Tobacco use, occupation, coffee, various nutrients, and bladder cancer.

In a Canadian population-based case-control study of 480 males and 152 female case-control pairs, the relative risk for development of bladder cancer for ever used versus never used cigarettes was 3.9 for males and 2.4 for females, with a dose-response relationship in both sexes. A reduced risk was associated with the use of filter cigarettes compared to nonfilter cigarettes. After control for cigarette usage, a significant risk was noted for male pipe smokers. For male ex-smokers the risk after 15 years of no smoking was less than one-half that of current male smokers. Bladder cancer risk was found for workers in the chemical, rubber, photographic, petroleum, medical, and food processing industries among males and for workers occupationally exposed to dust or fumes among both sexes. Bladder cancer risk was elevated for males consuming all types of coffee, regular coffee, and instant coffee and for females consuming instant coffee, but no dose-response relationship was found. Risk was found for males consuming water from nonpublic supples but not for females. No risk was observed in males or females consuming nitrate-containing foods, beverages other than coffee, or fiddlehead greens. Hair dye usage in females and phenacetin usage in males and females carried no risk. Divergent findings by area for aspirin suggested that an overall association was not causal. Reevaluation of the data on artificial sweeteners confirmed a significant bladder cancer risk in males and a dose-response relationship. The cumulated population attributable risk for bladder cancer was 90% for males from cigarette smoking, industrial exposure, and exposure to nonpublic water supplies and 29% for females from cigarette smoking, industrial exposure, and instant coffee consumption.

Potentiation of cigarette smoking and radiation: evidence from a sputum cytology survey among uranium miners and controls.

To assess the effect of cigarette smoking and of exposure to radon daughters, a prospective survey consisting of periodic sputum cytology evaluation was initiated among 249 underground uranium miners and 123 male controls. Sputum cytology specimens showing moderate atypia, marked atypia, or cancer cells were classified as abnormal. As compared to control smokers, miners who smoke had a significantly higher incidence of abnormal cytology (P = .025). For miner smokers, the observed frequencies of abnormal cytology were linearly related to cumulative exposure to radon daughters and to the number of years of uranium mining. A statistical model relating the probability of abnormal cytology to the risk factors was investigated using a binary logistic regression. The estimated frequency of abnormal cytology was significantly dependent, for controls, on the duration of cigarette smoking, and for miners, on the duration of cigarette smoking and of uranium mining.

Cigarette smoking associated with sleep difficulty.

A group of 50 smokers experienced greater sleep difficulty than a group of 50 nonsmokers matched by age and sex. The two groups did not differ in personality patterns or drug consumption. Also, sleep patterns significantly improved in a group of eight chronic smokers when they abstained from cigarette smoking. These findings are consistent with reports on the stimulant effects of nicotine.

Interaction of factors associated with cancer of the nasopharynx.

A retrospective study of nasopharyngeal carcinoma (NPC) revealed that smoking, working under poor ventilation, use of nasal balms or oil for nasal and throat troubles, use of herbal drugs, and anti-EBV antibody titer were found statistically associated. The dural interactions of these factors to the risk of NPC were presented. Except in work conditions with poor ventilation and when herbal drugs are used, all the combinations were synergistic. The synergistic actions were especially remarkable with smoking and other factors. The possible etiological mechanisms of NPC are discussed.

The combined effect of smoking and coffee drinking on LDL and HDL cholesterol.

Conflicting reports on the effect of smoking and coffee drinking on lipoproteins prompted us to study the combined effect of these two associated, widely prevalent habits in 361 persons randomly sampled from the Evans County cohort. Low-density lipoprotein (LDL) cholesterol levels were significantly higher among persons who smoked cigarettes and consumed five or more cups of coffee per day than among nonsmokers who abstained from coffee. Conversely, high-density lipoprotein (HDL) cholesterol was higher in persons who did not smoke or drink coffee than in coffee-consuming smokers. However, this trend was not statistically significant. Triglycerides and very low-density lipoprotein (VLDL) cholesterol were highest among smokers who drank five or more cups of coffee per day, but these differences did not reach statistical significance. Lipoprotein cholesterol levels were adjusted for age, sex and body mass. Smoking and coffee drinking interact in affecting LDL and total cholesterol, but coffee drinking alone did not appear to affect blood lipids.

Opium: a potential urinary bladder carcinogen in man.

Evidence is presented that opium addition is a risk factor for cancer of the bladder. A case-control study of 99 bladder cancer patients admitted to Nemazee Hospital in Shiraz, Iran was evaluated. Cancer patients and controls, matched by age and sex, were analyzed as to their opium and/or cigarette smoking habits. A high correlation between opium addiction and bladder cancer has been observed. This evidence significantly exceeded the one observed in relation to cigarette smoking only. The sex ratio for this cancer site, from hospitalized cases in Southern Iran, is estimated to be about nine male cases per one female case. This high male to female ratio was attributed to the greater addiction of males to opium. It was concluded that opium and, more likely, its pyrolysis derived fractions may represent potential bladder carcinogens in man.

Submucous fibrosis in Taiwan.

Thirty-five cases of submucous fibrosis have been collected in Taiwan. The fibrotic changes occurred most often in the buccal and palatal mucosa, and between the ages of 30 and 50 years. The occurrence of the disease correlated highly with the habit of betel nut chewing. Tobacco, hot spicy foods, and liquor were not important etiologic factors.

Tooth staining effects of an alexidine mouthwash.

The primary purpose of this study was to determine the amount of tooth staining produced by an alexidine mouthrinse. One hundred and eighty subjects rinsed twice daily for 1 month with either 15 ml of alexidine (0.035%) or a placebo solution. Prior to the study, the subjects were classified according to their smoking, coffee and tea drinking habits and these factors were subsequently considered in the analysis of the stain scores. Additionally, the effects on staining of a prior prophylaxis and the use of a fluoridated toothpaste during the study were determined. Upon termination of the study, subjects utilizing the active mouthrinse manifested a greater degree of staining than placebo users. The amount and intensity of the stain due to alexidine were not influenced (increased) by smoking, tea or coffee drinking habits. A prior prophylaxis did not reduce the staining propensity of alexidine users. The method of scoring developed can be used to assess the degree of tooth staining induced by antiplaque agents.

Abuse of alcohol, drugs and tobacco during pregnancy--consequences for the child.

There is an increasing awareness that alcohol and drug abuse and smoking are not only harmful for the consumer but will also, when taken by a pregnant woman, adversely affect her unborn child. The consequence of the abuse will result from a combination of specific toxic effects of abusing substances and a nonspecific effect from the often very unstable environment of an alcohol- or drug-dependent mother. Poor prenatal care is a common finding in alcohol and drug abuse leading to a high incidence of complications during pregnancy and delivery including premature labor and small-for-gestational-age babies. An increased perinatal mortality has been reported following all types of abuse including tobacco use, probably as a consequence of poor prenatal care as well as of a toxic effect on the fetus. Withdrawal symptoms after birth are most prominent in opiate addiction. The already intrauterinely damaged child will if it stays with its parents often continue to be exposed to several abverse environmental factors. However, symptoms such as mental retardation following alcohol abuse and hyperactivity and emotional disturbances following drug exposure during intrauterine life have also been found in children who have been taken from the parents and placed in foster homes immediately after birth. This means that children of abusing parents both in their custody and in foster home will have to be regarded as risk children that should be subjected to careful medical and psychological follow-up.

Extrinsic discoloration of teeth.

The majority of tooth discolorations are extrinsic in nature and appear as brown integuments. Various clinical indices and photometric techniques have been used for the evaluation of extrinsic discolorations. Smoking, tea or coffee consumption and increasing age are promoting factors and such discolorations are frequently seen in connection with oral use of antibacterial plaque-inhibiting mouthrinses. Chemical alteration of the acquired pellicle appears to be the major reason for these brown integuments.