The effects of passive smoking on respiratory illness in early childhood in Shanghai, P.R.China

The effects of household exposure to cigarette smoke on the incidence of respiratory illness were examined among 1007 18 month old children at Lu-wan District, Shanghai City, People's Republic China. The passive smoking quantity was estimated by summing the total daily cigarette consumption of family members. No mothers who smoked were found. A significant dose-response relationship of passive smoking to hospitalization for respiratory illness during the children's first 18 months of life was found, for which no confounding factors were discovered. The relative risk was 2.4 for children living in families including people who smoked 20 or more cigarettes a day compared with those living in nonsmoking families. The children who were boys or artificially (bottle) fed were more affected than those who were girls or breast fed. The cumulative incidence of bronchitis and pneumonia increased significantly with increasing cigarette smoking of family members, that did not change when sex, birth weight, type of feeding, coal for cooking, or parental education were taken into account. Family smoking status was not found to be significantly associated with the cumulative incidence of asthma, whooping cough, sinusitis or measles

Chronic respiratory diseases related to tabagism

Les broncho-pneumopathies chroniques obstructives (B.P.C.O.), qui associent bronchite chronique et emphysème, constituent un important problème de santé publique, à l’origine duquel le tabagisme joue un rôle capital. De nombreuses enquêtes cliniques et épidémiologiques ont montré qu’il existait une relation étroite entre ces maladies et le nombre de cigarettes fumées, la précocité du tabagisme et la façon d’inhaler la fumée. De plus, l’inhalation passive de fumée de tabac est susceptible d’altérer la fonction respiratoire chez l’enfant et l’adolescent, notamment chez les asthmatiques. L’expérimentation animale a montré que la fumée provoquait une inflammation de la muqueuse bronchique, avec paralysie ciliaire et hyper sécrétion muqueuse, favorisant la colonisation bactérienne locale et la survenue d’infections bronchiques. Au niveau du poumon profond, les macrophages alvéolaires présentent des altérations de leurs activités sécrétoires, avec notamment libération accrue de radicaux libres de l’oxygène, activité chimiotactique des neutrophiles, et production d’enzy mes protéolytiques. Cela mène à un déséquilibre de la balance protéases- antiprotéases, et entraîne une destruction des parois alvéolaires caracté ristiques de l’emphysème. De nouvelles recherches sont indispensables pour préciser les effets des composants de la fumée de tabac sur l’appa reil respiratoire, et pour mettre au point de nouvelles tactiques de pré vention.Chronic obstructive lung diseases (COPD) — including chronic bron chitis and emphysema — are an important and increasing public health problem, in which cigarette smoking has been identified as the main responsible factor. Clinical and epidemiological investigations have indicated a strong dose-response relation between COPD and the number of cigarettes smoked per day, the earliness of smoking initiation and the depth of smoke inhalation. In addition, passive inhalation of tobacco smoke may have adverse effects on the respiratory function in children and adolescents, particularly in asthmatics. Experimental studies have demonstrated that tobacco smoke induced inflammatory changes in bronchial mucosa, with ciliary dysfunction and excessive mucus secretion, favouring bacterial colonization and bronchial infection. In the lower respiratory tract of smokers, alveolar macro phages demonstrate many metabolic and functional alterations, with increase in superoxide anion production, neutrophil chemotactic activity and protease secretion, leading to an imbalance between proteases, espe cially elastase, and alpha 1 protease inhibitor. These changes in alveolar macrophage activities result in alveolar wall damage and enlargement of the distal air spaces. Further research is needed to identify the effects of tobacco smoke components on the respiratory tract, and to evaluate preventive approaches

The health consequences of involuntary smoking : a report of the Surgeon General, 1986

This, the 1986 Report of the Surgeon General, is the U.S. Public Health Service's 18th in the health consequences of smoking series and the 5th issued during my tenure as Surgeon General. Previous Reports have documented the tremendous health burden to society from smoking, particularly cigarette smoking. The evidence establishing cigarette smoking as the single largest preventable cause of premature death and disability in the United States is overwhelming-totaling more than 50,000 studies from dozens of cultures. Smoking is now known to be causally related to a variety of cancers in addition to lung cancer; it is a cause of cardiovascular disease, particularly coronary heart disease, and is the major cause of chronic obstructive lung disease. It is estimated that smoking is responsible for well over 800,000 deaths annually in the United States, representing approximately 15 percent of all mortality. Thirty years ago, however, the scientific evidence linking smoking with early death and disability was more limited. By 1964, the year the Advisory Committee to the Surgeon General issued the first report on smoking and health, a substantial body of evidence had accumulated upon which a judgment could be made that smoking was a cause of disease in active smokers. Subsequent reports over the last 20 years have expanded our understanding and knowledge about smoking behavior, the toxicity and carcinogenicity of tobacco smoke, and the specific disease risks resulting from exposure to this agent. This Report is the first issued since 1964 that identifies a chronic disease risk resulting from exposure to tobacco smoke for individuals other than smokers. It is now clear that disease risk due to the inhalation of tobacco smoke is not limited to the individual who is smoking, but can extend to those who inhale tobacco smoke emitted into the air. This Report represents a detailed review of the health effects resulting from nonsmoker exposure to environmental tobacco smoke (ETS). ETS is the combination of smoke emitted from a burning tobacco product between puffs (sidestream smoke) and the smoke exhaled by the smoker. The 1986 Report, The Health Consequences of Involuntary Smoking, is a critical review of all the available scientific evidence pertaining to the health effects of ETS exposure on nonsmokers. The term "involuntary smoking" is used to note that such exposures often occur as an unavoidable consequence of being in close proximity to smokers.Includes bibliographical references and index.1986704

Health benefits of smoking cessation : a report of the Surgeon General

More than 38 million Americans have quit smoking cigarettes, and nearIy half of all living adults who ever smoked have quit. Unfortunately, some 5O million Americans continue to smoke cigarettes. despite the many health education programs and anti- smoking campaigns that have been conducted during the past quarter century, despite the declining social acceptability of smoking, and despite the consequences of smoking to their health.Twenty previous reports of the Surgeon General have reviewed the health effects of smoking. Scientific data are now available on the consequences of smoking cessation for most smoking-related diseases. Previous reports have considered some of these data, but this Report is the first to provide a comprehensive and unified review of this topic.Suggested citation: U.S. Department of Health and Human Services. Health benefits of smoking cessation.~. U.S. Department of Health and Human Services. Public Health Service. Centers for Disease Control. Center for Chronic Disease Prevention and Health Promotion. Office on Smoking and Health. DHHS Publication No. (CDC) 90-8416. 1990.1990714

Assessing airways deposition, physiology and pharmacokinetics of monodisperse aerosols in obstructive lung disease

Inhaled medication is standard therapy in asthma and COPD. However the amount of drug reaching the lung is influenced by several factors including aerosol particle size and upper airway morphology. While smaller sized aerosol particles may be transported to the small airways there is still a need to examine the systemic risk and efficacy associated with small particle aerosols. On one hand small particles can be transported to the lung periphery (small airways) where they can reduce small airways dysfunction. On the other hand small particles can increase plasma concentrations of the drug worsening systemic side effects. Aerosol particle size determines deposition throughout the whole of the respiratory tract including the upper airway and by altering aerosol delivery characteristics it is possible to avoid deposition in the upper airway. This thesis set out to investigate how to improve drug deposition in the lung by controlling aerosol delivery characteristics mainly particle size and flow rate and investigate how the filtering effects of the upper airway can be overcome. The specific aims of this thesis were: To quantify aerosol deposition in the upper airway both in vitro and in vivo with the hope of using in vitro techniques to predict what happens in vivo. Explore how aerosol particle size effects lung deposition and pulmonary bioavailability through pharmacokinetics. Investigate and evaluate novel tests of small and large airways function and see if these can detect physiological improvement following inhalation of small (1.5 µm) particles and large (6 µm) particles. In vitro tests on upper airway models somewhat predicted what happens in vivo. The increasing effect of both particle size and flow rate was shown to increase upper airway deposition. Tests of respiratory function and inflammation demonstrated greater between test variability than routine tests of lung function and warrant further evaluation. Improvements in small and large airway function were not associated with the deposition of small and large aerosol particles following one off dosing of an inhaled corticosteroid fluticasone propionate and a link between these tests and aerosol particle size warrants further investigation.Open Acces

Massachusetts Domestic and Foreign Corporations Subject to an Excise: For the Use of Assessors (2004)

International audienc