January 2014 and June 2017 were used to show tobacco market trends and to estimate the impact of the 2015 tobacco tax increase on tobacco consumption. Segmented regression analysis was used to estimate the immediate effect of the 2015 tax policy and the time trends in consumption due to the policy change. Findings: After the tobacco tax increase was announced in May 2015, the market share of slim cigarettes initially decreased by 0.2117 (p = 0.067). However, by the third month after the policy change, consumption began to increase, and the market share of slim cigarettes was 1.6 times the normal increase over time. Slim cigarettes gained a 2.02% additional share by the second quarter of 2017 (from 2.58% to 4.60%), controlling for the price difference between slim cigarettes and regular cigarettes. The coefficient of the share and the price ratio (slim cigarettes/regular cigarettes) was ?0.7536 (p = 0.0044), suggesting that slim cigarettes are a substitute for regular cigarettes. Estimates also show that after the tax increase was implemented, consumption of slim cigarettes increased almost three times the normal consumption rate (0.0069 versus 0.0024). Conclusion: The slim cigarette industry in China has grown rapidly in recent years. The 2015 tax increase has had only minimal or short-term impact on reducing the growing popularity of slim cigarettes. Since slim cigarettes are a substitute for regular cigarettes, more empirical research is urgently needed to study the health impacts of slim cigarette use and the impact of tobacco control policies on slim cigarette consumption.

Smoking and Passive Smoking

Objective:To review the literature on associations between cardiovascular diseases and tobacco use,including recent trends in smoking behaviors and clinical approaches for cessation of smoking.Methods:A literature review of recent scientifi c fi ndings for smoking and cardiovascular diseases and recommendations for obtaining cessation.Results:Tobacco smoking is causally related to cardiovascular disease,with nearly a half million deaths annually attributed to cigarette smoking in the United States.The human,economic,medical,and indirect costs are enormous.Secondhand smoke as inhaled from the environment also plays an important role in the genesis of cardiovascular diseases.A recent trend in the use of e-cigarettes is noted particularly among youth.For children,prevention is the best strategy.For adult smokers,behavioral treatments,self-help approaches,and pharmacologic therapies are readily available.Clinicians can have a signifi cant impact on patients’smoking habits.Adding to individual strategies,regulatory community and public health approaches provide the potential for eliminating the use of tobacco.Conclusion:Tobacco smoke causes cardiovascular morbidity and death.Clinicians can play a role in preventing smoking and promoting cessation.

Electronic cigarettes — myocardial infarction, hemodynamic compromise during pregnancy, and systolic and diastolic dysfunction: Minireview

The aim of this study was to review the most recent literature on the safety of electronic cigarettes(ECs)in the context of cardiovascular disease and in the context as a tool for smoking cessation and recreational purposes.The format of this review begins with relevant research from the basic sciences and follows through with a pertinent review of clinical trials.Daily use of ECs has implications in myocardial infarction(MI)with an odds ratio of 1.70 compared to healthy,nonsmokers and even worse risk for MI with dual use of combustible cigarettes together with EC with an odds ratio of 4.62.Studies measuring cardiac function with echocardiography reported both systolic and diastolic dysfunction along with reduced ejection fractions.Platelet aggregation,endothelial function,and hemodynamics during pregnancy were all but some of the pernicious cardiovascular implications of EC exposure.Though more studies need to be done on the topic of EC use and cardiovascular disease,the majority of studies considered in this review concluded some level of harm albeit in some instances less than that of traditional combustible cigarettes.ECs are toxic to human beings and their harmful effects cannot be overlooked.There is some favorable evidence of efficacy in smoking cessation though mixed with concern of chronic EC use.It will take decades to collect data for chronic EC use on long term sequelae,such as lung cancer.Though more and more reports of acute lung injury and hospitalizations related to EC use have been reported.Due to undergoing investigations of possible harm and life threatening complications of EC use,we cannot recommend ECs as safer or a more efficacious method of smoking cessation to traditional nicotine replacement therapies.A notable consideration for much of the literature reviewed are that standardization of EC use is difficult as device generation and battery voltage,frequency of use,and contents of ECliquid are just some of the vast complicating factors that limit the ability to effectively compare data.

On the Development and Maintenance of Cigarettes Exported to North Korea

According to the requirements of " going out" strategy of Jilin Tobacco Industry Co. Ltd.,in order to further expand the Changbaishan series brand in the market of North Korea,this paper elaborates the product development and maintenance ideas and measures for three cigarette companies in North Korea based on the actual work being done,so as to determine the development and maintenance focus of export cigarettes and provide strong technical support for accelerating the pace of localization of production while achieving homogenization of production.

Misclassification of smoking habits:An updated review of the literature

BACKGROUND Misclassification of smoking habits leads to underestimation of true relationships between diseases and active smoking, and overestimation of true relationships with passive smoking. Information on misclassification rates can be obtained from studies using cotinine as a marker.AIM To estimate overall misclassification rates based on a review and meta-analysis of the available evidence, and to investigate how misclassification rates depend on other factors.METHODS We searched for studies using cotinine as a marker which involved at least 200 participants and which provided information on high cotinine levels in selfreported non-, never, or ex-smokers or on low levels in self-reported smokers. We estimated overall misclassification rates weighted on sample size and investigated heterogeneity by various study characteristics. Misclassification rates were calculated for two cotinine cut points to distinguish smokers and nonsmokers, the higher cut point intended to distinguish regular smoking.RESULTS After avoiding double counting, 226 reports provided 294 results from 205 studies. A total of 115 results were from North America, 128 from Europe, 25 from Asia and 26 from other countries. A study on 6.2 million life insurance applicants was considered separately. Based on the lower cut point, true current smokers represented 4.96%(95% CI 4.32-5.60%) of reported non-smokers, 3.00%(2.45-3.54%) of reported never smokers, and 10.92%(9.23-12.61%) of reported exsmokers. As percentages of true current smokers, non-, never and ex-smokers formed, respectively, 14.50%(12.36-16.65%), 5.70%(3.20-8.20%), and 8.93%(6.57-11.29%). Reported current smokers represented 3.65%(2.84-4.45%) of true non-smokers. There was considerable heterogeneity between misclassification rates.Rates of claiming never smoking were very high in Asian women smokers, the individual studies reporting rates of 12.5%, 22.4%, 33.3%, 54.2% and 66.3%. False claims of quitting were relatively high in pregnant women, in diseased individuals who may recently have been advised to quit, and in studies considering cigarette smoking rather than any smoking. False claims of smoking were higher in younger populations. Misclassification rates were higher in more recently published studies. There was no clear evidence that rates varied by the body fluid used for the cotinine analysis, the assay method used, or whether the respondent was aware their statements would be validated by cotinine-though here many studies did not provide relevant information. There was only limited evidence that rates were lower in studies classified as being of good quality,based on the extent to which other sources of nicotine were accounted for.CONCLUSION It is important for epidemiologists to consider the possibility of bias due to misclassification of smoking habits, especially in circumstances where rates are likely to be high. The evidence of higher rates in more recent studies suggests that the extent of misclassification bias in studies relating passive smoking to smoking-related disease may have been underestimated.

Bilateral Pneumonia and Pleural Effusions Subsequent to Electronic Cigarette Use

Electronic nicotine delivery systems also known as electronic cigarettes (or e-cigarettes) are marketed by their manufactures as a safer alternative to tobacco cigarettes because of potentially reduced delivery of toxins. However, the scientific evidence and the long-term health effects of e-cigarettes are limited. We describe a case of a 43-year-old man who had been smoking electronic cigarettes excessively for three days and presented with acute dyspnea, increased work of breathing and tachycardia. Subsequent chest x-ray revealed bilateral pleural effusions. In addition, the patient had a new oxygen requirement and was thus admitted with a diagnosis of pneumonia and bilateral pleural effusions. The case and the potential harmful effects of electronic cigarettes are discussed herein.

Toxicology of Commonly Found Ingredients in E-Cigarettes: A Brief Review

Electronic cigarettes (EC) have gained popularity among smokers due to their taste, smell, appearance, and easy availability compared to traditional cigarettes, as well as the perception that they are safer than traditional cigarettes. These devices result in aerosols containing nicotine, propylene glycol, glycerin, ethylene glycol, vitamin E, and chemical flavors inhaled into the lungs. Other components found in these vapors include heavy metals such as nickel, chromium, lead, manganese, and tin. In addition, some ingredients volatilization leads to toxic aldehydes formation such as formaldehyde, acetaldehyde, and acrolein. Smoking cigarettes is addictive and has been associated with many health issues such as heart disease, lung cancer, etc. Rising awareness of these dangers moves more people towards these electronic delivery systems, reducing the health effects of cigarettes. The toxicity of EC’s ingredients is well studied when ingested;however, their toxicity through inhalation remains unclear. Consequently, the use of ECs has become a significant concern worldwide and raises whether it is indeed safe to use. This paper will serve as a literature review paper to discuss the toxicity of commonly found ingredients in ECs and their associated health issues. Our conclusion emphasizes that even though smoking EC is less risker than smoking traditional cigarettes, it is still not safe due to the potentially harmful effect these E-cig’s ingredients have on the human’s health. In addition, E-cigarette’s aerosol could also contain toxic compounds such as formaldehyde, acetaldehyde, and acrolein due to glycerin’s thermo-degradation.

Use of Cigarettes and Other Tobacco Products among Primary and Secondary School Students in Khartoum State, Sudan

Introduction: In Sudan, tobacco use is common;it is used in some form by 20% of the population. As most users start during adolescence, we aimed to determine the prevalence of ever use of tobacco products (i.e. cigarettes, herbal cigarettes, shisha and tombak) among Sudanese adolescent males and females, and to assess associations between tobacco ever use and personal characteristics. Methods: This cross-sectional study was conducted in Khartoum State, Sudan. The study data were collected in June 2014. The target population consisted of adolescents in 8th grade of primary education or 1st and 2nd grade of secondary education. They were asked to fill in a written questionnaire during the school break. Schools were randomly selected using a stratified two-stage cluster sampling design method. Results: A total of 1229 respondents (56.4% male), with a mean age of 14.5 years, were included in the analysis. Prevalence of cigarettes, herbal cigarettes, shisha and tombak ever use were 13%, 7.8% 5.9% and 3.5%, respectively. Older respondents were significantly more likely to have ever smoked cigarettes. Males were found to be significantly more likely to have ever used any tobacco products. Urban adolescents were significantly more likely to have ever used shisha. Respondents were in the bottom third percentiles with regard to academic achievements, had an almost three-fold increased risk of having ever smoked a cigarette and were at least five-fold more likely to have ever smoked herbal cigarettes. Moreover, respondents in the middle third percentiles were more than twice as likely to have ever smoked herbal cigarettes. Conclusion: As uptake of tobacco products increased significantly with age among males with a middle and lower school performance living in urban areas, timely prevention targeting adolescents, such as school-based tobacco control programmes, are recommended. Our findings show that prevention should start in primary school.

高速卷烟胶粘剂的研究

Abstract Introduce the method of the composite modification for the preparation of ad-hesive which is used for the lap joint of cigarettes made at high-speed. The adhesive, whichis fine and smooth and not easy to send up tabbles, has excellet fluidity, strong initial adher-ence, quick drying speed and high adhesive strength. And it has low reject rate and containsno harmful addities. The adhesive can meet the demand of the making speed ranging from7000 to 10000 cigarettes per minute.

Multiple Effects of Air Pollution on Chinese Male Skin

Air pollution is becoming a very important subject, especially in big cities. In the past years, many publications reported potential adverse effects of air pollution on skin, such as skin inflammation, skin aging and pigmentation. Although men are more often exposed to environment due to probably longer time working, sporting and smoking, the researches about adverse effects of air pollution on male skin are relatively smaller. This article focuses the correlation between air pollution and male skin disorders. We found out that, in the mimic pollution environment for 4 hours, the skin L* value and ITA° value are decreased, a* value is increased, urea content is decreased, keratin carbonylation value is increased. While, water content, transepidermal water loss (TEWL), lactic content and ceramides content remain the same.

Surfactant protein D inhibits lipid-laden foamy macrophages and lung inflammation in chronic obstructive pulmonary disease

Increased levels of surfactant protein D (SP-D) and lipid-laden foamy macrophages (FMs) are frequently found under oxidative stress conditions and/or in patients with chronic obstructive pulmonary disease (COPD) who are also chronically exposed to cigarette smoke (CS). However, the roles and molecular mechanisms of SP-D and FMs in COPD have not yet been determined. In this study, increased levels of SP-D were found in the bronchoalveolar lavage fluid (BALF) and sera of ozone- and CS-exposed mice. Furthermore, SP-D-knockout mice showed increased lipid-laden FMs and airway inflammation caused by ozone and CS exposure, similar to that exhibited by our study cohort of chronic smokers and COPD patients. We also showed that an exogenous recombinant fragment of human SP-D (rfhSP-D) prevented the formation of oxidized low-density lipoprotein (oxLDL)-induced FMs in vitro and reversed the airway inflammation and emphysematous changes caused by oxidative stress and CS exposure in vivo. SP-D upregulated bone marrow-derived macrophage (BMDM) expression of genes involved in countering the oxidative stress and lipid metabolism perturbations induced by CS and oxLDL. Our study demonstrates the crucial roles of SP-D in the lipid homeostasis of dysfunctional alveolar macrophages caused by ozone and CS exposure in experimental mouse emphysema, which may provide a novel opportunity for the clinical application of SP-D in patients with COPD.

Arsenic species in electronic cigarettes:Determination and potential health risk

Human exposure to contaminants from electronic cigarettes(e-cigarettes)and the associated health effects are poorly understood.There has been no report on the speciation of arsenic in e-liquid(solution used for e-cigarettes)and aerosols.We report here determination of arsenic species in e-liquids and aerosols generated from vaping the e-liquid.Seventeen e-liquid samples of major brands,purchased from local and online stores in Canada and China,were analyzed for arsenic species using high-performance liquid chromatography and inductively coupled plasma mass spectrometry.Aerosols condensed from vaping the eliquids were also analyzed and compared for arsenic species.Six arsenic species were detected,including inorganic arsenate(iAsⅤ),arsenite(iAsⅢ),monomethylarsonic acid(MMA),and three new arsenic species not reported previously.In e-liquids,iAsⅢwas detected in 59%,iAsⅤin 94%,and MMA in 47%of the samples.In the condensate of aerosols from vaping the e-liquids,iAsⅢwas detected in 100%,iAsv in 88%,and MMA in 13%of the samples.Inorganic arsenic species were predominant in e-liquids and aerosols of e-cigarettes.The concentration of iAsⅢin the condensate of aerosols(median 3.27μg/kg)was significantly higher than that in the e-liquid(median 1.08μg/kg)samples.The concentration of inorganic arsenic in the vaping air was approximately 3.4μg/m3,which approaches to the permissible exposure limit(10μg/m3)set by the United States Occupational Safety and Health Administration(OSHA).According to the Environmental Protection Agency’s unit risk factor(4.3×10-3 perμg/m3)for inhalation exposure to inorganic arsenic in the air,the estimated excess lung cancer risk from lifetime exposure to inorganic arsenic in the ecigarette vaping air(3.4μg/m3),assuming e-cigarette vaping at 1%of the time,is as high as1.5×10-4.These results raise health concerns over the exposure to arsenic from electronic cigarettes.

Burns resulting from spontaneous combustion of electronic cigarettes: a case series

Background:Electronic cigarette(e-cigarette)sales have grown rapidly in recent years,coinciding with a public perception that they are a safer alternative to traditional cigarettes.However,there have been numerous media reports of fires associated with e-cigarette spontaneous combustion.Case Presentation:Three severe burns caused by spontaneous combustion of e-cigarettes within a 6-month period were treated at the Santa Clara Valley Medical Center Burn Unit.Patients sustained partial and full-thickness burns.Two required hospitalization and surgical treatment.Conclusions:E-cigarettes are dangerous devices and have the potential to cause significant burns.Consumers and the general public should be made aware of these life-threatening devices.

Reanalysis of Cigarettes Confirms Increased Addictive Nicotine

吸烟对人健康的危害不言而喻,"戒烟"也早已成为关注公众健康的各国政府努力的方向。然而面对席卷全球的戒烟浪潮的烟草商们却在悄悄采取策略以保障他们的收益:他们增加每根香烟中尼古丁的含量,刻意延长人们吸一支烟的时间,或是增加吸烟时吞吐烟雾的次数。烟草商的目的只有一个,即千方百计诱使人们对香烟更加上瘾!针对这种现象,人们不得不呼吁司法层面的监控。

Medical Association:‘Safe’Cigarettes Don't Exist

刚刚收到裴小江的来稿,就收到了胡盼盼的邮件。两文大唱对台戏！本文见11月9日的Yahoo！短文文笔之犀利,有一股凛然正气！对Vector公司推出“微害”香烟之说,本文评论道:The research on which these claims are made isall done by an industry(that)is notorious for lying。本文的另一句话发人深省: cigarettes and cigarette smoke contain more than 4,000 chemicals that are harmful,so reducing a few won’t have much of an effect。我们不知道这种牌子为Omni的所谓“微害”香烟是否会飘洋过海来到中国,希望读者警惕。】