Passive Smoking and Risk of Cognitive Impairment in Women Who Never Smoke
Division of Health and Social Care Research, King's College London, Capital House, 42 Weston St, Seventh Floor, London SE1 3QD, England. ) Archives of internal medicine
(Impact Factor: 17.33).
02/2012; 172(3):271-3. DOI: 10.1001/archinternmed.2011.762
Available from: John RM Copeland
- "Chen R, et al. Occup Environ Med 2013;70:63–69. doi:10.1136/oemed-2012-100785 Environment"
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Environmental tobacco smoke (ETS) has a range of adverse health effects, but its association with dementia remains unclear and with dementia syndromes unknown. We examined the dose–response relationship between ETS exposure and dementia syndromes.
Using a standard method of GMS, we interviewed 5921 people aged ≥60 years in five provinces in China in 2007–2009 and characterised their ETS exposure. Five levels of dementia syndrome were diagnosed using the Automated Geriatric Examination for Computer Assisted Taxonomy instrument. The relative risk (RR) of moderate (levels 1–2) and severe (levels 3–5) dementia syndromes among participants exposed to ETS was calculated in multivariate adjusted regression models.
626 participants (10.6%) had severe dementia syndromes and 869 (14.7%) moderate syndromes. Participants exposed to ETS had a significantly increased risk of severe syndromes (adjusted RR 1.29, 95% CI 1.05 to 1.59). This was dose-dependently related to exposure level and duration. The cumulative exposure dose data showed an adjusted RR of 0.99 (95% CI 0.76 to 1.28) for >0–24 level years of exposure, 1.15 (95% CI 0.93 to 1.42) for 25–49 level years, 1.18 (95% CI 0.87 to 1.59) for 59–74 level years, 1.39 (95% CI 1.03 to 1.84) for 75–99 level years and 1.95 (95% CI 1.34 to 2.83) for ≥100 level years. Significant associations with severe syndromes were found in never smokers and in former/current smokers. There were no positive associations between ETS and moderate dementia syndromes.
ETS should be considered an important risk factor for severe dementia syndromes. Avoidance of ETS may reduce the rates of severe dementia syndromes worldwide.
Occupational and environmental medicine 10/2012; 70(1). DOI:10.1136/oemed-2012-100785 · 3.27 Impact Factor
Archives of internal medicine 07/2012; 172(13):1045-6. DOI:10.1001/archinternmed.2012.2159 · 17.33 Impact Factor
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ABSTRACT: In this review we have sought to examine the epidemiological, basic scientific, and public health data regarding the association between second hand smoke exposure and the development of coronary heart disease. Second hand smoke (SHS) increases the risk of coronary heart disease (CHD) by 25-30% according to multiple cohort, case-control, and meta-analytical studies. Physiologic and basic science research suggests that the mechanisms by which SHS affects the cardiovascular system are multiple and include increased thrombogenesis and low density lipoprotein oxidation, decreased exercise tolerance, dysfunctional flow-mediated vasodilatation, and activation of inflammatory pathways with concomitant oxidative damage and impaired vascular repair. As a result, chronic exposure promotes atherogenesis and the development of cardiovascular disease, increasing the risk of having an acute coronary syndrome. With the implementation of state-wide and nation-wide public smoke-free legislation across the United States and Europe respectively over the last 10-15 years, there has been a significant and reciprocal decline in the incidence of emergency admissions for acute coronary syndrome by an average 17% despite persistent attempts on the part of the tobacco industry to diminish the correlation between SHS exposure and CHD. These findings underscore the importance of the effects of smoking legislation on community health.
Cardiology in review 09/2012; 21(2). DOI:10.1097/CRD.0b013e31827362e4 · 2.41 Impact Factor
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