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Aldo Lorenzetti M.D, Internal Medicine & Hepatology, Milano - SIMEDET Delegate
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#Smoking may lead to heart #failure by thickening the heart wall

http://www.alphagalileo.org/ViewItem.aspx?ItemId=167707&CultureCode=en

The study examined data from 4,580 participants in the Atherosclerosis Risk in Communities (ARIC) Study who underwent an echocardiogram. Even after accounting for factors such as age, race, body mass index, blood pressure, diabetes and alcohol consumption, current smokers had thicker heart walls and reduced pumping function, compared with nonsmokers and former smokers.
#Epigenetic Signatures of Cigarette #Smoking

http://m.circgenetics.ahajournals.org/content/early/2016/09/14/CIRCGENETICS.116.001506

Conclusions—Cigarette smoking has a broad impact on genome-wide methylation that, at many loci, persists many years after smoking cessation. Many of the differentially methylated genes were novel genes with respect to biologic effects of smoking, and might represent therapeutic targets for prevention or treatment of tobacco-related diseases. Methylation at these sites could also serve as sensitive and stable biomarkers of lifetime exposure to tobacco smoke.
#Smoking-induced Skeletal #Muscle Dysfunction. American Journal of Respiratory and Critical Care Medicine http://www.atsjournals.org/doi/10.1164/rccm.201410-1830PP Smoking is the most important risk factor for the development of chronic obstructive pulmonary disease (COPD). Patients with COPD commonly suffer from skeletal muscle dysfunction, and it has been suggested that cigarette smoke exposure contributes to the development of skeletal muscle dysfunction even before overt pulmonary pathology. This review summarizes the evidence that muscles of nonsymptomatic smokers are weaker and less fatigue resistant than those of nonsmokers. Although physical inactivity of many smokers contributes to some alterations observed in skeletal muscle, exposure to cigarette smoke per se can also induce skeletal muscle dysfunction. Cigarette smoke constituents and systemic inflammatory mediators enhance proteolysis and inhibit protein synthesis, leading to loss of muscle mass. Reduced skeletal muscle contractile endurance in smokers may result from impaired oxygen delivery to the mitochondria and ability of the mitochondria to generate ATP due to interaction of carbon monoxide with hemoglobin, myoglobin, and components of the respiratory chain. Besides hampering contractile function, smoking may have immediate beneficial effects on motor skills, which are attributable to nicotine. In contrast to pulmonary pathology, many of the effects of smoking on skeletal muscle are most likely reversible by smoking cessation.
Does current #smoking predict future #frailty? The English longitudinal study of ageing
https://academic.oup.com/ageing/article/doi/10.1093/ageing/afx136/4062212/Does-current-smoking-predict-future-frailty-The

smoking is the single most preventable cause of morbidity and mortality. The evidence on independent associations between smoking in later life and incident frailty is scarce of 2,542 participants, 261 and 2,281 were current smokers and non-smokers, respectively. The current smokers were significantly frailer, younger, with lower BMI, less educated, less wealthy and lonelier compared with non-smokers at baseline. In multivariable logistic regression models adjusting for age and gender, current smokers were twice as likely to develop frailty compared with non-smokers (odds ratio (OR) = 2.07, 95% confidence interval (CI) = 1.39–3.39, P = 0.001). The association is attenuated largely by controlling for socioeconomic status. Smoking remains significantly associated with incident frailty in fully adjusted models including age, gender, socioeconomic status, alcohol use, cognitive function and loneliness (OR = 1.60, 95% CI = 1.02–2.51, P = 0.04). The relationship is however attenuated when taking account of non-response bias through multiple imputation.

Conclusions
current smokers compared with non-smokers were significantly more likely to develop frailty over 4 years among community-dwelling older people. Given that smoking is a modifiable lifestyle factor, smoking cessation may potentially prevent or delay developing frailty, even in old age
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Effect of #smoking cessation on the risk of #dementia: a longitudinal study

https://onlinelibrary.wiley.com/doi/full/10.1002/acn3.633

Compared to continual smokers, long‐term quitters and never smokers had decreased risk of overall dementia (hazard ratio, HR 0.86 95% CI, confidence interval 0.75–0.99 and HR: 0.81; 95% CI: 0.71–0.91, respectively). Never smokers had decreased risk of Alzheimer's disease (HR: 0.82; 95% CI: 0.70–0.96) compared to continual smokers. Finally, both long‐term quitters (HR: 0.68; 95% CI: 0.48–0.96) and never smokers (HR: 0.71; 95% CI: 0.54–0.95) had decreased risk of vascular dementia compared to continual smokers.

Interpretation
Smoking was associated with increased risk of dementia. Smokers who quit for a prolonged period of time may benefit from reduced risk of dementia. Therefore, smokers should be encouraged to quit in order to reduce the risk of developing dementia, especially in the elderly population who are already at risk.
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#Smoking and the Risk of Non-alcoholic Fatty Liver Disease: A Cohort Study

https://www.nature.com/articles/s41395-018-0283-5

During 1,070,991 person-years of follow-up, 45,409 participants developed #NAFLD. Self-reported current smoking, pack-years, and urinary cotinine level were significantly associated with increased risk for NAFLD. For men, the multivariable-adjusted hazard ratios (aHR) (95% confidence intervals (CI)) for incident NAFLD comparing 10–19.9, and ≥20 pack-years to 0 pack-years were 1.25 (1.21–1.29), and 1.36 (1.30–1.42), respectively; for women, aHR (95% CI) for NAFLD comparing 5–9.9, and ≥10 pack-years to 0 pack-years were 1.25 (1.04–1.50), and 1.46 (1.17–1.81), respectively. Smoking pack-years were also associated with increased risk for NAFLD plus intermediate or high fibrosis score. For men, the aHR (95% CI) for NAFLD plus intermediate or high NFS comparing ≥20 pack-years to 0 pack-years was 1.29 (1.18–1.42); for women, the aHR (95% CI) comparing ≥10 pack-years to 0 pack-years was 1.75 (1.12–2.73).

Conclusion
In a large cohort of young and middle-aged men and women, current smoking, pack-years, and urinary cotinine levels were positively associated with the risk of incident NAFLD, suggesting that smoking contributes to the development of NAFLD
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#Smoking during pregnancy increases #chemerin expression in neonatal tissue

https://physoc.onlinelibrary.wiley.com/doi/10.1113/EP087307

..Chemerin mRNA was elevated in both whole tissue (NS: 2409.20 ± 555.28 counts and S: 2966.72 ± 636.84 counts; P < 0.01) and primary fibroblasts (NS: 1.12 ± urn:x-wiley:09580670:media:eph12392:eph12392-math-0001 and S: 2.13 ± urn:x-wiley:09580670:media:eph12392:eph12392-math-0002; P = 0.04) collected from infants born to smoking mothers.

Chemerin DNA methylation was reduced in whole tissue of offspring born to smokers (NS: 4.18 ± 1.28 and S: 3.07 ± 1.31%; P = 0.02), which may contribute to the increased gene expression. Neonates born to mothers who smoke during pregnancy exhibit distinct changes in chemerin gene expression in response to in utero tobacco smoke exposure which are regulated in part by epigenetic alterations.
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Impact and timing of #smoking cessation on reducing risk for #rheumatoid arthritis among women in the Nurses’ Health Studies

https://onlinelibrary.wiley.com/doi/abs/10.1002/acr.23837

Compared to never smoking, current smoking increased risk for all RA (multivariable HR 1.47, 95%CI 1.27‐1.72) and seropositive RA (HR 1.67, 95%CI 1.38‐2.01), but not seronegative RA (HR 1.20, 95%CI 0.93‐1.55). Increasing smoking pack‐years was associated with increased trend of risk for all RA (p<0.0001) and seropositive RA (p<0.0001). With increasing duration of smoking cessation, a decreased trend was observed in risk for all RA (p=0.009) and seropositive RA (p=0.002). Compared to recent quitters (<5 years), those who quit ≥30 years ago had HR of 0.63 (95%CI 0.44‐0.90) for seropositive RA. However, a modestly elevated RA risk was still detectable 30 years after quitting smoking (all RA: HR 1.25, 95%CI 1.02‐1.53; seropositive RA: HR 1.30, 95%CI 1.01‐1.68; reference: never smoking).

Conclusions
These results confirm smoking as a strong risk factor for seropositive RA and demonstrate for the first time that a behavior change of sustained smoking cessation could delay or even prevent seropositive RA.
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Evidence for causal effects of lifetime #smoking on risk for #depression and #schizophrenia: a Mendelian randomisation study

Smoking prevalence is higher amongst individuals with schizophrenia and depression compared with the general population. Mendelian randomisation (MR) can examine whether this association is causal using genetic variants identified in genome-wide association studies (GWAS).

There was strong evidence to suggest smoking is a risk factor for both schizophrenia (odds ratio (OR) 2.27, 95% confidence interval (CI) 1.67–3.08, p < 0.001) and depression (OR 1.99, 95% CI 1.71–2.32, p < 0.001). Results were consistent across both lifetime smoking and smoking initiation. We found some evidence that genetic liability to depression increases smoking (β = 0.091, 95% CI 0.027–0.155, p = 0.005) but evidence was mixed for schizophrenia (β = 0.022, 95% CI 0.005–0.038, p = 0.009) with very weak evidence for an effect on smoking initiation.

Conclusions
These findings suggest that the association between smoking, schizophrenia and depression is due, at least in part, to a causal effect of smoking, providing further evidence for the detrimental consequences of smoking on mental health.

https://bit.ly/2CzyzqF
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Clinicians have an opportunity to provide #smoking cessation interventions to smokers who present to emergency departments (EDs). The effectiveness of a brief intervention based on self-determination theory for smoking cessation is uncertain.

..The intervention group received brief advice (about 1 minute) and could choose their own quit schedules (immediate or progressive)

..Compared with the control group, the intervention group had statistically higher biochemically validated abstinence at 6 months: 6.7% (53 of 787) vs 2.8% (22 of 784) (P < .001), with an adjusted relative risk of 3.21 (95% CI, 1.74-5.93; P < .001). The intervention group also had higher self-reported quit rates at 6 months (12.2% [96 of 787] vs 9.3% [73 of 784], P = .04) and 12 months (13.0% [102 of 787] vs 8.5% [67 of 784], P < .01), as well as higher biochemically validated abstinence at 12 months (7.0% [55 of 787] vs 3.7% [29 of 784], P < .001). The additional cost for each intervention group participant was US $0.47, with an estimated gain of 0.0238 quality-adjusted life-year. The incremental cost per quality-adjusted life-year (US $19.53) fell within acceptable thresholds.

Conclusions and Relevance This brief, low-cost self-determination theory–based intervention for smokers presenting at EDs effectively increased the biochemically validated quit rate at 6 months. If delivered routinely, such a simple intervention may offer a cost-effective and sustainable approach to help many smokers quit smoking.

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2756237
Effects of changes in #smoking status on blood pressure among adult males and females in Indonesia: a 15-year population-based cohort study
https://2medical.news/2020/05/09/effects-of-changes-in-smoking-status-on-blood-pressure-among-adult-males-and-females-in-indonesia-a-15-year-population-based-cohort-study/

The continuing rise of smoking behaviours will inevitably lead to a further increase in hypertension prevalence. However, limited research has examined the impacts of changes in smoking status on blood pressure (BP). We sought to assess correlations between increases or decreases of males’ and females’ cigarette consumption on systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP), and to investigate the relationship …
#Cerebrovascular and Neurological Dysfunction under the Threat of #COVID-19: Is There a Comorbid Role for #Smoking and Vaping?
https://2medical.news/2020/07/28/cerebrovascular-and-neurological-dysfunction-under-the-threat-of-covid-19-is-there-a-comorbid-role-for-smoking-and-vaping/

The recently discovered novel coronavirus, SARS-CoV-2 (COVID-19 virus), has brought the whole world to standstill with critical challenges, affecting both health and economic sectors worldwide. Although initially, this pandemic was associated with causing severe pulmonary and respiratory disorders, recent case studies reported the association of cerebrovascular-neurological dysfunction in COVID-19 patients, which is also life-threatening. Several SARS-CoV-2 positive case studies have been reported where there are …
#Smoking Cessation, #Weight Change, #Diabetes, and #Hypertension in Korean Adult
https://2medical.news/2020/11/15/smoking-cessation-weight-change-diabetes-and-hypertension-in-korean-adult/

This study investigates the association of smoking cessation and postcessation weight gain with the development of type 2 diabetes mellitus and hypertension. Methods A total of 96,524 individuals without diabetes mellitus and hypertension aged ≥20 years between 2006 and 2008 were included, with follow-up until December 31, 2015. Smoking status and weight changes were monitored for 2 years. Hazard ratios and 95% CIs were calculated …
#Smoking, #Radiation Therapy, and Contralateral #Breast Cancer Risk in Young Women
https://2medical.news/2021/04/02/smoking-radiation-therapy-and-contralateral-breast-cancer-risk-in-young-women/

Evidence is mounting that cigarette smoking contributes to second primary contralateral breast cancer (CBC) risk. Whether radiation therapy (RT) interacts with smoking to modify this risk is unknown. In this multicenter, individually-matched case-control study, we examined the association between RT, smoking, and CBC risk. The study included 1,521 CBC cases and 2,212 controls with unilateral breast cancer, all diagnosed with first invasive breast cancer between …