The impact of prehistoric human dispersals on the presence of tobacco-related oral cancer in Northeast India.

BACKGROUND: Northeast (NE) India is a subject of debate for predicting its involvement in prehistoric anatomically modern human (AMH) dispersal. The unique lifestyle and genetic characteristics of native ethnic groups in this region are believed to be responsible for their susceptibility to tobacco-related oral cancer (TrOC). The present study assessed mitochondrial macro-haplogroup (mHG) diversity and TrOC susceptibility autosomal loci to evaluate the impact of prehistoric AMH dispersal on the present day's high TrOC prevalence in major NE Indian ethnics. METHODS: We considered 175 unrelated individuals from 35 ethnic groups and previously published 374 sequences for sequencing-based assessment of mtDNA-based marker by subsequent analyses like haplogroup diversity, phylogenetic, genetic structure by AMOVA, and MDS, descriptive statistics of demographic parameters, and migration analysis. Besides, we selected prolonged tobacco-chewing 124 case-control individuals from similar ethnic backgrounds for genotyping 115 autosomal loci in Sequenom iPLEX MassARRAY™ platform and mined 1000genome data (n = 398) for consequent global admixture and ancestry-specific allele frequencies-based analyses. RESULTS: Our mtDNA-based findings suggested that NE populations were distinct from other Indian populations, owing to the first wave of migration from ancient southern China (∼54kya) and two successive spatial expansion events at âˆ¼45kya and âˆ¼43kya. Consequently, it probably acted as another source for prehistoric AMH dispersal in N/NE Asia. Besides, the second wave of back-migration from SE Asia (∼40kya) probably replaced the mitochondrial footprints of survivors from the first migrants and introduced the TrOC susceptibility traits in this region. Afterward, the autosomal marker-based observations on the transition of the disease-associated admixture component 'K6' from SE Asia reconfirmed these results. Moreover, we also observed that the mitochondrial mHG 'R' is significantly associated with the risk of TrOC (OR > 9.5) in NE India. Furthermore, the possible onset of the phenotypic expression of those traits was predicted at âˆ¼4kya, thus, contributing to present-day's TrOC prevalence. CONCLUSIONS: This study reflects its uniqueness by revealing an updated AMH dispersal route for the peopling in and out of NE India, which probably introduced the disease-causing traits in the ancestral NE Indian population. Those traits were then imprinted in their genome to get transferred through their respective generations, forming the present-day's TrOC-prevalent NE Indian population.

Transferrin saturation is independently associated with the severity of obstructive sleep apnea syndrome and hypoxia among obese subjects.

INTRODUCTION & AIMS: Obstructive sleep apnea syndrome (OSAS) is a frequent complication of obesity. Intermittent chronic hypoxia which frequently results from OSAS could modulate the systemic control of iron metabolism and alter serum iron parameters, especially among obese patients. AIMS: to evaluate whether serum parameters of iron bioavailability and storage (primary), as well as age, waist circumference, arterial hypertension and tobacco use (secondary) are associated with OSAS severity and/or hypoxia. METHODS: design: a single-center retrospective study with prospective data collection; inclusion criteria: consecutive patients referred for initial assessment for obesity underwent nocturnal respiratory polygraphy and iron status serum assessment within a 3-month period. The adjusted analyzes were performed using ANOVA and reported as adjusted means and 95% confidence interval (95% CI). RESULTS: 13 men and 56 women were included. OSAS prevalence: 72% (n = 50). Ferritin (mean ± SD, 260 ± 276 vs. 111 ± 89 µg/l, p = 0.01) and transferrin saturation (31 ± 10 vs. 24 ± 9%, p = 0.002) were significantly higher in case of moderate/severe OSAS than in absent/mild OSAS, independently from gender and tobacco use. Serum iron (19.4 µg/l [CI95%, 16.5-22.3] vs. 16.2 µg/l ([14.1-18.2], p = 0.056) and transferrin saturation (31.5% [26.3-36.7]) vs. 25.3% [21.6-29.1], p = 0.043) were higher when time under oxygen saturation <90% was >15%. Age (mean ± SD, 51 ± 11 vs. 41 ± 12 yr, p = 0.001), waist circumference (136 ± 18 vs. 123 ± 12 cm, p = 0.003), arterial hypertension (59% (n = 13/22) vs. 23% (n = 11/47), p = 0.004) and tobacco use (64% (n = 14/22) vs. 32% (n = 15/47), p = 0.01) were significantly greater in moderate/severe OSAS than in absent/mild OSAS. CONCLUSIONS: Transferrin saturation was associated with OSAS severity and time under hypoxia. This suggests a relationship between OSAS-induced hypoxia and iron metabolism among obese patients.

Leukocytosis and Tobacco Use: An Observational Study of Asymptomatic Leukocytosis.

PURPOSE: This study aimed to characterize the white blood cell differential of tobacco smoking-induced leukocytosis and describe the longitudinal impact of smoking cessation on this peripheral blood abnormality. METHODS: Medical records of patients undergoing evaluation by hematologists for persistent leukocytosis were reviewed. Patients in whom leukocytosis was determined to be secondary to tobacco use after exclusion of other causes were identified. Demographic and laboratory data were collected at time of diagnosis. Patients were longitudinally followed and information regarding smoking cessation and follow-up white blood cell values were recorded. RESULTS: Forty patients were determined to have smoking-induced leukocytosis. The median age was 49.5 years (range: 28-75 years), 24 patients were female, and the mean body mass index (BMI) was 31.5 kg/m2. The mean white blood cell count was 13.3 × 109/L (range: 9.8-20.9 × 109/L); 39 patients had absolute neutrophilia (98%), 21 had lymphocytosis (53%), 20 had monocytosis (50%), and 19 had basophilia (48%). During follow-up, 11 patients either quit (n = 9) or reduced (n = 2) tobacco use. Reduction in tobacco smoking led to a significant decrease in mean white blood cell count (13.2 × 109/L vs 11.1 × 109/L, P = 0.02). The median time to decrease in white blood cell count following reduction in tobacco use was 8 weeks (range: 2-49 weeks). CONCLUSIONS: Tobacco-induced leukocytosis was characterized by a mild elevation in total white blood cell count and was most commonly associated with neutrophilia, lymphocytosis, monocytosis, and basophilia. Cessation of smoking led to improvement in leukocytosis. Tobacco history should be elicited from all patients presenting with leukocytosis to limit unnecessary diagnostic testing, and counseling regarding smoking cessation should be offered.

Quantification of Nicotine and Cotinine in Plasma, Saliva, and Urine by HPLC Method in Chewing Tobacco Users.

BACKGROUND: Nicotine acts as major alkaloid of all tobacco products including smokeless tobacco (SLT) forms. The mode of SLT consumption is in the form of chewing under the cheek or lip and induced biochemical alterations in the plasma, saliva, and urine. MATERIALS AND METHODS: The smokeless tobacco products like Raja or blue bull tobacco brands are widely consumed by human male volunteers under the age of 18-30 years for the period of 3 years consisting of 30g per day. The concentrations of nicotine and cotinine in samples of plasma, saliva, and urine are quantified by the method of HPLC. The remaining variables of plasma are evaluated by auto analyzer and spectrophotometric methods. RESULTS: The analysis of results presented that significant increase in the levels of nicotine and cotinine in plasma, saliva, and urine of chewing tobacco users. The lipid profile (Cholesterol, triglycerides, HDL-C, and LDL-C), liver marker enzymes (SGOT, SGPT, and ALP), kidney markers (Creatinine, urea, and uric acid), glucose, and the remaining variables are present within normal range observed in SLT users. The lipid peroxidation (LPO), nitric oxide (NO) (NO2 and NO3), protein carbonyls (PCO), and peroxynitrites (ONOO-) are reported to be higher levels in the plasma of experimental subjects in comparison with normal controls. The various brands of tobacco varieties (Raja, madhu chhap, hans chhap, miraj, badshah, blue bull, and swagat gold tobacco) are presented. CONCLUSION: The chewing tobacco users exhibited greater amounts of nicotine and cotinine are at risk of cardiovascular due to nicotine has cardiovascular effects, and oral cancer disease complications in the future for chronic consumption of smokeless tobacco products  due to the presence of carcinogens of tobacco-specific N-nitrosamines.

Genotoxic effects of tobacco use in residents of hilly areas and foot hills of Western Ghats, Southern India.

Smoking and smokeless tobacco consumption is a significant risk factor that provokes genetic alterations. The present investigation was to evaluate the biomarkers of genotoxicity including micronucleus (MN), chromosome aberrations (CA) and DNA strand breaks among tobacco consumers and control individuals residing in hilly areas of Western Ghats, Tamilnadu, South India. This study included 268 tobacco consumers with equal number of controls. The tobacco consumers were divided into Group I (<10 years of tobacco consumption with an age range from 15 to 35 years) and group II (>10 years consumption above 35 years of age). Chromosome aberration (CA) and comet assay were performed using blood and micronucleus assay from exfoliated buccal epithelial cells obtained from tobacco consumers and controls. Elevated levels of CA were found in group II (Chromatid type: 2.39 ± 1.13 and chromosome type: 1.44 ± 1.24) exposed subjects, high micronucleus and DNA damage (TL:4.48 ± 1.24 and TM:3.40 ± 1.58) levels were significantly (p < 0.05) observed in both smoking and smokeless tobacco consumers when comparison with group I and controls. This study also observed a lack of awareness among the tobacco consumers about the harmful health effects of tobacco. Tobacco consumption contributes to the significant alteration in genetic materials. In addition, a high rate of spontaneous abortion was also seen in the studied population.

Plasma metabolite profiling and chemometric analyses of tobacco snuff dippers and patients with oral cancer: Relationship between metabolic signatures.

BACKGROUND: Cancer of oral cavity is a seriously growing problem in many parts of the world. In Indian subcontinent, most of these cases have been attributed to the use of tobacco-related products. This study is focused on the identification of distinguishing metabolites of oral cancer in comparison with tobacco snuff dippers and healthy controls. METHODS: A total of 234 plasma samples including 62 healthy controls, 81 tobacco snuff dippers, and 91 oral cancer samples were analyzed using mass spectrometry. RESULTS: Twenty-nine of 3326 metabolites were found to distinguish among oral cancer, tobacco snuff dippers, and healthy controls using P-value ≤.001 and fold change ≥3. Prediction model was generated with an overall accuracy of 89.3%. Two metabolites, that is, stearyl alcohol and sucrose, can be used as predictive biomarkers showing progression of tobacco snuff dippers toward oral cancer. CONCLUSION: The unique metabolite profile gives evidence of a strong correlation between tobacco snuff dipping and oral cancer.

Assessing tobacco use in an African population: Serum and urine cotinine cut-offs from South Africa.

BACKGROUND: Cotinine, a nicotine metabolite, is used to measure tobacco use and exposure, but recommended cut-offs to differentiate tobacco users from those exposed through the environment range from 3 to 58 ng/ml in serum, and 2.5 to 550 ng/ml in urine. Cut-offs may differ by ethnicity, sex and age. As data from adults in Africa are scarce, our aim was to evaluate cut-offs for serum and urine cotinine that best predict self-reported tobacco use in South African adults. METHODS: Two datasets were explored: African-PREDICT (n = 941 black and white healthy young adults, 20-30 years, serum cotinine); and WHO SAGE Wave 2 (n = 604 adults, 18-102 years, urine cotinine). Population specific cut-offs (ROC analyses) were compared with published cut-offs and self-reported tobacco use. RESULTS: Overall, 19% (293 of 1545) reported current tobacco use. The following cotinine cut-offs showed the highest sensitivity and specificity: serum ≥15 ng/ml in black and white men, and white women; serum ≥10 ng/ml in black women; urine ≥300 ng/ml for black, mixed ancestry, and older adults (50-plus years); urine ≥500 ng/ml for younger adults (18-49 years). Specificity was lower for urine than for serum cotinine. CONCLUSION: Our study suggests that a serum cotinine level of ≥15 ng/ml and a urine cotinine level of ≥300 ng/ml best distinguish current tobacco users from non-users generally in the South African adult population.

Tobacco Use and Prevalence of Human Papillomavirus in Self-Collected Cervicovaginal Swabs Between 2009 and 2014.

OBJECTIVE: To evaluate relationships between an objective biomarker of current tobacco exposure and high-risk genital human papillomavirus (HPV) prevalence among adult women in the United States. METHODS: We performed a retrospective analysis of adult women (aged 18-59 years) using three consecutive 2-year cycles (2009-2014) from the cross-sectional National Health and Nutrition Examination Surveys. Women who provided self-collected cervicovaginal swabs and serum were included. Human papillomavirus genotyping was conducted on cervicovaginal samples with a Linear Array HPV assay. Cotinine, a major metabolite of nicotine, was assayed from serum to provide a biomarker of recent tobacco exposure. Participants were stratified into three levels of tobacco exposure (nonsmokers, secondhand smoke exposure, and smokers) based on serum cotinine concentration levels using previously published ethnic-specific cut points. Weighted percentages are provided to account for unequal selection probabilities among participants and adjustments for nonresponse. RESULTS: Among the 5,158 women analyzed, 2,778 were classified as nonsmokers (57.1%, 95% CI 54.5-59.6%), 1,109 classified as having secondhand smoke exposure (18.4%, 95% CI 16.5-20.3%), and 1,271 classified as smokers (24.6%, 95% CI 22.8-26.5%) using serum cotinine concentration levels. Prevalence of HPV infection differed between nicotine exposure groups (P<.001): 441 smokers (32.1%, 95% CI 29.6-34.7%), 322 women with secondhand smoke exposure (26.1%, 95% CI 22.7-29.7%), and 451 nonsmokers (15.1%, 95% CI 13.3-17.1%) had a high-risk genital HPV infection. Controlling for demographics and number of lifetime sexual partners, the risks compared with nonsmokers for infection with a high-risk HPV genotype for smokers (adjusted odds ratio [OR] 1.7, 95% CI 1.4-22) and secondhand smokers (adjusted OR 1.4, 95% CI 1.1-1.8) are similarly increased (P<.001). CONCLUSION: In this large cross-sectional, population-based study, we show a relationship between an objective biomarker of current tobacco use and genital HPV infection. Cigarette smoking and exposure to secondhand smoke are associated with increased odds of infection with high-risk genital HPV independent of lifetime number of sexual partners.

Biomarkers of Tobacco Exposure: Summary of an FDA-Sponsored Public Workshop.

Since 2009, the FDA Center for Tobacco Products (CTP) has had the authority to regulate the manufacturing, distribution, and marketing of tobacco products in order to reduce the death and disease caused by tobacco use. Biomarkers of exposure pertain to actual human exposure to chemicals arising from tobacco use and could play an important role across a number of FDA regulatory activities, including assessing new and modified-risk tobacco products and identifying and evaluating potential product standards. On August 3-4, 2015, FDA/CTP hosted a public workshop focused on biomarkers of exposure with participants from government, industry, academia, and other organizations. The workshop was divided into four sessions focused on: (i) approaches to evaluating and selecting biomarkers; (ii) biomarkers of exposure and relationship to disease risk; (iii) currently used biomarkers of exposure and biomarkers in development; and (iv) biomarkers of exposure and the assessment of smokeless tobacco and electronic nicotine delivery systems. This article synthesizes the main findings from the workshop and highlights research areas that could further strengthen the science around biomarkers of exposure and help determine their application in tobacco product regulation. Cancer Epidemiol Biomarkers Prev; 26(3); 291-302. ©2016 AACR.

Serum lipid profile in oral squamous cell carcinoma: alterations and association with some clinicopathological parameters and tobacco use.

Hypocholesterolemia has been observed in patients with cancers of various organs; however the potential role of alterations in serum lipid profile in oral cancer remains controversial. Hence, this study aimed to evaluate the serum lipid profile in oral squamous cell carcinoma (OSCC) and its prognostic significance. Ninety untreated OSCC patients, who reported to the craniofacial unit for treatment between 2011 and 2014, were identified to obtain clinicopathological data and preoperative blood investigations including lipid profile. The fasting blood lipid profile, including total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), and low density lipoprotein (LDL), was evaluated using a fully automated biochemistry analyser. Data were analyzed statistically using the Student's t-test, analysis of variance, and post hoc tests. Statistically significant decreases in serum TC, HDL, and LDL levels were observed in OSCC patients as compared to healthy controls (P<0.05). There was no statistically significant difference in mean lipid profile values in terms of stage, grade, or lymph node metastasis. This study identified changes in lipid profiles in OSCC. The results suggest that during the development and progression of OSCC, levels of serum lipids are decreased. A review of the literature confirmed that OSCC patients exhibit aberrant serum lipid patterns.

Serum Telomerase Levels and COPD Exacerbations.

BACKGROUND: To our knowledge, there is no study on the level of telomerase in subjects with COPD during an exacerbation period. The objective of this work was to compare lipid peroxidation, telomerase, zinc (Zn), copper (Cu), and malondialdehyde levels in asymptomatic smokers and subjects with COPD exacerbation. METHODS: The study included 45 subjects with COPD exacerbation and 42 healthy subjects with tobacco use as a control group. Samples were taken from blood and after the serum levels of telomerase malondialdehyde, Cu, and Zn were measured, the values were compared between the 2 groups. Tests for respiratory function were performed, and sedimentation and C-reactive protein levels were measured. RESULTS: The COPD exacerbation group had a significantly (P < .001) lower Cu/Zn ratio compared with the control group; however, the COPD exacerbation group had significantly (P < .001) higher levels of telomerase malondialdehyde, Cu, and Zn compared with the control group. Malondialdehyde, Cu, Zn, and FEV1 were found negatively correlated in the COPD exacerbation and control groups (P < .001). The COPD exacerbation group had lower FEV1 and FVC compared with the control group. The COPD exacerbation group had significantly (P < .001) higher levels of C-reactive protein and a higher blood cell sedimentation rate compared with the control group. CONCLUSIONS: The reason why the subjects had a reduced Cu/Zn ratio and increased levels of telomerase, Cu, and Zn is likely to be oxidative stress, which can be defined as an increased exposure to oxidants and/or decreased antioxidant capacities It is obvious from this study that lung oxidant-antioxidant balance is abnormal in subjects with COPD exacerbation and also that the increased level of telomerase is associated with this imbalance.

No association of multiple sclerosis activity and progression with EBV or tobacco use in BENEFIT.

OBJECTIVE: To evaluate whether Epstein-Barr virus (EBV) immunoglobulin G (IgG) antibody levels or tobacco use were associated with conversion to multiple sclerosis (MS) or MS progression/activity in patients presenting with clinically isolated syndrome (CIS). METHODS: In this prospective, longitudinal study, we measured EBV IgG antibody and cotinine (biomarker of tobacco use) levels at up to 4 time points (baseline, months 6, 12, and 24) among 468 participants with CIS enrolled in the BENEFIT (Betaferon/Betaseron in Newly Emerging Multiple Sclerosis for Initial Treatment) clinical trial. Outcomes included time to conversion to clinically definite or McDonald MS, number of relapses, Expanded Disability Status Scale (EDSS) changes, brain and T2 lesion volume changes, and number of new active lesions over 5 years. Analyses were adjusted for age, sex, treatment allocation, baseline serum 25-hydroxyvitamin D level, number of T2 lesions, body mass index, EDSS, steroid treatment, and CIS onset type. RESULTS: We found no associations between any EBV IgG antibody or cotinine levels with conversion from CIS to MS or MS progression as measured by EDSS or activity clinically or on MRI. The relative risk of conversion from CIS to clinically definite MS was 1.14 (95% confidence interval 0.76-1.72) for the highest vs the lowest quintile of EBNA-1 IgG levels, and 0.96 (95% confidence interval 0.71-1.31) for cotinine levels >25 ng/mL vs <10. CONCLUSIONS: Neither increased levels of EBV IgG antibodies, including against EBNA-1, nor elevated cotinine levels indicative of tobacco use, were associated with an increased risk of CIS conversion to MS, or MS activity or progression over a 5-year follow-up.

Analysis of salivary secretor status in patients with oral submucous fibrosis: a case-control study.

AIM: Many individuals have various tobacco-related habits, yet only some develop clinical manifestation of lesions. This raises the question of whether there any inherent or host risk factors involved in the pathogenesis which need to be further investigated. The aim of the present study was to analyze the ABO antigen, secretor status, and blood groups of patients. METHODS: The study consisted of 99 participants, with 33 patients allocated to three groups: (a) patients with a tobacco-related habit and oral submucous fibrosis (OSF); (b) patients with a tobacco-related habit, but no lesions; and (c) healthy controls. A total of 1 mL unstimulated saliva was collected in a sterile test tube, and the Wiener agglutination test was performed to analyze the ABO antigen in all three groups. RESULTS: All of the OSF patients were non-secretors, whereas 84.8% were non-secretors in the group of individuals with habits as compared to 15.2% in the healthy group. A statistically-significant difference was observed between the OSF and healthy groups. The patients in the OSF group were predominantly blood-group A, followed by groups O, B, and AB. CONCLUSION: There is a correlation between salivary secretor status and the development of OSF. Thus, non-secretors are at greater risk of and more prone to the development of oral lesions. Blood-groups A and O predominate over the B and AB blood groups.

Tobacco exposure by various modes may alter proinflammatory (IL-12) and anti-inflammatory (IL-10) levels and affects the survival of prostate carcinoma patients: an explorative study in North Indian population.

OBJECTIVE: Inflammation is an important hallmark of all cancers and net inflammatory response is determined by a delicate balance between pro- and anti-inflammatory cytokines, which may be affected by tobacco exposure, so the present study was designed to explore the effect of various modes of tobacco exposure on interleukin-12 (IL-12) and interleukin-10 (IL-10) inflammatory cytokine levels and survival in prostate carcinoma (PCa) patients. METHODS: 285 cancer patients and equal controls with 94 BPH (benign prostatic hyperplasia) were recruited; baseline levels of serum IL-12 and IL-10 were measured and analyzed in various tobacco exposed groups by appropriate statistical tool. Five-year survivals of patients were analyzed by Log-rank (Mantel-Cox) test (graph pad version 5). RESULTS: The expression of serum proinflammatory (IL-12) and anti-inflammatory (IL-10) cytokines was correlated with tobacco exposed group as smokers, chewers, and alcohol users have shown significantly higher levels (P < 0.001) with significantly lower median survivals (27.1 months, standard error = 2.86, and 95% CI: 21.4-32.62); than nonusers. Stages III and IV of tobacco addicted patients have also shown significantly increased levels of IL-12 and IL-10. CONCLUSIONS: IL-12 and IL-10 seem to be affected by various modes of tobacco exposure and inflammation also affects median survival of cancer patients.

Validation of self-reported smokeless tobacco use by measurement of serum cotinine concentration among US adults.

Although investigators have assessed the relationship between self-reported cigarette smoking and biomarker levels, the validity of self-reported information on smokeless tobacco (SLT) use is uncertain. We used aggregated data from the 2003-2004, 2005-2006, 2007-2008, and 2009-2010 administrations of the National Health and Nutrition Examination Survey (NHANES) to compare self-reported SLT use with serum concentrations of cotinine, a metabolite of nicotine, among US adults aged ≥18 years. Receiver operating characteristic analysis was used to determine the optimal serum cotinine cutpoint for discriminating SLT users from nonusers of tobacco, and concordance analysis was used to compare self-reported SLT use with cotinine levels. Among the 30,298 adult respondents who completed the NHANES during 2003-2010, 418 reported having exclusively used SLT and no other type of tobacco (cigarettes, cigars, or pipes) during the past 5 days, while 23,457 reported not using any tobacco. The optimal cotinine cutpoint for discriminating SLT users from non-tobacco users was 3.0 ng/mL (sensitivity=97.0%, specificity=93.0%), which was comparable to a revised cutpoint recommended for identifying adult cigarette smokers. Concordance with cotinine was 96.4% and 93.7% for self-reported SLT use and tobacco nonuse, respectively. These findings indicate that self-reported SLT use among adults correlates highly with serum cotinine levels and that the optimal cutpoint for minimizing misclassification of self-reported use is a serum cotinine concentration of 3.0 ng/mL.

Accuracy of self-reported tobacco use status among hematopoietic SCT patients.

Tobacco use is a risk factor for adverse outcomes among hematopoietic SCT (HSCT) patients. Accurate identification of tobacco use offers a vital opportunity to treat this risk factor. The current study compared self-reported tobacco use status with serum cotinine levels among HSCT patients at the time of pre-transplant evaluation. A total of 444 participants completed both assessments; 44 participants (9.9%) were classified as tobacco users with serum cotinine concentrations >2 ng/mL vs 29 with self-reporting. Sensitivity and specificity of self-reporting were 65.9% and 100%, respectively. Positive and negative predictive values were 100% and 96.4%, respectively. Comparing tobacco use documented in the medical record with cotinine, sensitivity and specificity were 51.2% and 99.2%, respectively. Factors associated with tobacco use were male gender, single relationship status, less education and younger age. In summary, utilization of serum cotinine assays increased detection of tobacco use cases >50% over self-reporting. Results are discussed in the context of translation to care, including clinical and ethical implications, and current tobacco use treatment guidelines. When cotinine assays are not available, self-reporting of any tobacco use in the year before HSCT should trigger brief advice and cessation or relapse prevention counseling.

Study of antioxidant enzymes superoxide dismutase and glutathione peroxidase levels in tobacco chewers and smokers: a pilot study.

CONTEXT: Free radical associated damages play a major role in causation of cancer in tobacco habituates. The free radicals released by tobacco bring about alterations in antioxidant levels in humans and these free radical associated damages are reflected through antioxidant enzyme activities in blood. AIMS: To evaluate the effects of tobacco consumption on the erythrocyte Antioxidant enzymes-Superoxide dismutase (SOD) and Glutathione Peroxidase (GPx) as they act as first line of defense antioxidants. MATERIALS AND METHODS: A case control study comprising of 4 study groups of healthy controls (n = 27), smokers (n = 27), tobacco chewers (n = 30) and combination habit (n = 22) were included. Erythrocyte SOD and GPx enzyme activities were measured by spectrophotometry. The results were statistically analyzed using one way-Anova and Mann Whitney test. RESULTS: The data analysis revealed an alteration in mean SOD levels as it was decreased in cases compared to control group where as mean GPx was seen to be increased in cases compared to controls. When SOD and GPx were compared for the frequency and duration of habit, GPx showed a significant decrease in chewers with increase in frequency and duration of habit. CONCLUSIONS: The present study gave us an insight about the relationship between antioxidant enzyme activity, oxidative stress and tobacco. The altered antioxidant enzyme levels observed in this study will act as a predictor for pre potentially malignant lesions. Therefore an early intervention of tobacco habit and its related oxidative stress would prevent the development of tobacco induced lesions.

Accuracy of self-reported tobacco use in newly diagnosed cancer patients.

PURPOSE: Accurate identification of tobacco use is critical to implement evidence-based cessation treatments in cancer patients. The purpose of this study is to evaluate the accuracy of self-reported tobacco use in newly diagnosed cancer patients. METHODS: Tobacco use questionnaires and blood samples were collected from 233 newly diagnosed cancer patients (77 lung, 77 breast, and 79 prostate cancer). Blood was analyzed for cotinine levels using a commercially available enzyme-linked immunosorbent assay. Patients with cotinine measurements exceeding 10 ng/mL were categorized as current smokers. Smoking status based upon cotinine levels was contrasted with self-report in current smokers, recent quitters (1 or less year since quit), non-recent quitters (>1 year since quit), and never smokers. Multivariate analyses were used to identify potential predictors of discordance between self-reported and biochemically confirmed smoking. RESULTS: Cotinine confirmed 100 % accuracy in self-reporting of current and never smokers. Discordance in cotinine and smoking status was observed in 26 patients (15.0 %) reporting former tobacco use. Discordance in self-reported smoking was 12 times higher in recent (35.4 %) as compared with non-recent quitters (2.8 %). Combining disease site, pack-year history, and employment status predicted misrepresentation of tobacco use in 82.4 % of recent quitters. CONCLUSIONS: Self-reported tobacco use may not accurately assess smoking status in newly diagnosed cancer patients. Patients who claim to have recently stopped smoking within the year prior to a cancer diagnosis and lung cancer patients may have a higher propensity to misrepresent tobacco use and may benefit from biochemical confirmation.