Prévenir la prise de poids à l'arrêt du tabac: pas de solution miracle: revue Cochrane pour le praticien. [Preventing weight gain in smoking cessation: there is no miracle solution]

http://resfranco.cochrane.org/sites/resfranco.cochrane.org/files/uploads/Arrettabac2009.pdf

An examination of male and female odds ratios by BMI, cigarette smoking, and alcohol consumption for cancers of the oral cavity, pharynx, and larynx in pooled data from 15 case-control studies.

BACKGROUND: Greater tobacco smoking and alcohol consumption and lower body mass index (BMI) increase odds ratios (OR) for oral cavity, oropharyngeal, hypopharyngeal, and laryngeal cancers; however, there are no comprehensive sex-specific comparisons of ORs for these factors. METHODS: We analyzed 2,441 oral cavity (925 women and 1,516 men), 2,297 oropharynx (564 women and 1,733 men), 508 hypopharynx (96 women and 412 men), and 1,740 larynx (237 women and 1,503 men) cases from the INHANCE consortium of 15 head and neck cancer case-control studies. Controls numbered from 7,604 to 13,829 subjects, depending on analysis. Analyses fitted linear-exponential excess ORs models. RESULTS: ORs were increased in underweight (<18.5 BMI) relative to normal weight (18.5-24.9) and reduced in overweight and obese categories (>/=25 BMI) for all sites and were homogeneous by sex. ORs by smoking and drinking in women compared with men were significantly greater for oropharyngeal cancer (p < 0.01 for both factors), suggestive for hypopharyngeal cancer (p = 0.05 and p = 0.06, respectively), but homogeneous for oral cavity (p = 0.56 and p = 0.64) and laryngeal (p = 0.18 and p = 0.72) cancers. CONCLUSIONS: The extent that OR modifications of smoking and drinking by sex for oropharyngeal and, possibly, hypopharyngeal cancers represent true associations, or derive from unmeasured confounders or unobserved sex-related disease subtypes (e.g., human papillomavirus-positive oropharyngeal cancer) remains to be clarified.

Exposure to tobacco smoke before and after a partial smoking ban in prison: indoors air quality measures

Although exposure to secondhand smoke (SHS) is reportedly high in prison, few studies have measured this in the prison environment, and none have done so in Europe. We measured two indicators of SHS exposure (particulate matter PM10 and nicotine) in fixed locations before (2009) and after (2010) introduction of a partial smoking ban in a Swiss prison. Access to smoking cessation support was available to detainees throughout the study. Objectives To measure SHS before and after the introduction of a partial smoking ban. Methods Assessment of particulate matter PM10 (suspended microparticles of 10 μm) and nicotine in ambient air, collected by real-time aerosol monitor and nicotine monitoring devices. Results The authors observed a significant improvement of nicotine concentrations in the air after the introduction of the smoking ban (before: 7.0 μg/m(3), after: 2.1 μg/m(3), difference 4.9 μg/m(3), 95% CI for difference: 0.52 to 9.8, p=0.03) but not in particulate matter PM10 (before: 0.11 mg/m(3), after: 0.06 mg/m(3), difference 0.06 mg/m(3), 95% CI for difference of means: -0.07 to 0.19, p=0.30). Conclusions The partial smoking ban was followed by a decrease in nicotine concentrations in ambient air. These improvements can be attributed to the introduction of the smoking ban since no other policy change occurred during this period. Although this shows that concentrations of SHS decreased significantly, protection was still incomplete and further action is necessary to improve indoor air quality.

High expectation in non-evidence-based smoking cessation interventions among smokers--the CoLaus study.

To assess the preferred methods to quit smoking among current smokers. Cross-sectional, population-based study conducted in Lausanne between 2003 and 2006 including 988 current smokers. Preference was assessed by questionnaire. Evidence-based (EB) methods were nicotine replacement, bupropion, physician or group consultations; non-EB-based methods were acupuncture, hypnosis and autogenic training. EB methods were frequently (physician consultation: 48%, 95% confidence interval (45-51); nicotine replacement therapy: 35% (32-38)) or rarely (bupropion and group consultations: 13% (11-15)) preferred by the participants. Non-EB methods were preferred by a third (acupuncture: 33% (30-36)), a quarter (hypnosis: 26% (23-29)) or a seventh (autogenic training: 13% (11-15)) of responders. On multivariate analysis, women preferred both EB and non-EB methods more frequently than men (odds ratio and 95% confidence interval: 1.46 (1.10-1.93) and 2.26 (1.72-2.96) for any EB and non-EB method, respectively). Preference for non-EB methods was higher among highly educated participants, while no such relationship was found for EB methods. Many smokers are unaware of the full variety of methods to quit smoking. Better information regarding these methods is necessary.

The tobacco industry's past role in weight control related to smoking.

BACKGROUND: Smoking is thought to produce an appetite-suppressing effect by many smokers. Thus, the fear of body weight gain often outweighs the perception of health benefits associated with smoking cessation, particularly in adolescents. We examined whether the tobacco industry played a role in appetite and body weight control related to smoking and smoking cessation. METHODS: We performed a systematic search within the archives of six major US and UK tobacco companies (American Tobacco, Philip Morris, RJ Reynolds, Lorillard, Brown & Williamson and British American Tobacco) that were Defendants in tobacco litigation settled in 1998. Findings are dated from 1949 to 1999. RESULTS: The documents revealed the strategies planned and used by the industry to enhance effects of smoking on weight and appetite, mostly by chemical modifications of cigarettes contents. Appetite-suppressant molecules, such as tartaric acid and 2-acetylpyridine were added to some cigarettes. CONCLUSION: These tobacco companies played an active and not disclaimed role in the anti-appetite effects of smoking, at least in the past, by adding appetite-suppressant molecules into their cigarettes.

The tobacco industry's past role in weight control related to smoking

Résumé (français)ContexteLe tabagisme est connu pour produire un effet coupe-faim chez la plupart des fumeurs. La crainte de la prise de poids à l'arrêt de la cigarette l'emporte souvent sur la perception des bénéfices sur la santé associés à l'abandon du tabac, particulièrement chez les adolescents. Nous avons examiné quel a été le rôle de l'industrie du tabac dans cet effet de la fumée sur l'appétit et sur le contrôle du poids.MéthodesNous avons réalisé une recherche systématique dans les archives de six grandes compagnies de tabac américaines et du Royaume-Uni (American Tobacco, Philip Morris, RJ Reynolds, Lorillard, Brown & Williamson et British American Tobacco) qui avaient été mises en cause dans les procès du tabac en 1998 aux Etats-Unis. Les résultats concernent les années 1949 à 1999.RésultatsLes archives de ces industries montrent qu'elles ont mis au point et ont utilisé diverses stratégies pour améliorer les effets du tabagisme sur le poids et l'appétit, la plupart du temps en réalisant des modifications chimiques des cigarettes. Des substances coupe-faim, telles que l'acide tartrique et le 2-acétylpyridine ont notamment été ajoutées aux cigarettes.ConclusionEn tout cas par le passé, ces compagnies de tabac ont activement modifié leurs cigarettes afin d'en augmenter l'effet de diminution de l'appétit, notamment en y ajoutant des substances coupe-faim.

Smoking offsets the metabolic benefits of parental longevity in women: the CoLaus study.

OBJECTIVE: We evaluated whether subjects with long-lived parents show lower levels of cardiovascular risk factors, including the metabolic syndrome. METHODS: We analyzed data from a Swiss population-based sample (1163 men and 1398 women) aged 55-75 years from Lausanne. Participants were stratified by number of parents (0, 1, 2) who survived to 85 years or more. The associations of parental longevity with cardiovascular risk factors and related metabolic variables were analyzed using multiple linear regressions. RESULTS: Age-adjusted metabolic syndrome prevalence varied from 24.8%, 20.5% to 13.8% in women (P<0.05) and from 28.8%, 32.1% to 27.6% in men (not significant) with 0, 1 and 2 long-lived parents. The association between parental longevity and metabolic syndrome prevalence was particularly strong in women who had never smoked. In this group, women with 2 long-lived parents had lower Body Mass Index and smaller waist circumference. In never-smokers of both genders, mean (95% CI) adjusted High Density Lipoprotein-cholesterol levels were 1.64(1.61-1.67), 1.67(1.65-1.70) and 1.71(1.65-1.76) mmol/L for 0, 1 and 2 long-lived parents (P<0.01), respectively. The trend was not significant in former and current smokers. CONCLUSIONS: In women, not in men, parental longevity is associated with a better metabolic profile. The metabolic benefits of having long-lived parents are offset by smoking.

Quantification of nicotine, cotinine, trans-3'-hydroxycotinine and varenicline in human plasma by a sensitive and specific UPLC-tandem mass-spectrometry procedure for a clinical study on smoking cessation.

A sensitive and specific ultra performance liquid chromatography-tandem mass spectrometry method for the simultaneous quantification of nicotine, its metabolites cotinine and trans-3'-hydroxycotinine and varenicline in human plasma was developed and validated. Sample preparation was realized by solid phase extraction of the target compounds and of the internal standards (nicotine-d4, cotinine-d3, trans-3'-hydroxycotinine-d3 and CP-533,633, a structural analog of varenicline) from 0.5mL of plasma, using a mixed-mode cation exchange support. Chromatographic separations were performed on a hydrophilic interaction liquid chromatography column (HILIC BEH 2.1×100mm, 1.7μm). A gradient program was used, with a 10mM ammonium formate buffer pH 3/acetonitrile mobile phase at a flow of 0.4mL/min. The compounds were detected on a triple quadrupole mass spectrometer, operated with an electrospray interface in positive ionization mode and quantification was performed using multiple reaction monitoring. Matrix effects were quantitatively evaluated with success, with coefficients of variation inferior to 8%. The procedure was fully validated according to Food and Drug Administration guidelines and to Société Française des Sciences et Techniques Pharmaceutiques. The concentration range was 2-500ng/mL for nicotine, 1-1000ng/mL for cotinine, 2-1000ng/mL for trans-3'-hydroxycotinine and 1-500ng/mL for varenicline, according to levels usually measured in plasma. Trueness (86.2-113.6%), repeatability (1.9-12.3%) and intermediate precision (4.4-15.9%) were found to be satisfactory, as well as stability in plasma. The procedure was successfully used to quantify nicotine, its metabolites and varenicline in more than 400 plasma samples from participants in a clinical study on smoking cessation.

The effect of a smoking ban introduction to environmental tobacco smoke exposure in Swiss hospitality workers : Abstracts of the 23rd Annual Conference of the International Society of Environmental Epidemiology (ISEE), September 13-16, 2011, Barcelona, Spain

Background and Aims: To protect the population from environmental tobacco smoke (ETS) Switzerland introduced a nationwide rather heterogeneous smoking ban in May 2010. The exposure situation of non-smoking hospitality workers before and after implementation of the new law is being assessed in a prospective cohort study. Methods: Exposure to ETS was measured using a novel method developed by the Institute for Work and Health in Lausanne. It is a passive sampler called MoNIC (Monitor of NICotine). The nicotine of the ETS is fixed onto a filter and transformed into salt of not volatile nicotine. Subsequently the number of passively smoked cigarettes is calculated. Badges were placed at the workplace as well as distributed to the participants for personal measuring. Additionally a salivary sample was taken to determine nicotine concentration. Results: At baseline Spearman's correlation between workplace and personal badge was 0.47. The average cigarette equivalents per day at the workplace obtained by badge significantly dropped from 5.1 (95%- CI: 2.4 to 7.9) at baseline to 0.3 (0.2 to 0.4) at first follow-up (n=29) three months later (p<0.001). For personal badges the number of passively smoked cigarettes declined from 1.5 (2.7 to 0.4) per day to 0.5 (0.3 to 0.8) (n=16).Salivary nicotine concentration in a subset of 13 participants who had worked on the day prior to the examination was 2.63 ng/ml before and 1.53 ng/ml after the ban (p=0.04). Spearman's correlation of salivary nicotine was 0.56 with workplace badge and 0.79 with personal badge concentrations. Conclusions: Workplace measurements clearly reflect the smoking regulation in a venue. The MoNIC badge proves to be a sensitive measuring device to determine personal ETS exposure and it is a demonstrative measure for communication with lay audiences and study participants as the number of passively smoked cigarettes is an easily conceivable result.

Acute respiratory and cardiovascular admissions after a public smoking ban in geneva, Switzerland.

BACKGROUND: Many countries have introduced legislations for public smoking bans to reduce the harmful effects of exposure to tobacco smoke. Smoking bans cause significant reductions in admissions for acute coronary syndromes but their impact on respiratory diseases is unclear. In Geneva, Switzerland, two popular votes led to a stepwise implementation of a state smoking ban in public places, with a temporary suspension. This study evaluated the effect of this smoking ban on hospitalisations for acute respiratory and cardiovascular diseases. METHODS: This before and after intervention study was conducted at the University Hospitals of Geneva, Switzerland, across 4 periods with different smoking legislations. It included 5,345 patients with a first hospitalisation for acute coronary syndrome, ischemic stroke, acute exacerbation of chronic obstructive pulmonary disease, pneumonia and acute asthma. The main outcomes were the incidence rate ratios (IRR) of admissions for each diagnosis after the final ban compared to the pre-ban period and adjusted for age, gender, season, influenza epidemic and secular trend. RESULTS: Hospitalisations for acute exacerbation of chronic obstructive pulmonary disease significantly decreased over the 4 periods and were lowest after the final ban (IRR = 0.54 [95%CI: 0.42-0.68]). We observed a trend in reduced admissions for acute coronary syndromes (IRR = 0.90 [95%CI: 0.80-1.00]). Admissions for ischemic stroke, asthma and pneumonia did not significantly change. CONCLUSIONS: A legislative smoking ban was followed by a strong decrease in hospitalisations for acute exacerbation of chronic obstructive pulmonary disease and a trend for reduced admissions for acute coronary syndrome. Smoking bans are likely to be very beneficial for patients with chronic obstructive pulmonary disease.

Smoking offsets the metabolic benefits of parental longevity in women : the CoLaus study

Rapport de synthèse : Objectif: nous avons regardé si les sujets dont les parents vivaient plus longtemps présentaient des niveaux plus faibles de facteurs de risques cardiovasculaires, y compris pour le syndrome métabolique. Méthodes: nous avons analysé les données d'un échantillon représentatif de la population suisse (1163 hommes et 1398 femmes) âgé de 55 à 75 ans, de la ville de Lausanne. Les participants ont été stratifiés par nombre de parents (0, 1, 2) qui ont vécu jusqu'à 85 ans ou plus. Les associations entre la longévité parentale et les facteurs de risques cardiovasculaires ou les variables métaboliques associées ont été analysées au moyen de régressions linéaires multiples. Résultats: la prévalence ajustée pour l'âge du syndrome métabolique varie de 24.8%, 20.5% à 13.8% chez les femmes (P<0.05) et de 28.8%, 32.1 % à 27.6% chez les hommes (non significatif) pour 0, 1 et 2 parents à forte longévité. L'association entre la longévité parentale et la prévalence du syndrome métabolique est particulièrement forte pour les femmes qui n'ont jamais fumé. Dans ce groupe, les femmes qui ont 2 parents à forte longévité ont un BMI plus faible et un tour de taille moins grand. Chez les gens qui n'ont jamais fumé, pour les deux sexes, les niveaux moyens (95% d'intervalle de confiance) et ajustés de cholestéro-HDL étaient de 1.64(1.61-1.67), 1.67(1.65-1.70) et 1.71(1.65-1.76) mmol/L pour 0, 1 et 2 parents à forte longévité (P<0.01), respectivement. La tendance n'était pas significative chez les anciens fiuneurs et fumeurs actuels. Conclusions: la longévité parentale est associée à un meilleur profil métabolique chez les femmes, mais pas chez les hommes. Les avantages métaboliques du fait d'avoir des parents âgés sont fortement atténués par le tabagisme.

Effects of smoking and physical exercise on platelet free cytosolic calcium in healthy normotensive volunteers.

Platelet free cytosolic calcium (PFCC) was measured in 21 healthy volunteers before and after cigarette smoking or physical exercise. The aim was to investigate whether acute blood pressure changes and increases in circulating levels of catecholamines and vasopressin modify PFCC. PFCC was determined using the Quin-2 method. Following cigarette smoking, significant increases in blood pressure, heart rate, plasma epinephrine (35 +/- 18 pg/ml before versus 51 +/- 31 pg/ml after smoking, P less than 0.05, mean +/- s.d.) and vasopressin levels (0.8 +/- 0.3 pg/ml before and 4.2 +/- 4.1 pg/ml after smoking, P less than 0.001) were observed. However, despite these acute hormonal and hemodynamic changes, PFCC remained stable at 156 +/- 55 nmol/l prior to the study and 157 +/- 29 nmol/l and 156 +/- 38 nmol/l at 20 and 80 min post-smoking, respectively. Acute physical exercise led to an increase in heart rate and systolic blood pressure but to a decrease in diastolic pressure. Moreover, a marked increase in plasma norepinephrine levels was observed after exercise (213 +/- 71 pg/ml before versus 747 +/- 501 pg/ml after exercise, P +/- 0.001). Again, PFCC was stable at 185 +/- 56 nmol/l at baseline versus 188 +/- 51 nmol/l at 20 min and 155 +/- 26 nmol/l at 80 min after exercise. These results therefore demonstrate that PFCC is not influenced acutely either by blood pressure increases, or by elevations in circulating catecholamine and vasopressin concentrations.

A genomewide association study of smoking relapse in four European population-based samples.

OBJECTIVES: Genomewide association studies (GWAS) have identified clear evidence of genetic markers for nicotine dependence. Other smoking phenotypes have been tested, but the results are less consistent. The tendency to relapse versus the ability to maintain long-term abstinence has received little attention in genetic studies; thus, our aim was to provide a better biological understanding of this phenotype through the identification of genetic loci associated with smoking relapse. METHODS: We carried out a GWAS on data from two European population-based collections, including a total of 835 cases (relapsers) and 990 controls (abstainers). Top-ranked findings from the discovery phase were tested for replication in two additional independent European population-based cohorts. RESULTS: Of the seven top markers from the discovery phase, none were consistently associated with smoking relapse across all samples and none reached genomewide significance. A single-nucleotide polymorphism rs1008509, within the Xylosyltransferase II (XYLT2) gene, was suggestively associated with smoking relapse in the discovery phase (β=-0.504; P=5.6E-06) and in the first replication sample (ALSPAC) (β=-0.27; P=0.004; n=1932), but not in the second sample (KORA) (β=0.19; P=0.138; n=912). We failed to identify an association between loci implicated previously in other smoking phenotypes and smoking relapse. CONCLUSION: Although no genomewide significant findings emerged from this study, we found that loci implicated in other smoking phenotypes were not associated with smoking relapse, which suggests that the neurobiology of smoking relapse and long-term abstinence may be distinct from biological mechanisms implicated in the development of nicotine dependence.

Association of smoking and nicotine dependence with pre-diabetes in young and healthy adults.

INTRODUCTION: Several studies have shown an increased risk of type 2 diabetes among smokers. Therefore, the aim of this analysis was to assess the relationship between smoking, cumulative smoking exposure and nicotine dependence with pre-diabetes. METHODS: We performed a cross-sectional analysis of healthy adults aged 25-41 in the Principality of Liechtenstein. Individuals with known diabetes, Body Mass Index (BMI) >35 kg/m² and prevalent cardiovascular disease were excluded. Smoking behaviour was assessed by self-report. Pre-diabetes was defined as glycosylated haemoglobin between 5.7% and 6.4%. Multivariable logistic regression models were done. RESULTS: Of the 2142 participants (median age 37 years), 499 (23.3%) had pre-diabetes. There were 1,168 (55%) never smokers, 503 (23%) past smokers and 471 (22%) current smokers, with a prevalence of pre-diabetes of 21.2%, 20.9% and 31.2%, respectively (p <0.0001). In multivariable regression models, current smokers had an odds ratio (OR) of pre-diabetes of 1.82 (95% confidential interval (CI) 1.39; 2.38, p <0.0001). Individuals with a smoking exposure of <5, 5-10 and >10 pack-years had an OR (95% CI) for pre-diabetes of 1.34 (0.90; 2.00), 1.80 (1.07; 3.01) and 2.51 (1.80; 3.59) (p linear trend <0.0001) compared with never smokers. A Fagerström score of 2, 3-5 and >5 among current smokers was associated with an OR (95% CI) for pre-diabetes of 1.27 (0.89; 1.82), 2.15 (1.48; 3.13) and 3.35 (1.73; 6.48) (p linear trend <0.0001). DISCUSSION: Smoking is strongly associated with pre-diabetes in young adults with a low burden of smoking exposure. Nicotine dependence could be a potential mechanism of this relationship.