Molecular profile of driver genes in lung adenocarcinomas of Brazilian patients who have never smoked: implications for targeted therapies.

INTRODUCTION: Lung cancer in never-smoker (LCINS) patients accounts for 20% of lung cancer cases, and its biology remains poorly understood, particularly in genetically admixed populations. We elucidated the molecular profile of driver genes in Brazilian LCINS. METHODS: The mutational and gene fusion status of 119 lung adenocarcinomas from self-reported never-smoker patients, was assessed using targeted sequencing (NGS), nCounter, and immunohistochemistry. A panel of 46 ancestry-informative markers determined patients' genetic ancestry. RESULTS: The most frequently mutated gene was EGFR (49.6%), followed by TP53 (39.5%), ALK (12.6%), ERBB2 (7.6%), KRAS (5.9%), PIK3CA (1.7%), and less than 1% alterations in RET, NTRK1, MET∆ex14, PDGFRA, and BRAF. Except for TP53 and PIK3CA, all other alterations were mutually exclusive. Genetic ancestry analysis revealed a predominance of European (71.1%), and a higher African ancestry was associated with TP53 mutations. CONCLUSION: Brazilian LCINS exhibited a similar molecular profile to other populations, except the increased ALK and TP53 alterations. Importantly, 73% of these patients have actionable alterations that are suitable for targeted treatments.

Histoplasmosis bucal / Oral histoplasmosis

Introducción: La histoplasmosis es una micosis causada por Histoplasma capsulatum. Este hongo se encuentra en las excretas de algunos animales (murciélagos y aves) y su reservorio es el suelo. Es una enfermedad endémica en el continente americano. La inhalación de esporas causa infección pulmonar primaria que puede diseminarse. Objetivo: Describir un caso de histoplasmosis bucal en un paciente seronegativo al virus de inmunodeficiencia humana. Caso clínico: Paciente diabético, fumador y alcohólico con cuadro febril de varios meses acompañado de manifestaciones respiratorias. Además, se constataron úlceras en encías y lengua, lesiones nodulares en mucosas del carrillo, fondo del surco vestibular y reborde alveolar. Se informó anemia, leucopenia y aumento de la velocidad de sedimentación globular. El diagnóstico se confirmó mediante citología e histopatología. La terapéutica empleada fue itraconazol 200 mg tres veces al día, luego 200 mg dos veces al día por dos meses y una tableta diaria hasta seis meses después del segundo mes. El paciente se encuentra asintomático y las lesiones bucales desaparecieron. Conclusiones: La histoplasmosis se diagnostica fundamentalmente por la epidemiología, la clínica y el cultivo. Los estudios citopatológicos e histopatológicos de la úlcera confirman el diagnóstico. Este caso representa una forma no habitual de presentación de la enfermedad, que aunque no se sospecha usualmente, puede ocurrir. Este trabajo es una alerta a los estomatólogos, maxilofaciales y a todo aquel personal de la salud que asiste a pacientes con manifestaciones sistémicas(AU)

Introduction: Histoplasmosis is a mycosis caused by Histoplasma capsulatum. This fungus is found in the feces of some animals (bats and birds) and its reservoir is the soil. Histoplasmosis is an endemic disease in the American continent. Inhalation of spores causes primary pulmonary infection, which may in turn be disseminated. Objective: Describe a case of oral histoplasmosis in a patient seronegative to the human immunodeficiency virus. Clinical case: A case is presented of a diabetic, smoker and alcoholic patient with fever of several months' evolution and respiratory manifestations. Examination revealed ulcers in the patient's gums and tongue, as well as nodular lesions in the mouth mucosa, the bottom of the vestibular sulcus and the alveolar ridge. Laboratory testing found anemia, leucopenia and an increased globular sedimentation rate. The diagnosis was confirmed by cytology and histopathology. The treatment indicated was 200 mg itraconazole three times a day and then 200 mg twice a day for two months, and a daily tablet for six months after the second month. The patient is now asymptomatic and the oral lesions have disappeared. Conclusions: Histoplasmosis is mainly diagnosed by epidemiological testing, clinical examination and culture. Cytopathologic and histopathological analysis of the ulcer confirm the diagnosis. The case illustrates an infrequent form of presentation of the disease, not usually suspected but possible. The study is a warning to dentists, maxillofacial specialists and all the health personnel caring for patients with systemic manifestations(AU)

Pesticides residues in tobacco smoke: risk assessment study.

Pesticides are not only used on food but also on non-food crops, such as tobacco, to control a range of unwanted animal, plant, and microbial, fungal pests. The residue levels in tobacco leaves are expected to decline up to harvest, during drying, and when the leaves are further processed. Additional pesticides may also be applied to the finished product and residue levels may remain present even when the tobacco is burned. Human exposure to pesticide residues on tobacco occurs when residues remaining in cigarette smoke are inhaled. Based on this assumption, the objectives of this research were (i) to determine the level of pesticides residues in harvested tobacco leaves and (ii) to assess the risk of human exposure to these residues in tobacco smoke. Pesticide residues were detected in all analysed tobacco samples. These detected residues represent ten different active ingredients (AI), three of these AIs (thiodicarb, alachlor, and endosulfan) are no longer allowed in Europe. A 54.7% of these residues were quantifiable. Furthermore, it was found that with the use of solid-phase extraction sorbent (SPE) as adsorbent and n-hexane as solvent, higher recoveries of the pesticide residues in the tobacco smoke from the amount spiked can be obtained. It was also found that cigarette filters help to reduce the intake of residues of pesticides that may be present in cigarettes. Finally, the study concluded that both active smoking and passive smoking populations are exposed to pesticide residues in the tobacco smoke.

Lung cancer in never smokers: The role of different risk factors other than tobacco smoking.

Lung cancer (LC), the leading cause of cancer-related deaths worldwide, is a complex and highly heterogeneous disease. Additional to its biological complexity, LC patients are often confronted with a high degree of stigma, mostly from the association of the disease with tobacco. Nonetheless, a proportion of LC patients are never-smokers, a population which we are beginning to comprehensively explore. Several risk factors have been linked to LC in never-smokers. Studies have consistently shown that radon exposure and domestic fuel smoke increase LC risk. Additionally, infections such as Mycobacterium tuberculosis, and Human Papilloma Virus are also risk factors. Other less conclusive associations include inflammatory diseases such as asthma and sarcoidosis. Moreover, we are now aware that molecular characteristics of LC vary widely according to smoking history, with important therapeutic implications. This review comprehensively assesses the current knowledge in terms of risk factors and disease characteristics in the never-smoker lung cancer population.

Petiveria alliacea, a plant used in Afro-Brazilian smoke rituals, triggers pulmonary inflammation in rats

Abstract Petiveria alliacea L., Phytolaccaceae, a plant used in Afro-Brazilian religious smoke rituals is reported to have "harmonic properties" (anxiolytic effect) by ethnobotanical survey. In the present work, we analyzed the chemical composition of volatiles produced by leaves of P. alliacea, using headspace gas chromatography/mass spectrometry and its potential anxiolytic and toxic effects in smoke-exposed rats. Locomotor activity and anxiety-like behavior were allocated into groups, according to substance administration: acute (locomotor activity) or chronic (anxiety-like behavior) burning charcoal or to smoke from P. alliacea. Inflammatory cell counts in the bronchoalveolar lavage and morphometric analysis in airway were assessed. Animals exposed to P. alliacea smoke had no locomotor activity or elevated plus maze open arm exploration impairment, while lungs had lower number of macrophages in bronchoalveolar fluid and an increased number of mononuclear and polymorphonuclear cells in the peribronchovascular region. Chemical analysis of plant material allowed the identification of dimethylsulfide (18.7%), diethylsulfide (33.4%) and nerolidol (25.8%) as main volatile compounds. Taken together, prolonged exposure to P. alliacea smoke does not induce anxiolytic effects, but histological analyses indicate a possible pulmonary inflammatory response.

Aneurysmal Subarachnoid Hemorrhage Associated with Small Aneurysms in Smokers and Women: A Retrospective Analysis.

BACKGROUND: Previous studies have shown low rupture rates for small aneurysms (<10 mm), suggesting that the risk of treatment could exceed the benefits. However, evidence has changed, showing crescent rates of aneurysmal subarachnoid hemorrhage (aSAH) associated with small aneurysms. We report trends in size, localization, clinical characteristics, and outcomes of intracranial aneurysms (IAs). METHODS: In this retrospective study, a total of 200 clinical histories of patients diagnosed with IAs over an 8-year period were analyzed. Variables considered included age, sex, tobacco consumption, morphological characteristics of the aneurysm, complications, vasospasm, and mortality. Qualitative variables were assessed by measurements of absolute and relative frequency. Smoking behavior, aneurysm size, and aneurysm rupture (AR) were compared using 1-way analysis of variance. Categorical variables were analyzed using Pearson's χ2 test. RESULTS: The average age at presentation was 58 years. The average size of ruptured aneurysms in the general group was 2.5-7.5 mm, and AR was most common in women (76%) and in patients age 50-60 years (33%). The rate of vasospasm was 19%, and mortality was 37%. Smokers composed 32% of the cohort. Heavy smokers had a 57% rate of aSAH, with an average size of rupture of 5 mm. The most common location of aneurysms and AR was the AComA (33%). CONCLUSIONS: Our results suggest increasing AR rates in aneurysms smaller than 10 mm. This trend is seen especially in individuals with heavy tobacco consumption and in women of perimenopausal age. Our findings show a tendency of AR in accordance with previous results and are expected to serve as basis for further research on aneurysm management.

El tabaco a la luz de la historia y la medicina / The tobacco in the light of history and medicine

Resumen: Se relata la admirable trayectoria del tabaco desde su primer encuentro con el hombre europeo el 15 de octubre de 1492 hasta la época nuestra. Dicha planta se conoció en Europa gracias a publicaciones del médico sevillano Nicolás Monardes (1574), a las relaciones de fray Andrés Thevet (1575) y al célebre tratado botánico de Charles de l' Écluse (1605). El botánico sueco Karl von Linneo incluyó la planta del tabaco en la familia de las solanáceas y se eliminaron de este grupo otras plantas que quedaban entremezcladas con esta. Su nombre botánico (Nicotiana tabacum) deriva del apellido del embajador francés en Portugal, Jean Nicot de Villemain, quien en 1560 la hizo llegar a la reina madre de Francia Catalina de Médicis. El uso del tabaco se difundió rápidamente por toda Europa, en donde se volvió común en el siglo XVII. Hacia fines del siglo XVIII en la Nueva España, además de los puros, ya se confeccionaban los cigarrillos que se vendían en cajetillas de diferente contenido y precio. La confección de las variadas formas de presentación del tabaco, realizadas en las fábricas tabacaleras de la capital novohispana y de varias ciudades de provincia, originó en 1796 la creación de las primeras guarderías infantiles para los hijos de quienes trabajaban en ellas. Esto gracias a la feliz iniciativa del entonces virrey Marqués de Branciforte. Pero contrariamente a las previsiones del padre Clavijero S.J. y de la señora Calderón de la Barca, esposa del primer representante diplomático español ante el gobierno de la República Mexicana, el uso del tabaco, con el pasar del tiempo, lejos de menguar ha ido aumentando en todas las clase sociales. Y ahora, más que los hombres, fuman las mujeres.

Abstract: Super trajectory is reported of tobacco from his first meeting with the European man October 15, 1492. This plant was known in Europe by the publications of the Sevillan physician Nicolas Monardes (1574), the relations of friar Andrés Thevet (1575) and the famous botanical treatise of Charles de l'Écluse (1605). The Swedish botanist Karl Linnaeus inclused tobacco plant in the family Solanaceae and deleted from this group other plants that were intermixed with it. Its botanical name (Nicotiana tabacum) derived from the surname of the French ambassador to Portugal, Jean Nicot of Villemain, who in 1560 sent it to the Queen Mother of France Cathérine de Medicis. The use of snuff quickly spread throughout Europe, were it became common in the seventeenth century. By the late eighteenth century in New Spain, in addition to cigars, cigarettes and due in packs of different content the tobacco is concocted and price. The preparation of the different presentations of snuff, tobacco made in factories in the capital and several provincial cities, originated in 1796 the creation of the first kindergartens for the children of those working in them. This thanks to the successful initiative of then viceroy Marquis of Branciforte. But contrary to the forecasts of Father F. J. Clavijero and Mrs. F. Calderón de la Barca, wife of the first Spanish diplomatic representative to the government of Mexico, the use of tobacco, with the passage of time, far from waning has been increasing in every social class. And now, more than men, women are smokers.

[The tobacco in the light of history and medicine]. / El tabaco a la luz de la historia y la medicina.

Super trajectory is reported of tobacco from his first meeting with the European man October 15, 1492. This plant was known in Europe by the publications of the Sevillan physician Nicolas Monardes (1574), the relations of friar Andrés Thevet (1575) and the famous botanical treatise of Charles de l'Écluse (1605). The Swedish botanist Karl Linnaeus inclused tobacco plant in the family Solanaceae and deleted from this group other plants that were intermixed with it. Its botanical name (Nicotiana tabacum) derived from the surname of the French ambassador to Portugal, Jean Nicot of Villemain, who in 1560 sent it to the Queen Mother of France Cathérine de Medicis. The use of snuff quickly spread throughout Europe, were it became common in the seventeenth century. By the late eighteenth century in New Spain, in addition to cigars, cigarettes and due in packs of different content the tobacco is concocted and price. The preparation of the different presentations of snuff, tobacco made in factories in the capital and several provincial cities, originated in 1796 the creation of the first kindergartens for the children of those working in them. This thanks to the successful initiative of then viceroy Marquis of Branciforte. But contrary to the forecasts of Father F. J. Clavijero and Mrs. F. Calderón de la Barca, wife of the first Spanish diplomatic representative to the government of Mexico, the use of tobacco, with the passage of time, far from waning has been increasing in every social class. And now, more than men, women are smokers.

Múltiplas definições de ser fumante e diagnóstico de tabagismo: uma revisão sistemática / Multiple definitions and diagnosis of smoking: a systematic review

Esta é uma revisão sistemática de artigos que trataram sobre as definições de ser fumante, dependente químico de cigarro e tabagista e os elementos associados a cada definição. A busca em bases eletrônicas de dados foi realizada no mês de abril de 2013, no PUBMED, MEDLINE, LILACS e PSYCINFO. Os descritores foram: smoker OR tobacco addicted OR nicotine addicted OR tobacco user OR nicotine user, que deveriam aparecer no título dos artigos. Foram selecionados 17 artigos do total de 235. Destes, foram encontradas 16 definições diferentes para o que é ser fumante, sendo que apenas dois artigos apresentavam uma definição comum para o termo. Conclui-se que não há uma definição única de ser fumante: há diversos fatores envolvidos na identificação do tabagista. Porém, a formulação de definições mais consistentes e de instrumentos validados de avaliação são importantes para a melhor qualidade de intervenções e pesquisas na área do tabagismo.(AU)

This study aims to conduct a systematic review of articles that dealt with the definitions of being a smoker and cigarette addict and the elements associated with each setting. The search in electronic databases was conducted in April 2013, on PUBMED, MEDLINE, LILACS and PSYCINFO. The descriptors were: smoker OR tobacco addicted OR nicotine addicted OR tobacco user OR nicotine user, which should appear on the articles titles. Out of 235 references, 17 articles were selected. Of these, there were 16 different definitions for what is a smoker, and only two articles had a common definition for the term. There isn´t a general definition of being a smoker: there are several factors involved in the smoker's identification. However, the formulation of more consistent definitions and validated assessment instruments are important for the best quality of interventions and research in the smoking area.(AU)

Múltiplas definições de ser fumante e diagnóstico de tabagismo: uma revisão sistemática / Multiple definitions and diagnosis of smoking: a systematic review

This study aims to conduct a systematic review of articles that dealt with the definitions of being a smoker and cigarette addict and the elements associated with each setting. The searchin electronic databases was conducted in April 2013, on PUBMED, MEDLINE, LILACS and PSYCINFO. The descriptors were: smoker OR tobacco addicted OR nicotine addicted OR tobacco user OR nicotine user, which should appear on the articles titles. Out of 235 references, 17 articles were selected. Of these, there were 16 different definitions for what is a smoker, and only two articles had a common definition for the term. There isn´t a general definition of being a smoker: there are several factors involved in the smoker’s identification. However, the formulation of more consistent definitions and validated assessment instruments are important for the best quality of interventions and research in the smoking area(AU)

Esta é uma revisão sistemática de artigos que trataram sobre as definições de ser fumante, dependente químico de cigarro e tabagista e os elementos associados a cada definição. A busca em bases eletrônicas de dados foi realizada no mês de abril de 2013, no PUBMED,MEDLINE, LILACS e PSYCINFO. Os descritores foram: smoker OR tobacco addicted OR nicotine addicted OR tobacco user OR nicotine user, que deveriam aparecer no título dos artigos.Foram selecionados 17 artigos do total de 235. Destes, foram encontradas 16 definições diferentes para o que é ser fumante, sendo que apenas dois artigos apresentavam uma definição comumpara o termo. Conclui-se que não há uma definição única de ser fumante: há diversos fatores envolvidos na identificação do tabagista. Porém, a formulação de definições mais consistentes e de instrumentos validados de avaliação são importantes para a melhor qualidade de intervenções e pesquisas na área do tabagismo(AU)

Immunoexpression of p53 in Oral Squamous Cell Carcinoma and Oral Dysplastic Lesions in Patients with the Habit of Reverse Smoke / Inmunoexpresión de p53 en Carcinoma Bucal Escamo Celular y Displasias Orales en pacientes con el Hábito de Fumar Invertido

Molecular biological markers have been suggested to be of value in the diagnosis and prognostic evaluation of precancerous lesions. The purpose of the current study was to investigate the expression of p53 protein in normal oral mucosa, oral dysplastic lesions (DL), and oral squamous cell carcinoma (SCC), comparing patients with the habit of reverse smoking and conventional smokers. The patients were subjected to incisional biopsy and the soft tissue specimens were routinely fixed in 10% formalin and processed in the laboratory. Immunohistochemical technique was performed using the avidin-biotin-peroxidase protocol. The 102 patients included 42 reverse smokers and 60 conventional smokers. There were 79 cases of mild, 15 of moderate, and 3 of severe epithelial dysplasia. Five microinvasive oral SCC included one male and four females. The clinical characteristics of microinvasive tumors included patches, plaques or erosions; 100% showed positive nuclear staining for p53. It was found a significant association of p53 expression and exposure of reverse smoking among microinvasive oral SCC and oral DL patients in the population studied.

Marcadores biológicos moleculares se han sugerido para ser de valor en el diagnóstico y evaluación pronóstica de lesiones precancerosas. El propósito del presente estudio fue investigar la expresión de la proteína p53 en mucosa oral normal, lesiones displásicas orales (LD), y en el carcinoma oral de células escamosas (COCC), comparando pacientes con el hábito de fumar convencional y fumar invertido. Los pacientes fueron sometidos a biopsia por incisión y los especímenes de tejidos blandos fueron fijados en formalina al 10% y se procesaron en el laboratorio. La técnica inmunohistoquímica se realizó utilizando el protocolo de avidina-biotina-peroxidasa. De los 102 pacientes incluidos, 42 fueron fumadores invertidos y 60 fumadores convencionales. Hubo 79 casos de displasia epitelial leve, 15 moderada, y 3 severa. Cinco casos de COCC microinvasivo incluyeron un hombre y cuatro mujeres. Las características clínicas de los tumores microinvasores incluyen parches, placas o erosiones; el 100% mostró tinción nuclear positiva para p53. Se encontró una asociación significativa de la expresión de p53 y la exposición de los fumadores invertidos entre pacientes con COCC microinvasivo y DL en la población estudiada.

Melanosis bucal asociada a tabaquismo inhalado en un grupo de venezolanos: estudio clínico transversal / Oral melanosis related to smoking in a group of venezuelans: cross sectional clinical study

El objetivo del presente trabajo fue determinar la prevalencia de melanosis asociada a tabaquismo en un grupo de individuos venezolanos. Metodología: Fueron evaluados clínicamente 50 individuos fumadores (grupo fumadores) (GF) y 50 individuos no fumadores (grupo control) (GC) (n=100) que acudían a consulta odontológica de rutina. Después de firmado el correspondiente consentimiento informado, los datos epidemiológicos fueron recolectados así como la presencia de melanosis en la mucosa bucal. La prevalencia y el riesgo de melanosis por tabaquismo fueron determinados mediante SPSS versión 17.0 Resultados: El GF estuvo constituido por 18 mujeres (36%) y 32 hombres (64%) con una media de edad de 32.98±13.56 años. El GC fue conformado por 30 mujeres (60%) y 20 hombres (40%) con una media de edad de 34.4±13.88 años. 20 individuos del GF mostraron melanosis en la mucosa bucal (40%), principalmente localizadas en la encía y sólo 1 individuo (2%) del GC presentó pigmentaciones generalizadas. La presencia de melanosis fue estadísticamente mayor en el GF (p=0.0001), así como el riesgo a tener la entidad cuando se fuma (OR=32.67; 95%IC 26.36 a 38.97). Conclusiones: La melanosis o pigmentaciones bucales, principalmente de la encía, fueron una lesión frecuente observada en los individuos fumadores estudiados. Una persona con tabaquismo tiene un riesgo 30 veces mayor que una persona no fumadora de desarrollar melanosis de la mucosa bucal especialmente en la encía de la zona anterior

The aim of this study was to determine the prevalence of melanosis associated with smoking in a group of Venezuelans. Methodology: 50 smokers (smoking group) (GF) and 50 nonsmokers (control group) (GC) (n=100) were clinically evaluated during a routine dental appointment. After signing the corresponding informed consent, epidemiological data and the presence of melanosis in the oral mucosa were collected. The data were statistically analyzed by SPSS version 11.0. The prevalence and risk of melanosis by smoking were determined. Results: The GF was formed by 18 women (36%) and 32 men (64%) with a mean age of 32.98 ± 13.56 years. The GC was formed by 30 women (60%) and 20 men (40%) with a mean age of 34.4 ± 13.88 years. GF 20 individuals showed melanosis of the oral mucosa (40%), mainly located in the gums and only 1 patient had pigmentation GC (2%) of generalized type. The presence of melanosis was statistically higher in the GF (p = 0.0001), and the risk of getting that condition when smoked (OR = 32.67, 95% CI 26.36 to 38.97). Conclusions: The oral melanosis or pigmentation, especially the gum, was a common injury in smokers studied. A person who smokes has a risk 30 times greater than a nonsmoker to develop melanosis of the oral mucosa especially in the anterior gingiva

Non-small cell lung cancer in never smokers: a clinical entity to be identified

OBJECTIVES: It has been recognized that patients with non-small cell lung cancer who are lifelong never-smokers constitute a distinct clinical entity. The aim of this study was to assess clinical risk factors for survival among neversmokers with non-small cell lung cancer. METHODS: All consecutive non-small cell lung cancer patients diagnosed (n = 285) between May 2005 and May 2009 were included. The clinical characteristics of never-smokers and ever-smokers (former and current) were compared using chi-squared or Student's t tests. Survival curves were calculated using the Kaplan-Meier method, and log-rank tests were used for survival comparisons. A Cox proportional hazards regression analysis was evaluated by adjusting for age (continuous variable), gender (female vs. male), smoking status (never- vs. ever-smoker), the Karnofsky Performance Status Scale (continuous variable), histological type (adenocarcinoma vs. non-adenocarcinoma), AJCC staging (early vs. advanced staging), and treatment (chemotherapy and/or radiotherapy vs. the best treatment support). RESULTS: Of the 285 non-small cell lung cancer patients, 56 patients were never-smokers. Univariate analyses indicated that the never-smoker patients were more likely to be female (68 percent vs. 32 percent) and have adenocarcinoma (70 percent vs. 51 percent). Overall median survival was 15.7 months (95 percent CI: 13.2 to 18.2). The never-smoker patients had a better survival rate than their counterpart, the ever-smokers. Never-smoker status, higher Karnofsky Performance Status, early staging, and treatment were independent and favorable prognostic factors for survival after adjusting for age, gender, and adenocarcinoma in multivariate analysis. CONCLUSIONS: Epidemiological differences exist between never- and ever-smokers with lung cancer. Overall survival among never-smokers was found to be higher and independent of gender and histological type.

Pais fumantes: o que pensam seus filhos? / Smoking parents: what do their children think?

A presente pesquisa¹ foi realizada com a finalidade de alcançar uma melhor comprensão da dinâmica familiar em lares de pais fumantes. O foco está no relacionamento entre pais fumantes e seus filhos e o ponto central é o fato do tabagismo passivo ser a terceira maior causa de morte evitável no mundo. Fizeram parte do estudo 41 crianças e 22 adultos. A opção metodológica é de corte quali-quantitativo, sendo utilizada a técnica do Discurso do Sujeito Coletivo-DSC. Na pesquisa com as crianças, ressaltou-se que pais fumantes poderiam levar os filhos a fumar; entretanto a maioria das crianças entrevistadas declarou que não pretende fumar e a razão mais freqüentemente apontada foi o medo das doenças e mesmo da morte. Parte considerável das crianças declara que os pais fumam em sua presença e se revelaram incomodadas com isso. Os pais dizem não fumar na presença dos filhos, percebendo-se uma consciência dos males do cigarro para o fumante passivo. Por se tratar de um estudo inicial, com uma amostra pequena, as conclusões não podem ser generalizadas para todo tipo de pré-adolescentes desta faixa etária, nem mesmo para a população de escolares desta mesma faixa etária. Ressalte-se, no entanto, que de um ponto de vista qualitativo, os resultados sugerem uma ampla variedade de temas e sub temas a serem explorados em pesquisas posteriores.(AU)

The objective of this research project was to achieve a better understanding of family dynamics in smoking parents' homes. The focus is on the relationship between smoking parents and their children and the central theme is the fact that passive smoking is the third biggest cause of preventable deaths in the world. Forty-one children and 22 adults participated in the study. The methodology involved is the Discourse of the Collective Subject (in Portuguese, DSC), which depicts a quali-quantitative profile. The findings revealed that the children emphasized that smoking parents could lead the children to smoke themselves; however, they do not intend to smoke and the most frequent reason mentioned was fear of illnesses and death. A substantial part of the kids stated that the parents smoke in their presence, which they deeply dislike and resent. But parents say they try not to do it, displaying some awareness of the hazards to the passive smoker. Because the present research is an initial study, with a small sample, the conclusions cannot be generalized to all types of pre-adolescents. However, from a qualitative point of view, the results suggest a broad variety of subjects and sub-subjects to be explored in future research studies.(AU)