Net Effect of Short-Term Smoking Cessation on Mental Health Changes:Inverse Probability of Treatment Weighting and Difference-in-Differences Method

Background:In response to the need for research clearly demonstrating the net effect of smoking cessation on mental health status,considering the causal relationship between smoking cessation and changes in mental health status,this study was undertaken.Thus,this study aimed to examine the net effect of short-term smoking cessation on five specific mental health metrics and the overall mental health status score.Methods:We used data from the first wave of the Korean Health Panel(KHP)Survey(2011–2013,2016–2018)and focused on men aged 19 years and older,to explore the effects of smoking cessation.We compared mental health status before and after cessation among current non-smokers who had quit smoking and continuous smokers.We ensured homogeneity between the two groups via inverse probability of treatment weighting(IPTW)and employed a difference-in-differences(DID)analysis to assess changes in mental health status.This study controlled for factors that could influence mental health and explored the net effect of short-term smoking cessation through difference-in-differences model using multiple regression analysis.Results:The results showed that short-term smoking cessation significantly alleviated mental and physical stress(p<0.1),reduced experiences of frustration(p<0.01),and improved the overall mental health status score(p<0.1).Conclusion:Thus,these results highlight a meaningful link between positive health behavior changes,such as smoking cessation,and enhanced mental health.Moreover,the application of temporal variables further improved the understanding of the causal relationship between health behaviors and mental health.

Effect of smoking on the risk of gastrointestinal cancer after cholecystectomy: A national population-based cohort study

BACKGROUND The role of smoking in the incidence of colorectal cancer(CRC)or gastric cancer(GC)in populations undergoing cholecystectomy has not been investigated.AIM To evaluate the effect of smoking on CRC or GC development in cholecystectomy patients.METHODS A total of 174874 patients who underwent cholecystectomy between January 1,2010 and December 31,2017 were identified using the Korean National Health Insurance Service claims database.These patients were matched 1:1 with mem-bers of a healthy population according to age and sex.CRC or GC risk after cholecystectomy and the association between smoking and CRC or GC risk in cholecystectomy patients were evaluated using adjusted hazard ratios(HRs)and 95%CIs.RESULTS The risks of CRC(adjusted HR:1.15;95%CI:1.06-1.25;P=0.0013)and GC(adjusted HR:1.11;95%CI:1.01-1.22;P=0.0027)were significantly higher in cholecystectomy patients.In the population who underwent cholecystectomy,both CRC and GC risk were higher in those who had smoked compared to those who had never smoked.For both cancers,the risk tended to increase in the order of non-smokers,ex-smokers,and current smokers.In addition,a positive correlation was observed between the amount of smoking and the risks of both CRC and GC.CONCLUSION Careful follow-up and screening should be performed,focusing on the increased risk of gastrointestinal cancer in the cholecystectomy group,particularly considering the individual smoking habits.

Smoking cessation prior to elective total joint arthroplasty results in sustained abstinence postoperatively

BACKGROUND Tobacco use is a well-documented modifiable risk factor for perioperative complications.AIM To determine the tobacco abstinence rates of patients who made cessation efforts prior to a total joint arthroplasty(TJA)procedure.METHODS A retrospective evaluation was performed on 88 self-reported tobacco users who underwent TJA between 2014-2022 and had tobacco cessation dates within 3 mo of surgery.Eligible patients were contacted via phone survey to understand their tobacco use pattern,and patient reported outcomes.A total of 37 TJA patients participated.RESULTS Our cohort was on average 61-years-old,60%(n=22)women,with an average body mass index of 30 kg/m^(2).The average follow-up time was 2.9±1.9 years.A total of 73.0%(n=27)of patients endorsed complete abstinence from tobacco use prior to surgery.Various cessation methods were used perioperatively including prescription therapy(13.5%),over the counter nicotine replacement(18.9%),cessation programs(5.4%).At final follow up,43.2%(n=16)of prior tobacco smokers reported complete abstinence.Patients who were able to maintain cessation postoperatively had improved Patient-Reported Outcomes Measurement Information System(PROMIS)-10 mental health scores(49 vs 58;P=0.01),and hip dysfunction and osteoarthritis outcome score for joint replacement(HOOS.JR)scores(63 vs 82;P=0.02).No patients in this cohort had a prosthetic joint infection or required revision surgery.CONCLUSION We report a tobacco cessation rate of 43.2%in patients undergoing elective TJA nearly 3 years postoperatively.Patients undergoing TJA who were able to remain abstinent had improved PROMIS-10 mental health scores and HOOS.JR scores.The perioperative period provides clinicians a unique opportunity to assist active tobacco smokers with cessation efforts and improve postoperative outcomes.

The impact of tobacco use and nicotine addiction on health: A literature review of nursing interventions for smoking cessation

Tobacco use remains one of the leading preventable causes of morbidity and mortality globally,with nicotine addiction significantly impacting health outcomes.This literature review explores the multifaceted nature of tobacco use and its health implications,emphasizing the role of nursing interventions in smoking cessation.The review highlights various strategies employed by nurses,including assessment,counseling,pharmacotherapy support,and behavioral interventions,which are essential for effective tobacco cessation.By analyzing current evidence-based practices,the study underscores the importance of comprehensive assessments and personalized care plans tailored to individual patient needs.It also addresses the significance of motivational interviewing and the 5 A’s framework in facilitating successful quit attempts.In addition,the review discusses the integration of cognitive-behavioral therapy and stress management techniques as vital components of behavioral interventions.Recommendations for improving tobacco cessation efforts include enhanced training for healthcare professionals,the establishment of community-based support groups,and advocacy for robust tobacco control policies.The findings underscore the critical need for ongoing research into the long-term effectiveness of cessation interventions across diverse populations.This study aims to inform nursing practice and public health policy,ultimately contributing to the reduction of tobacco-related health issues and promoting healthier communities.

Does Smoking Weaken the Immune System: A Narrative Review

Smoking has a complex impact on the immune system, affecting both innate and adaptive immunity. It can exacerbate pathogenic immune responses and attenuate defensive immunity, leading to a higher susceptibility to infections and certain diseases. The chemicals in cigarette smoke, such as nicotine and carbon monoxide, can alter immune cell functions and inflammatory responses. Smoking can also have long-term effects on the immune system, with some changes persisting even after quitting [1]. According to a Penn Medicine Physician, the Medical Oncologist Dr. David Porter, “People who are smokers tend to get sicker from infections”, “It may be that smoking impacts the immune system’s ability to respond appropriately”. Thus, such individuals within smoking exposure history might be considered as immunocompromised due to the altered and weakened immune system. Cigarette smoking is a prevalent habit with far-reaching health implications. Among its many adverse effects, smoking significantly alters the immune system’s functionality [1].

Exploring the Impact of Alcohol Consumption and Smoking on Primary Open Angle Glaucoma: A Mendelian Randomization Study

Objective: Utilizing Mendelian Randomization, this study employs Single Nucleotide Polymorphisms (SNPs) as instrumental variables to explore the causal relationships between bibulosity, smoking, and Primary Open Angle Glaucoma (POAG). Methods: GWAS data for bibulosity, smoking, and POAG were obtained from the Social Science Genetic Association Consortium website and the IEU OpenGWAS Project website, respectively. Using a P-value threshold of −8, a linkage disequilibrium coefficient (r2) of 0.001, and a linkage disequilibrium region width of 10,000 kb, the data were aggregated, resulting in 6 SNPs for bibulosity and 253 SNPs for smoking. Three regression models, MR-Egger, Weighted Median Estimator (WME), and Random-Effects Inverse-Variance Weighted (IVW) were applied to analyze the causal impact of bibulosity and smoking on POAG. Results: The GWAS data for alcohol consumption and smoking were derived from European populations, while the GWAS data for Primary Open-Angle Glaucoma (POAG) were sourced from East Asian populations, with no gender restrictions. Analysis using three different regression models revealed that neither excessive alcohol consumption nor smoking significantly increased the risk of developing POAG. Specifically, the odds ratios with 95% confidence intervals for the alcohol consumption group were 0.854 (0.597 - 1.221) in MR-Egger regression, 0.922 (0.691 - 1.231) in WME regression, and 0.944 (0.711 - 1.252) in IVW regression. For the smoking group, the odds ratios were 1.146 (0.546 - 2.406) in MR-Egger regression, 0.850 (0.653 - 1.111) in WME regression, and 0.939 (0.780 - 1.131) in IVW regression. Given the significant heterogeneity in the SNPs associated with smoking, the focus was primarily on the results from the IVW regression model. Conclusion: Alcohol consumption and smoking are not significant risk factors for the development of POAG.

The Prevalence of Smoking in Caribbean Towns and Correlation with Disease States: A Survey

Background: Smoking continues to be one of the most popular recreational practices despite its known harmful effects. Aim: The purpose of this survey was to assess the prevalence of smoking in the Caribbean and the correlation of smoking with the disease states of high blood pressure, diabetes and high cholesterol whose risk is known to be higher among smokers. Findings: Our study found a smoking prevalence of 22% in the population, similar to that reported by the World Health Organization (20%) and a positive correlation between smoking and diabetes. Conclusion: The survey shows that smoking numbers within the population are still high and that smoking increases the risk of certain disease states within smokers. Aggressive global efforts to reduce smoking should continue so as to minimize the negative impact of smoking on health.

Persuasive Technology for the Future of Smoking Cessation*

This paper explores the integration of persuasive technology into smoking cessation efforts through the development and evaluation of a mobile app, “No-Smoke.” Leveraging compelling features like social support, tracking, planning, and motivation, the app aims to augment user engagement and support the process of quitting smoking. The efficacy of these features has been substantiated through both automated testing and user feedback, highlighting their potential to enhance awareness, motivation, and behavior modification. Despite notable successes, limitations, including a limited user base and uncertainties regarding long-term efficacy, have been acknowledged, stemming from the inherent complexities of smoking cessation. Nevertheless, based on user experiences and feedback, “No-Smoke” represents a promising advancement in the use of technology for public health interventions, particularly in the realm of smoking cessation. To address existing challenges, future research is recommended to encompass a comprehensive, long-term study involving a larger and more diverse user base. Additionally, further investigation should focus on personalization enhancements and the integration of machine learning algorithms to better understand and respond to user behavior.

Effects of Different Yellowing Conditions on Neutral Aroma Components and Smoking Quality of Flue-cured Upper Leaves

A heated air circulation standard curing barn was used for baking tobacco leaves, and the effects of different yellowing conditions during the baking process on contents of neutral aroma components and smoking quality of upper leaves were studied by setting different yellowing time and color-fixing time. The results showed that during the baking process, only by prolonging the yellowing time by 24 h on the basis of control, the content of every kind of neutral aroma components in- creased obviously and the content of solanone increased by nearly 2.20 times. It was unfavorable for the degradation and accumulation of aroma components when only prolonging color-fixing time by 24 h. Prolonging both yellowing time and color- fixing time by 24 h mainly promoted the accumulation of chlorophyll degradation product neophytadiene, which increased by 33.24%, while the degradation and ac- cumulation of some aroma components were inhibited, indicating that only prolonging the yellowing time by 24 h could promote the accumulation of various kinds of neu- tral aroma components and improve the quality of tobacco leaves. The regression models were established of neutral aroma components in the first and second prin- cipal components to total aroma content, which were y=x＋0.053 47 （R^2=0.919 7） and y=x＋0.147 5 （R^2=0.698 4）, respectively, and they were verified to be feasible.

Miss Chimp Says No to Smoking

A chimpanzee(大猩猩)in the zoo in Xi'an,Shaanxi Province has given up smoking after 16 years with the help of her keepers(饲养员).The zookeepers,wor- ried about her health,helped 27-year-old“Ai Ai”off tobacco(烟草)by treating her with entertainment(娱乐)and tasty diets.

Association of smoking, alcohol drinking and dietary factors with esophageal cancer in high- and low-risk areas of Jiangsu Province, China

AIM： To study the main environmental and lifestyle factors that account for the regional differences in esophageal cancer （EC） risk in low- and high-risk areas of Jiangsu Province, China. METHODS： Since 2003, a population-based casecontrol study has been conducted simultaneously in lowrisk （Ganyu County） and high-risk （Dafeng County） areas of Jiangsu Province, China. Using identical protocols and pre-tested standardized questionnaire, following written informed consent, eligible subjects were inquired about their detail information on potential determinants of EC, including demographic information, socio-economic status, living conditions, disease history, family cancer history, smoking, alcohol drinking, dietary habits, frequency, amount of food intake, etc. Conditional logistic regression with maximum likelihood estimation was used to obtain Odds ratio （OR） and 95 % confidence interval （95% CI）, after adjustment for potential confounders. RESULTS： In the preliminary analysis of the ongoing study, we recruited 291 pairs of cases and controls in Dafeng and 240 pairs of cases and controls in Ganyu, respectively. In both low-risk and high-risk areas, EC was inversely associated with socio-economic status, such as level of education, past economic status and body mass index. However, this disease was more frequent among those who had a family history of cancer or encountered misfortune in the past 10 years. EC was also more frequent among smokers, alcohol drinkers and fast eaters. Furthermore, there was a geographic variation of the associations between smoking, alcohol drinking and EC risk despite the similar prevalence of these risk factors in both low-risk and high-risk areas. The dose-response relationship of smoking and smoking related variables, such as age of the first smoking, duration and amount were apparent only in high-risk areas. On the contrary, a dose-response relationship on the effect of alcohol drinking on EC was observed only in low-risk areas. CONCLUSION： The environmental risk factors, together with genetic factors and gene-environmental interactions might be the main reason for this high-risk gradient in .liangsu Province, China.

Perianal disease,small bowel disease,smoking,prior steroid or early azathioprine/biological therapy are predictors of disease behavior change in patients with Crohn's disease

AIM:To assess the combined effect of disease phenotype, smoking and medical therapy [steroid, azathioprine(AZA), AZA/biological therapy] on the probability of disease behavior change in a Caucasian cohort of patients with Crohn's disease(CD).METHODS:Three hundred and forty well-characterized, unrelated, consecutive CD patients were analyzed(M/F:155/185, duration:9.4 ± 7.5 years) with a complete clinical follow-up.Medical records including disease phenotype according to the Montreal classification, extraintestinal manifestations, use of medications and surgical events were analyzed retrospectively.Patients were interviewed on their smoking habits at the time of diagnosis and during the regular follow-up visits.RESULTS:A change in disease behavior was observed in 30.8% of patients with an initially non-stricturing, non-penetrating disease behavior after a mean diseaseduration of 9.0 ± 7.2 years.In a logistic regression analysis corrected for disease duration, perianal disease, smoking, steroid use, early AZA or AZA/ biological therapy use were independent predictors of disease behavior change.In a subsequent Kaplan-Meier survival analysis and a proportional Cox regression analysis, disease location(P = 0.001), presence of perianal disease(P < 0.001), prior steroid use(P = 0.006), early AZA(P = 0.005) or AZA/biological therapy(P = 0.002), or smoking(P = 0.032) were independent predictors of disease behavior change.CONCLUSION:Our data suggest that perianal disease, small bowel disease, smoking, prior steroid use, early AZA or AZA/biological therapy are all predictors of disease behavior change in CD patients.

Cyclooxygenase 2 polymorphism and colorectal cancer:-765G>C variant modifies risk associated with smoking and body mass index

AIM： To explore whether cyclooxygenase 2 （COX-2） -765G〉C polymorphism is associated with susceptibility of colorectal cancer （CRC） and to evaluate the risk of colorectal cancer in relation to environmental exposures and polymorphism. METHODS： We conducted a case-control study of 137 patients with colorectal cancer and 199 cancerfree controls in northeast China. Multivariate logistic regression analysis was performed to calculate the adjusted odds ratio （OR） and 95% confidence interval （95% CI）. RESULTS： The -765G〉C polymorphism was not independently associated with CRC risk. However, risk associated with the polymorphism differed by smoking and body mass index （BMI）. Smoking and BMI associated risks were stronger among those with -765GG genotype, showing that smokers had a 2.682-fold greater risk of CRC than nonsmokers （51/43 vs 68/126, P = 0.006）. Compared to those with a normal body mass index （BMI 18.5-22.9）, those with overweight （BMI 23-24.9） had a 3.909-fold higher risk of CRC （OR = 3.909, 95% CI = 2.081-7.344; P 〈 0.001）, while those with obesity （BMI 〉 25） had a 2.031- fold higher risk of CRC （OR = 1.107, 95% CI = 1.107-3.726; P = 0.022）. is not associated with an increased risk of CRC, -765GG genotype appears to be related to an increased risk in the presence of smoking and higher BMI.

Impact of cigarette smoking on recurrence of hyperlipidemic acute pancreatitis

AIM To investigate the impact of cigarette smoking on the recurrence rate and recurrence-free survival in patients with hyperlipidemic acute pancreatitis(HLAP).METHODS A total of 863 patients were admitted to our hospital for acute pancreatitis(AP) from January 2013 to March2016, of whom 88 diagnosed with HLAP were enrolled in this retrospective study. Demographic data, medical history, previous episodes of pancreatitis, consumption of alcohol and cigarettes, as well as biochemical and hematological data were carefully recorded for univariate and multivariate analyses. During followup, the information on current smoking status and recurrent AP was gathered. Recurrence-free survival(RFS) was calculated using the Kaplan-Meier method, and the differences between groups were compared using the log-rank test.RESULTS No significant differences were observed between the three groups in age or medical history of hyperlipidemia, fatty liver, diabetes mellitus, hypertension, or AP. The current smokers had a remarkably higher recurrence rate and a greater incidence of repeated episodes of AP(50.0% and 77.8%, respectively) than non-smokers(9.8% and 39.0%), and these two percentages were reduced to 9.1% and 36.4% for patients who gave up smoking. The median follow-up time was 13.5 mo and HLAP recurred after hospital discharge in 23(26.1%) patients. Multivariate analysis identified current smoking(HR = 6.3, P = 0.020) as an independent risk factor contributing to HLAP recurrence. Current smokers had significantly worse RFS than non-smokers(23 mo vs 42 mo), but no significant difference was documented between ex-smokers(34 mo) and non-smokers. The RFS was not significantly different between light and heavy smokers.CONCLUSION Smoking is associated with worse RFS and an increased rate of HLAP recurrence. Continued smoking correlates with a compromised survival and smoking cessation should be recommended.

Association of p53/p21 expression with cigarette smoking and prognosis in esophageal squamous cell carcinoma patients

【Abstract】factors,such as cigarette smoking,in esophageal squamous cell carcinoma(ESCC)in northeastern Iran,a region with a high incidence of ESCC.METHODS:The expression of p53 and p21 proteins was investigated immunohistochemically in tumor tissue from 80 ESCC patients and in 60 available paraffinembedded blocks of adjacent normal specimens from the cases,along with normal esophageal tissue from 80 healthy subjects.RESULTS:Positive expression of p53 protein was detected in 56.2%(45/80)of ESCC cases,and in none of the normal esophageal tissue of the control group(P【0.001).Furthermore,73.8%(59/80)of ESCC cases and 43.8%(35/80)of controls had positive expression of p21 protein(P【0.001).Cigarette smoking was significantly associated with p53 over-expression in ESCC cases(P=0.010,OR=3.64;95%CI:1.32-10.02).p21 over-expression was associated with poorer clinical outcome among the ESCC patients(P=0.009).CONCLUSION:Over-expression of p53 in association with cigarette smoking may play a critical role in ESCC carcinogenesis among this high-risk population of northeastern Iran.Furthermore,p21 over-expression was found to be associated with poor prognosis,specifically in the operable ESCC patients.

Synergistic effect of fatty liver and smoking on metabolic syndrome

AIM:To investigate the association of fatty liver and smoking on metabolic syndrome and its components.METHODS:This cross-sectional study enrolled participants who attended annual health screening at Shin Kong Wu Ho-Su Memorial Hospital from January to December 2005.A total of 3455(1981 men and 1474 women) subjects were included in final analyses.Fatty liver was diagnosed using abdominal ultrasonography by trained gastroenterologists.The modified National Cholesterol Education Program Adult Treatment Panel Ⅲ was used to define metabolic syndrome.The associations between smoking,fatty liver and metabolic syndrome were analyzed using multiple logistic regression.RESULTS:Subjects with fatty liver,and who smoked tobacco,had the highest odds ratios(ORs) for high waist circumference [OR,4.5(95% CI:3.3-6.1) ,P < 0.05],hypertriglyceridemia [OR,8.1(95% CI:6.0-10.9) ,P < 0.05],low serum high-density lipoprotein cholesterol(HDL-C) [OR,8.3(95% CI:6.1-11.3) ,P < 0.05],and metabolic syndrome [OR,9.5(95% CI:6.7-13.4) ,P < 0.05] compared to subjects without fatty liver who did not smoke tobacco.We also found that the ORs for hypertriglyceridemia,low serum HDL-C,and metabolic syndrome for subjects with fatty liver who smoked tobacco had greater than the sum of the ORs for subjects with fatty liver who did not smokeplus those who did not have fatty liver and who did smoke.CONCLUSION:Fatty liver and smoking had a synergistic effect on metabolic syndrome and its components,especially for hypertriglyceridemia and low serum HDL-C.

Smoking in inflammatory bowel diseases:Good,bad or ugly?

Smoking is an important environmental factor in inflammatory bowel disease （IBD）, having different effects in ulcerative colitis （UC） and Crohn＇s disease （CD）. A recent meta-analysis partially confirmed previous findings that smoking was found to be protective against ulcerative colitis and, after onset of the disease, might improve its course, decreasing the need for colectomy. However, smoking increases the risk of developing Crohn＇s disease and worsens its course, increasing the need for steroids, immunosuppressants and re-operations. Smoking cessation aggravates ulcerative colitis and improves Crohn＇s disease. Data are however, largely conflictive as well as the potential mechanisms involved in this dual relationship are still unknown. In this review article, the authors review the role of smoking in inflammatory bowel diseases.

Cigarette Smoking Increases Risk for Incident Metabolic Syndrome in Chinese Men—Shanghai Diabetes Study

Objective To determine whether smoking increases the risk for developing metabolic syndrome （MetS） in Chinese men.Methods A total of 693 men with no MetS at baseline were followed for 2.9‐5.5 years.Subjects were divided into nonsmokers,ex‐smokers,and current smokers according to baseline smoking status.Results After adjusting for age,education level,alcohol intake,fasting plasma insulin,HOMA‐IR index,and BMI at baseline and weight change,current smokers were dose‐dependently associated with increased risk for developing new MetS compared with nonsmokers.The odds ratio （OR） was 2.131 （95% CI,1.264,3.592;P0.01） for the NCEPIII definition or 3.083 （95% CI,1.807,5.295;P0.01） for the JCDCG definition of MetS.Ex‐smokers who had quit for ≥13 years significantly decreased the risk for developing new MetS defined by the JCDCG definition.Compared with nonsmokers,current smokers were significantly associated with increased incidence of hypertriglyceridemia and low HDL‐C.Conclusion Smoking is a risk factor for developing MetS in Chinese men after adjusting for age,education level,alcohol intake,fasting plasma insulin,HOMA‐IR,BMI,and weight change.This could be due to an increased incidence of dyslipidemia.Smoking cessation for 13 years decreased the risk for developing MetS defined by the JCDCG definition.

CYP2E1 RsaⅠpolymorphism impacts on risk of colorectal cancer association with smoking and alcohol drinking

AIM： To investigate associations between the Rsa I polymorphism of CYP2E1 and risk of colorectal cancer. METHODS： A case-control study was conducted with 315 colorectal cancer cases （105 colon, 210 rectal） and 439 population-based controls in Jiangsu Province of China. Genomic DNA samples were assayed for restriction fragment length polymorphisms in CYP2E1 by PCR amplification followed by digestion with Rsa I. Information on smoking and alcohol drinking was collected using a questionnaire. Odds ratios （ORs） were estimated with an unconditional logistic model. RESULTS： The proportional distribution of the CYP2E1 Rsa I c1/c1, c1/c2 and c2/c2 genotypes were 61.4%, 35.6% and 3.0% in controls, 60.6%, 33.7% and 5.8% in colon cancer cases, and 58.4%, 34.0% and 7.7% in rectal cancer cases, respectively. A significant differencewas noted between controls and rectal cancer cases （P = 0.029）, the c2/c2 genotype being associated with elevated OR （adjusted age, sex and status of the smoking and alcohol drinking） for rectal cancer （1.64, 95% CI, 1.12-2.41, vs cl allele carriers）, but not for colon cancer. In interaction analysis between the CYP2E1 Rsa I genotype and smoking and drinking habits, we found a significant cooperative action between the c2/c2 genotype and alcohol drinking in the sex-, age-adjusted ORs for both colon （4.74, 95% CI, 1.10-20.40） and rectal （5.75, 95% CI, 1.65-20.05） cancers. Among nonsmokers, the CYP2E1 Rsa I c2/c2 genotype was also associated with elevated ORs in the two sites （1.95, 95% CI, 0.99-3.86 and 2.30, 95% CI, 1.32-3.99）. CONCLUSION： The results of the present study suggest that the CYP2E1 c2/c2 genotype increases susceptibility to rectal cancer and the gene-environmental interactions between the CYP2E1 polymorphism and smoking or alcohol drinking exist for colorectal neoplasia in general.

Cigarette smoking,body mass index associated with the risks of age-related cataract in male patients in northeast China

AIM: To determine the association between cigarettes smoking, body mass index (BMI) and the risk of age-related cataract (ARC) in middle-aged and elderly men in Northeast China. METHODS: A hospital-based case control study was conducted. Cases (n =362) were men who had surgically treated ARC, 45-85 years old; controls frequency-matched (n=362) were men who had been admitted to the same hospital as cases for other diseases not related with eye diseases. Cases and controls were matched with 1:1. The cases and controls were interviewed during their hospital stay, using a structured interviewer-administrated questionnaire that included information on sociodemographic characteristics, socioeconomic, lifestyle habits (tobacco smoking and alcohol consumption, etc.), anthropometric measures, personal medical history, and family history of ARC in first-degree relatives, and simultaneously BMI was calculated. The odds ratios (OR) and 95% confidence intervals (CI) of ARC were estimated using multiple logistic regression models. RESULTS: After adjusting for age and multiple potential confounders, higher BMI was associated with an increased risk of ARC. Cigarette smoking, years smoking or moderate cigarette smoking (1-29 cigarettes per day) had no relation with the risk of ARC (P>0.05), although patients smoking >= 30 cigarettes per day had an elevated risk of ARC as compared with the non-smokers (OR=1.55, 95% CI; 1.16-2.85, P=0.026). Higher BMI was associated with an increased risk of ARC. Both overweight and obesity was associated with an obviously increased risk for surgically ARC (OR=1.55, 95% CI:1.02-1.98, P=0.015 and OR=1.71, 95% CI:1.32-2.39, P=0.013 respectively) compared to normal BMI. Then participants were grouped into quartiles of BMI (Q1 to Q4), compared to controls in the lowest quartile, the ORfor cases in the highest quartile of BMI was 1.54 (OR=1.54, 95% CI: 1.08-2.46, P=0.022). The results of univariate analysis showed cigarette smoking was not associated with ARC formation for men with lower or normal BMI (P >0.05). Compared to the non-smokers, for men of overweight or obesity, cigarette smoking was associated with a significantly increased risk for surgically ARC (OR=2.00, 95% CI: 1.49-6.65, P=0.003 and OR=1.66, 95% CI: 1.63-13.21, P=0.002 respectively). Similarly, smokers in the highest quartile of BMI had approximately 1.5 times the risk of ARC as non-smokers in the lowest quartile (OR =1.46, 95% CI: 1.06-5.29, P<0.001). Followed multivariate models revealed that the association had never changed. CONCLUSION: Current cigarette smoking is positively related to ARC only among those who smoking 30 or more cigarettes per day. For men who are both overweight and obesity, cigarette smoking is associated with a significantly increased risk for ARC.