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CENTERS FOR DISEASE CONTROL BIBLIOGRAPHY OF CONTINUING STUDIES ON SMOKING AND HEALTH

Selected Studies

Compiled and Edited by Wanda Hamilton

The following selected studies are all listed in the CDC's bibliography on smoking and health for 1984-85, with later studies appended. All abstracts quoted were written and submitted by the principal investigators of the studies. For many of the studies, the CDC bibliography listed the source of funding. Those listed as funded by the tobacco industry have been deliberately omitted from the compilation below. 

The numbers appearing at the top left of each citation are the index numbers assigned by the Centers for Disease Control. For the sake of economy, I have not reproduced the entire abstract of each study, but have included only a summary of salient information and direct quotations from the original abstract. For ease of reference, I have categorized the studies under various headings such as "Smoking and Lung Cancer," "Smoking and Nicotine: Benefits," etc. A few studies appear under more than one heading.
 

Categories


 

Smoking and Lung Cancer

Though there seem to be strong links between smoking and lung cancer, anti-tobacco propaganda often infers that smoking is THE cause of lung cancer, with the implicit message that if smoking could be eliminated, so could lung cancer. This is, of course, false. Smoking is by no means the only risk factor for lung cancer, and in some occupations cigarette smoking appears actually to help protect against getting the disease. Lung cancer is acknowledged to be on the rise both in the U.S. and elsewhere despite the decline in cigarette smoking which began more than 25 years ago. 

Further, lung cancer among nonsmokers seems to be increasing, while the rate of lung cancer among smokers is decreasing, thanks to the advent of filtered cigarettes, which nearly every study has shown decreases risk anywhere from 20% to 30% (only one such study is listed here). 

"Rising lung cancer mortality rates during 1953-1982 were similar for both sexes in all parts of Oregon; the steepest increases were among women living in the coastal counties." 
"Occupational risk differences among both sexes far exceeded those noted with other risk factors, suggesting that occupational exposures deserve primary emphasis in future efforts at lung cancer control."
"Causes of lung cancer other than smoking which are associated with particular occupations will be identified in the hope of eventually reversing the epidemic trend of this disease."

1375. University of Oregon, School of Medicine. Morton, W.E. "epidemiology of Lung Cancer in Oregon."

Methods: Following data have been collected:
 
 

  • (1) sex-specific, age-standardized, mean annual death rates for 5-year periods since 1953 for all counties [Portland-Vancouver area]
  • (2) occupations from death certificates since 1963
  • (3) all cases occurring in the Portland metropolitan area during 1963-1977 by search of tumour registries and hospital record rooms
  • (4) age-adjusted incidence rates by sex for geographic regions, socioeconomic strata, and occupational categories.


"Prospective contribution of pack-years to development of lung cancer was reduced by cross-sectional adjustment, but remained significant." But more important than pack years was airflow obstruction. "Data suggest that smokers who will develop lung cancer may be recognized by prior development of ventilatory obstruction."

 1006. Johns Hopkins University, School of Hygiene and Public Health. Tockman, M.S.; Anthoisen, N.R.; Wright E.C. "Airways Obstruction and the Risk of Lung Cancer."
 

 

AND

"AO was significantly associated with advanced age, male sex, PiZ allete, blood group A antigen, heavy coffee intake (> 3 cups/day) and first degree relationship to a patient with chronic obstructive pulmonary [lung] disease [genetical predisposition]" "Both AO and CB were associated with cigarette smoking and low socioeconomic status."

1005. Johns Hopkins University, School of Hygiene and Public Health. Tockman, M.S.; Khoury, M.J.; Cohen, B.H. "Different Risk Factor Distributions for Airways Obstruction [AO] and Chronic Bronchitis." 
 

"A cross-geographical analysis of lung cancer mortality for white male residents of Harris County for 1979 to 1981 is being made to assess the contribution of air pollution." "Regression techniques will be used to examine the relationship between mortality rates and measures of air pollution while statistically controller for variables that are known to be linked with excess lung cancer mortality, including age, smoking, and socioeconomic status, [emphasis added]"
Results not available at time of printing.

 1472. University of Texas Health Science Centre, School of Public Health. Buffler, P.A.; Stallones, R. "Air Pollution and Lung Cancer in Harris County, Texas." Funding: EPA (CR807108-01) 10/79-4/84.
 

Results to date (Sept, 1976-May, 1981): "A possible flattening in the dose-response [between smoking and lung cancer] was found and a low relative risk in an area of the world with one of the highest recorded incidence of lung cancer. The flattening of the dose-response curve occurred with an above-average consumption of 20 cigarettes/day" [emphasis added]

 0590. West of Scotland Cancer Surveillance Unit (Glasgow) and University of Michigan, School of Public Health. Gillis, C.R.; Hoie, D.J.; Hawthorne, VIM et al. "Retrospective Case Control Study of Smoking Habits and Lung Cancer in the West of Scotland." Funding: National Institutes of Health (N01-CP-05646). 
 

"Excess risks of lung cancer found in miners and foundry workers could not be fully explained by the high prevalence of smoking among these occupations," [emphasis added].

 0495. University of Zurich, Institute of Pathology (Switzerland). Schuler, G. "Epidemiology of Lung Cancer in Switzerland." 
 

Smoking has a protective effect on immunological abnormalities in asbestos workers.

 0429. Institute of Immunology and Experimental Therapy (Poland). Lange, A. "Effect of Smoking on Immunological Abnormalities in Asbestos Workers.
 

 

AND

Relative risk of lung cancer for asbestos workers was "highest for those who had never smoked, lowest for current smokers, and intermediate for ex-smokers. The trend was statistically significant. There was no significant association between smoking and deaths from mesothelioma," [emphasis added].

 0565. University of London, School of Hygiene and Tropical Medicine. "Cancer of the Lung Among Asbestos Factory Workers."

 [Many other studies show similar findings for asbestos workers].
 

"Over the 22 years of follow-up, exposed workers have had a very high risk of respiratory cancer, mostly of the lung. The risk has been dose related and has been much higher in nonsmokers and ex-smokers than in current smokers. The epidemic began to subside shortly after exposure to chloromethyl ethers ceased. The mean induction-latency period was 17 years. Most of the lung cancers in the moderate and high dose groups have been small cell carcinoma," [emphasis added].

1388. Hahnemann Medical College and Hospital (Philadelphia). Weiss, W. "Lung Cancer Dueto Chloromethyl Ethers."
 

Method: "A cohort of 125 workers (91 exposed to chloromethyl ethers) have been followed since 1963, and semi-quantitative estimates of degree of exposure and records of duration of exposure have been maintained. Information on smoking habits was obtained at the beginning of the observation period."

 "Marked atypia were found only in workers chemically exposed to BCME (4.8 percent of smokers and 6.2 percent of nonsmokers). The biological mechanism for increased injury in nonsmokers...has not yet been determined [emphasis added]."

 [Index number not recorded]. Labour Protection and Hygiene Centre, Laboratory of Cytology (Romania). Herivan, R.: Constantinescu, V.; Melinte, L. "BCME, Soot, Smoking and Lung Cancer. 

"Presence of chronic respiratory symptoms at baseline was inversely related to cessation of smoking. Respiratory impairment was positively associated with smoking cessation, but failed to reach statistical significance," [emphasis added].

 1544. DHHS, PHS, CDC, NIOSH. Ames, R.G. "Respiratory Effects of Exposure to Diesel Emissions in Underground Coal Miners." Funding: NIOSH. 

"Lung volume parameters were found to decrease with age, but there was no significant modification related to tobacco consumption."

 0241. Institut D'Etudes Et Recherches Pneumophtisiologiques (Institute of Studies on Tuber-culosis). France. Keisbauer, J.P. "Longitudinal Study of the Methods of Early Detection of Respiratory Diseases in a Population of Cab Drivers." 

"Neither smokers nor nonsmokers showed any changes in bronchial responsiveness after smoking cigarettes."

 0391. Yokohama City University, School of Medicine (Japan). Okubo, T; Suzuki, S; Sano, F. "Acute Effect of Smoking on Bronchial Responsiveness." 
 

"Chronic bronchitis was found more often in suburban inhabitants than in rural inhabitants, a significant difference."
"It is concluded that chronic bronchitis is twice as common in the city as in rural areas, however, in both areas, air pollution and cigarette smoking lead to higher incidence."

0427. Copernicus Academy of Medicine (Poland). Nikodemowicz, E.; Owsinski, J.M.; Chomicka, Z. et al. "Influence of Urban Factors on the Incidence of Chronic Bronchitis in Rural Populations."
 
 
 
 
 
 

Smoking and Heart Disease

 

The connection between smoking and heart disease is far more tenuous than that between smoking and lung disease. Though the medical establishment considers smoking to be a risk factor (among many risk factors) for heart disease, the fact remains that anywhere from 30 to 50% of those admitted to hospitals for coronary problems exhibit none of the known risk factors (including smoking), and that the research is by no means either consistent of conclusive in linking smoking the heart disease. It is true that deaths from heart disease, which is still the number one cause of death, are declining but most researchers attribute this to better surgical and medical techniques, not to a decline in smoking rates, since deaths from heart disease are declining world-wide, even in countries with high smoking rate. 

"No statistically significant relationship was found in either community between smoking and coronary heart disease, hypertension or somatic complaints" [emphasis added]

 1477. University of Texas School of Allied Health Sciences. Philips, B.U., Jr.; Bruhn, J.G. "Smoking Habits and Reported Illness in Two Communities With Different Systems of Social Support." FUNDING: Univ. of Texas; National Institute of Mental Health. 1981-83. 
 

"Preliminary data indicate greater frequency of anterior infarctions among nonsmokers." "Among patients with unstable angina, smoking was associated with less persistent rest pain and a lower proportion of smokers had chronic angina of effort prior to hospital admission. Preliminary analysis suggests a marginally lower in-hospital mortality rate among smokers after controlling for age and other prognostic factors." [emphasis added].

0298. St. Vincent's Hospital, Dept. of Preventive Cardiology and Cardiac Dept. (Dublin, Ireland). Cohort of 898 males and 415 female heart patients. 12/80-1/86. 
 

"Preliminary data indicate a high prevalence of IHD [Ischemic Heart Disease] in South Wales. A significant association between white cell count and IHD defined cross-sectionally is not explained by smoking habits. Prevalent IHD is not explained by smoking habit" [emphasis added]

0598. Medical Research Council, Epidemiology Unit (Wales). Yarnell, J.W.G; Elwood, P.C.; Sweetnam, P.M. "Caerphilly Prospective Study of Ischemic Heart Disease." Cohort study of 2,400 men (aged 44-60) began in 1979. Two samples of women also studied. 
 

"Recent secular trends in sex and age specific mortality from ischemic heart disease, both in the United Kingdom and in the United States, appear to be independent of changes in cigarette consumption."

 0564. University of Leeds, Dept. of Medical Physics (England). Burch, P.R.J. "Tests of Causal, Constitutional and Mixed Hypotheses of Associations between Smoking and Disease in Man," 1972 and continuing. Funding: Univ. Leeds. 
 

While smoking was more common among women who had myocardial infarction, "no such difference was observed between women with angina pectoris and other women." Also no significant differences were observed between smoking and nonsmoking women with respect to myocardial infarction and death during the 12-year follow-up.

 0464. Sahlgrenska Hospital, Medical Dept. (Sweden). Bengtsson, C.: Lapidus, L; Hallstrom, T. "The Population Study of Women in Gothenburg, Sweden." 
 

"In asymptomatic male aviators (aged 20 to 60), age and ratio of total cholesterol to high density lipoprotein cholesterol are most highly correlated with degree of coronary artery disease found on angiography. After removing the effect of age and this ratio, no statistically significant additional variance is explained by other risk factors [including smoking]." [emphasis added]

 1465. Department of Defense, Department of the Air Force, School of Aerospace Medicine (Brooks Air Force Base, Texas). Tolan, G.D.; Honck, P.; Hickman, R. et al. "Multivariate Approaches to the Detection of Asymptomatic Coronary Artery Disease." Funded by USAF. 1971 - continuing. 

Pipe smokers have a higher intake of nicotine than cigarette smokers (as measured by serum and urinary cotinine levels). "Since pipe smokers have little excess risk of CHD [chronic heart disease], higher chronic nicotine exposure is unlikely to be the cause of the excess seen in cigarette smokers."

 0534. Medical College of St. Bartholomew's Hospital. Dept. of Environmental and Preventative Medicine (England). Wald, M.J.; Bailey, A. "Nicotine and Heart Disease.". 
 
 
 
 
 

ETS and Heart Disease

 

"No difference in prevalence of cardiovascular symptoms was found [between those living with smokers and those not]" 

0591. West of Scotland Cancer Surveillance Unit, Ruchill Hospital (Scotland). Gillis, C.R.; Hole, D.J.; Hawthorne, V.M. "Health Effects of Exposure to ETS (Environmental Tobacco Smoke] in the West of Scotland." Cohort of 16,171 (45-64 years old) screened in 1972 and 1976.
 
 
 
 
 

Smoking and "Throat" Cancer

(See also appended bibliography for additional studies on this)
 

"All countries experienced a sharp increase in lung cancer mortality; [but] laryngeal and oral cavity cancers showed divergent trends (10 countries had steady or decreasing rates). Results suggest that tobacco may not be the major causative factor for laryngeal and oral cavity cancers." [emphasis added]

 0244. Institut National de Recherche et de Security (France). Moulin, J.J; Mur, J.M.; Cavelier, C. "Comparative Epidemiology, In Europe, of Tobacco-Related Cancers (Lung, Larynx, Pharynx, Buccal Cavity)." Data is from World Health Organization 1950-1977. 
 

"Secular trends in mortality from oesophageal cancer in the United Kingdom are independent of secular changes in cigarette consumption, but well correlated with secular changes in alcohol consumption...alcohol acts as an indirect causal agent. The proximal causal agent is likely to be a precipitator, such as a microorganism. Genetic predisposition is also implicated"

 0564. University of Leeds. Dept. of Medical Physics (England). Burch, P.R.J. "Tests of Causal, constitutional, and Mixed Hypotheses of Associations Between Smoking and Disease in Man." Funding: Univ. of Leeds. 1972 - continuing. 
 

..."alcohol consumption was the dominant risk factor [for oesophageal cancer" [em. add.]

 Dept. of HHS, National Cancer Institute. Blot, W.J.; Brown, L.M.; Ershow, A. et al. "Epidemiologic Studies of Tobacco Use and Risk Cancer." 
 
 
 
 
 

Smoking and Renal [Kidney] Cancer

 

"Preliminary results implicate relative weight in both men and women as a principal risk factor in renal cell carcinoma. Comparison with population controls failed to implicate cigarette smoking of beverage use as risk factors." [emphasis added]

 1363. University of Oklahoma, Health Sciences Canter. Asal, N.R.; Geyer, J. "Risk Factors in Kidney Cancer." Oct. 1981 - Feb., 1985. FUNDING:< National Cancer Institute. 
 

"A weak positive association with cigarette smoking has been found, but only after controlling for selection biases." "Findings appear to confirm previously observed associations with obesity, northeastern European ancestry, renal calculi [kidney stones], and use of phenacetin-containing analgesics." [emphasis added] 

1060. Harvard University, School of Public Health, Dept. of Epidemiology. MacMahon, B; Maclure, K.M. "A Casa Control Study of Renal Adenocarcinoma." Method: Used Cancer registries, pathology logs and medical records at 37 participating hospitals in the Boston area and follow-up interviews by phone. FINDING: Harvard School of Public Health; National Cancer Institute. 
 
 
 
 
 

ETS and Bladder Cancer

 

"No association was found for exposure to side-stream smoke, coffee drinking, or artificial sweetener use. The association of several occupations with bladder cancer risk has been found in males..."

 1216. American Health Foundation. Wynder, E.L.; Goodman, M.T.; Kabat, G.C., et al. "Studies in Tobacco-Related Cancers." FUNDING: National Cancer Institute. 
 
 
 
 
 

Smoking and Endometrial, Ovarian and Breast Cancer

 

"Overall, smoking was not found to be associated with any of the cancers studied." Centres for Disease Control. Epidemiologic Studies Branch. Division of Reproductive Health. Rubin, G.; Tyler, C.W.; Franks, A.L.; Stroup, M. "Smoking and Endometrial, Ovarian, and Breast Cancer." FUNDING: NICHD. 

"The risk of breast cancer does not appear to be influenced by cigarette smoking"

1039. Boston University Medical Centre. Drug Epidemiology Unit. Shapiro. S Rosenberg. L.; Kaufman. D. "Multiple Case-Control Study of the Long Term Effects of Drug, Use in the Treatment of Chronic Disease." FUNDING: FDA (U01 FD01222-03) and NICHD [National Institute nf Child Health & Human Development]. Emphasis added. 
 
 
 
 
 

Smoking and Cervical Cancer

 

"Sexual Behaviour and socioeconomic indicators predict cervical cancer incidence, as has been demonstrated in numerous other studies.: [emphasis added]"

 University of Utah. School of Medicine. Lyon J.L. "Epidemiologic Investigation of Cervical Cancer in an Area of Low Incidence " FUNDING: NCI (Dept. of Health &HS) 
 
 
 
 
 

Smoking and Pregnancy

 

Some studies have found a correlation between maternal smoking during pregnancy and lower birth weight in babies. However, there are many factors which correlate with low birth weight, and the dominant risk factors seem to be the mother's age and the mother's socioeconomic class. Even those studies which show a correlation between maternal smoking and low birth weight speak of weight differences in grams, not ounces, and one ounce = 28.35 grams. 
 

Risk factors associated with low birth weight (in rank order):
 
 

  1. Mother's age (too young or too old)
  2. First pregnancy
  3. More than two previous stillbirths
  4. Lower birth weight of older siblings
  5. Small stature and weight of mother
  6. Fewer examinations during pregnancy
  7. Smoking by mother or father

0360. Department of Public Health. Jichi Medical School (Japan). Nagai. M.; Yanagawa. H.; Kawaguchi, T. et al. "A Study of the Factors Associated With low Birth Weight. A Case-Control Study in Togichi Prefecture Apr. 1982-Dec. 1984. 
 

"Women who smoke during pregnancy have full-term babies which, on the average are 5-6 grams [a fraction of an ounce] smaller than full-term babies born to nonsmoking mothers."

 0755. University of Colorado. Health Sciences Centre. Moore. L.C. "Maternal O2 Transport During Pregnancy at High Altitude " [emphasis added] 
 

 

  • 1. Birth weight lower in the smoking group, but the incidence of smoking was higher in
  • young, unmarried women of lower socioeconomic status. Perinatal death was also higher
  • among young, unmarried, low income women.
  • 2. "No differences in antepartum hemorrhage or congenital anomalies between the groups"
  • 3. "Hypertension and postpartum hemorrhage were lower in smokers [emphasis added]."

0045. University of Tasmania, ( Queen Alexandra Hospital, Dept. of Obstetrics & Gynaecology. Correy, J.; Newman. N.: Currarn, J "An Assessment of Smoking in Pregnancy." Method: Since I974, this study was conducted on ALL patients in Tasmania (smoking data was collected since Jan.1981 ). Details of alcohol ingestion and drug use were also included. By 1984 information available on 90% of patients on average birth weight of infants, incidence of low birth weight (less than 2,500 grams), incidence of prematurity, congenital abnormalities, perinatal death antepartum hemorrhage and hypertension in pregnancy. 
 

"The proportion of complications of pregnancy and delivery were similar in smokers and nonsmokers."

 University of Oslo (Norway). Dalaher, K.; Grunfeld, B.; Jansen, A. 
 

"Data do not confirm the suggestion that changes in cord blood vessels similar to those of arteriosclerosis are brought about by maternal smoking during pregnancy. Pathological changes in the cord at term may be found in infants of healthy, nonsmoking mothers..."

 0184. Universitat Freiburg, Anatomische: Institut (Germany). Staubesand, J.; Seydewitz, V.; Hugod, C. et al. "Effects of Maternal Smoking on the Neonatal Umbilical Cord." 
 
 
 
 
 

Parental Smoking, ETS and Children

 

"...excess influenza virus infection was found for black infants and infants with at least one sibling (especially those with school-age siblings), and rhinovirus infection rates were highest among girls attending daycare. No convincing differences for viral infection or respiratory illness were seen with parental smoking as an isolated factor..." [emph. added]

 1462. Baylor College of Medicine, Influenza Research Centre (Texas). Gardner, G.C.; Frank, A.L.; Taber, L.H. "Effects of Social and Family Factors on Viral Respiratory Infection and Illness in the First Year of Life." A longitudinal study,1975 - 1980. This study was published in the Journal of Epidemiology and Community Health 39 (1); 42-48, March, 1984. 
 

"The correlation matrix revealed that maternal education was the variable most significantly inversely correlated with infection... Its statistical significance persisted in the presence of other added factors." "Maternal education appeared to have played a highly significant role in the health of the children studied." [emphasis added]

 0878. University of Kansas, College of Health Sciences. Holmes. G.E.; Hassanein, K.M.; Miller. H.C. "Factors Associated with Morbidity Among Breast Fed and Formula Fed Babies." The incidence of infection in babies was studied with regard to a number of factors, including maternal smoking. 
 
 
 
 
 

Nicotine and Smoking: Benefits

 

Though the risks of smoking are highly publicized, the medical benefits of smoking are rarely mentioned. The greatest risks of smoking come from the tars released during the combustion of tobacco, and these tars are implicated in lung cancer and other breathing disorders, though even the tar apparently has some beneficial effects in protecting the lungs from some noxious particulate matter (e.g. asbestos). According to many studies, the chief medical benefits of smoking are from the nicotine, which occurs naturally in tobacco as well as in certain vegetables such as tomatoes, potatoes, and red peppers, though in much smaller amounts. Interestingly, these three plants originated in the Americas so nicotine was essentially a "New World" substance. Native Americans were well aware of the curative properties of tobacco, and used it both medicinally and ceremonially. 

Numerous studies have shown the protective effects of smoking with regard to Parkinson's Disease and ulcerative colitis, and an increasing body of research indicates it also helps protect against Alzheimer's Disease and colo-rectal cancer. Since these effects are so well known, wehave not listed them below but have focused instead on a few more obscure medical benefits culled from the 1984-85 CDC bibliography. Brief documentation of the beneficial effects of smoking with regard to Parkinson's, ulcerative colitis, Alzheimer and colo-rectal cancer will appear in an attached appendix of some relevant studies from the 1991 CDC bibliography. 
 

 

  • 1. Smoking improves human information precessing.
  • 2. Higher nicotine cigarettes produce greater improvements [in information processing]
  • than low-nicotine cigarettes.
  • 3. Nicotine tablets produce similar effects.
  • 4. Nicotine can reverse the detrimental effects of scopolamine on performance
  • 5. Smoking effects are accompanied by increases in EEG arousal and decreases in the latency of the late positive component of the evoked potential."

0574. University of Reading, Department of Psychology (England). Warburton., D.M.; Wesnes, K. "The Effects of Cigarette Smoking on Human Information Processing and the role of Nicotine in These Effects " 
 

"In general, motor performance in all groups improved after smoking."

 0530. London University, Institute of Psychiatry. O'Connor, K.P "Individual Differences in Psychophysiology of Smoking and Smoking Behaviour " 
 

"Smokers in general are thinner than nonsmokers, even when they ingest more calories." [Numerous studies, but only two are listed below] 

0885. Kentucky State University. Lee. C.J.: Panemangalore. M. "Obesity Among Selected Elderly Females In Central Kentucky." FUNDING: USDA 0942. University of Louisville. Belknap Campus School of Medicine. Satmford, B.A.; Matter, S.; Fell, R.D., et al. "Cigarette Smoking, Exercise and High Density Lipoprotein Cholesterol" FUNDING: American Heart Association. 
 

"...all smokers had less plaque, gingival inflammation and tooth mobility than nonsmokers and similar periodontal pocket depth."

 Veterans Administration, Outpatient Clinic (Boston). Chauncey. H.H,; Kapur, K.K.; Feldmar, R S. "The Longitudinal and Cross-Sectional Study of Oral Health: in Healthy Veterans (Dental Longitudinal Study) 
 

"Smokers have lower incidence of postoperative deep vein thrombosis than nonsmokers."

 Guy's Hospital Medical School (England). Jones, R.M. "Influence of Smoking on Peri-Operative Morbidity." 

Hypertension (High blood pressure) is less common among smokers.

"Hypertension prevalence rate among smokers was 3.94 percent; among nonsmokers the rate was 4.90 percent."

 0146. Shanghai Institute of Cardiovascular Diseases. Chen, H.Z.; Pan, X.W.; Guo, G. et al. "Relation Between Cigarette Smoking and Epidemiology of Hypertension.

AND

"Hypertension and postpartum hemorrhage were lower in smokers."

 0045. University of Tasmania (Australia). Correy, J.; Newman, N. Curran, J. "An Assessment of Smoking in Pregnancy." 
 

"RBCs [red blood cells] from cigarette smokers contain more glutathione and catalase and protect lung endothelial cells against O2 [dioxide] metabolites better than RBCs from nonsmokers." [emphasis added]

 0759. University of Colorado. Refine, J.E.; Berger, E.M.; Beehler, C.J. et al. "Role of RBC Antioxidants in Cigarette Smoke Related Diseases." Jan 1980 - continuing. 
 

(A number of studies in the 1991 CDC bibliography describe the apparent protective effect of smoking with regard to mouth ulcers).
 
 

 

APPENDIX Following are studies listed in the Centres for Disease control's Bibliography on Smoking and Health, 1991. Many newer studies appear in this more recent CDC bibliography which support the earlier studies listed in the foregoing selected bibliography, including a lower risk of breast cancer, lower risk of endometrial cancer in smoking women; the improvement of fine motor control for smokers; lower incidence of overweight in smokers; lower incidence of high blood pressure among smokers. Below are selected studies which demonstrate the protective effect of smoking in Parkinson's Disease and ulcerative colitis. 
 

"Several epidemiological studies have indicated that there may be an inverse relationship between smoking and Parkinson's disease." There is an "apparent protective effect of cigarette smoke."

 1102. Carr, L.A.; Rowell, P.P. "Attenuation of 1methyl-4-phenyl-1,2,3,6-tetrahydrophyridine- induced neurotoxicity by tobacco smoke." Published in Neuro-pharmacology 29(3):311-4, Mar 1990. 
 

"These results indicate that in sufficient doses chronic treatment with nicotine may be considered in the pharmacological treatment of Parkinson's disease. It remains to be demonstrated whether these protective actions can be extended to include also other injured neurons..."

 1190. Janson, A.M.; Fuxe, K.; Agnati, L.F. Jansson, A. et al. "Protective effects of chronic nicotine treatment on lesioned nigrostriatal dopamine neurons in the male rat." Pub. in Progress in Brain Research 79:257-65, 1989. 
 

"Several studies have reported an apparent protective effect of cigarette smoking for the risk of idiopathic Parkinson's disease (IPD). These observations are supported by neurochemical studies..." These findings suggest that the inverse association between smoking and IPD may apply to NIP [neuroleptic-indiced parkinsonism]."

 4014. Decina, P.; Caracci, G.; Sandik, R.; Berman, W. et al. "Cigarette smoking and neuroleptic- induced parkinsonism." In Biological Psychiatry 28(6):502-8, Sept. 15, 1990 
 

"There is a low prevalence of smoking in ulcerative colitis. The disease often starts or relapses after stopping smoking."

 4101. Prytz, H.; Benoni, C.; Tagesson, C. "Does smoking tighten the gut?" In Scandinavian Journal of Gastroenterology 24(9):1084-8, Nov. 1989. 
 

"These results indicate that nonsmokers and especially ex-smokers of cigarettes have greater risk of UC [ulcerative colitis] and thus confirm the results of other studies."

 4134. Lorusso, D.; Leo, S.; Miscianga, G.; Guerra, V. "Cigarette smoking and ulcerative colitis. A case control Study." Hepato-Gastroenterology 36(4): 202-4, Aug. 1989. 
 

Documentation for the protective effect of smoking on Alzheimer's may be found in the 11 studies reviewed in the International Journal of Epidemiology, 1991. There is also documentation for lower incidence of colorectal cancer in JAMA in the early 1980s
 
 

 

ADDITIONAL BIBLIOGRAPHY Forces Canada wishes to thank Martha Perske for providing the following bibliography:
 

"...particular attention is paid to the consumption of ethanol [alcohol] which has a major impact on the incidence of human cancer"

 91-2046. Doll, R. Lifestyle: An overview. Cancer detection and prevention. 14(6): 589-94, 1990 
 

" There is little direct evidence that cancer prevention has led to any major reduction in cancer incidence or mortality."

 91-2068. Claysdon, D.B. " An overview of current and anticipated methods for cancer prevention." Cancer Letters. 50(1):3-9, April 9, 1990. 
 

"...the prevalence of mild and moderate disease [oesophageal cancer] was found to be positively associated with the consumption of burning hot beverages (odds ratio = 4.7), the prevalence of esophagitis among siblings (O.R. = 4.4) and family history (O.R. = 1.8) ... Weaker associations were seen for cigarette smoking and the use of cottonseed oil..."

 91-2069. Chang-Claude, J.C.; Wahrendorf, J. et al. " An epidemiological study of precursor lesions of oesophageal cancer among young persons in a high risk population in Hulxian, China." Cancer Research 50(8):2266-74, April 15, 1990. 
 

" The incidence of these cancers appear to be increasing rapidly in response to the increasing level of alcohol consumption in Denmark."

 91-2130. Miller, H. "Changing incidence of cancer of the tongue, oral cavity, and pharynx in Denmark." Journal of Oral Pathology and Medicine. 18(4): 224-9, Apr. 1989. 
 

" Cancers of the mouth or pharynx and oesophagus were independently and strongly related to alcohol consumption..."

 91-2147. Ferraroni, M.; Negri, E. et al. " Socioeconomic indicators, tobacco and alcohol in the aetiology of digestive tract neoplasms." International Journal of Epidemiology. 18(3): 556-62, Sep 1989. 
 

"...Linxian, a rural country in North Central China with one of the world,s highest mortality rates for these tumours. Cancer rates tended to raise with increasing intake of wheat or corn... Few persons reported drinking alcoholic beverages. Smoking was reported by 61% of the male cases and was a mild risk factor, related more to cancer of the cardia than of the oesophagus. The risk was increased by 70% among those whose parents had oesophageal or stomach cancer..."

 91-2180. Li, J.Y.; Brshow, A.G.; et al [including Blot, W.J.]. "A case-control study of cancer of yhe oesophagus and gastric cardia in Linxian [China]." International Journal of Cancer. 43(5) : 755-61, May 15, 1989. 
 

Odds ratios for oesophageal cancer: Current smokers: 3.8 - Heavy drinkers: 6.0

 91-2199 Franceschini, S.; Talamini, R., et al. "Smoking and drinking in relation to cancers of the oral cavity, pharynx, larynx, and oesophagus in Northern Italy." Cancer Research. 50(20) :6502-7, Oct. 15, 1990. 
 

"Highly significant associations with frequent intake of Maize emerged for oral cancer, pharyngeal cancer, and oesophageal cancer (OR = 3.3, 3.2, and 2.8, respectively). The risk elevation could not be explained in terms of difference in education, occupation, tobacco use, or consumption of fresh fruits and vegetables. The unfavourable effect of Maize... was evident only in those individuals who reported heavy drinking... The present findings agree with previous observations from Africa, China, the U.S., and Italy."

 91-2202. Franceschini, S.; Bidoli, E.; et al. "Maize (corn) and risk of cancer in the oral cavity, pharynx, and oesophagus in Northeastern Italy." Journal of the National Cancer Institute. 82(17) :1407-11, Sept. 5, 1990. 
 

"The three risk factor showed a strong tendency to be related to cancer only in combination, adding new evidence to the theory that risk factors in cancer act in a synergistic fashion."

 91-2322. Grossart-Maticek, R.; Eysenck, H.J. "Personality, smoking, and alcohol as synergistic risk factors for cancer of the mouth and pharynx." Phycological Reports. 67 (3 Pt. 1) : 1024-6, Dec. 1990. 
 

Source: Bibliography On Smoking and Health, 1991. Centres for Disease Control and Prevention.
 
 

 

SMOKERS HAVE REDUCED RISKS OF ALZHEIMER'S AND PARKINSON'S DISEASE Patients with Alzheimer's disease (AD) have a considerably decreased life expectancy, with the entire course of the disease taking an average of about eight years. AD is defined by a specific combination of neuropathologic features that include neuronal loss in particular regions of the brain and a high density of senile plaques and neurofibrillary tangles. It is hard to distinguish during life because of other damage and dementias. As many as 80% of the cases may be unrecognized by general practitioners.

 Acute administration of low doses of nicotine improved mental processes and may be protective in AD. This possibility was first put forward by Appel, who noted that only 6 out of 30 patients had smoked at any time in their lives. Since that time, nineteen case control studies have been published and are considered here. The overall from these showed a clear negative association, 15 out of 18 studies reporting a lower risk of AD in men and women who had smoked.

Of the 19 studies, 15 found a reduce risk in smokers, and none found an increased risk. And smoking is clearly associated with a reduced risk of Parkinson's disease, another disease in which nicotine receptors are reduced. The fact that acute administration of nicotine improves attention and information processing in AD patients adds further plausibility to the hypothesis.

"The risk of Alzheimer's disease decreased with increasing daily number of cigarettes smoked before onset of disease. In six families in which the disease was apparently inherited, the mean age of onset was 4-17 years later in smoking patients than in non- smoking from the same family."
(Conelia M. van Duljn MSC Albert Hoffman Md., Erasmus Univ. Md. School)

 STUDIES AND PUBLICATIONS

Amaducci LA, et al. A case-controlled study of an Italian population. Neurology, 1986, 36:922-931.
Barclay L, Kheyfets S. Tobacco used in Alzeimer's disease. Prog. Clin. Bho. Res 0989, 317:189-194.
Brenner DE, et al. Relationship between cig. smoking and Alz. disease. Neurology 1993, 43:293-300.
Broe GA et al. A case -controlled study of alz. in Australia. Neurology 1990, 40:1698-1707.
Chandra V. et al. Case study of the late on-set 'probable Alz. disease'. Neurology 1987, 37:1295-1300.
Dewey ME, et al. Risk factors for Dementia. Liverpool, Int. Geriatric Psychiatry 1988, 3:245-249.
Ferini-Strambi, et al. Clinical Aspect of Alz. Disease with pre-senile on-set. Neuro Epidem 1990, 9:34-49.
French LR, et al. Case-control study of dementia of Alz. type. Am J Epidemiol 1985, 121:414-421.
Graves, AB, et al. Case controlled study of Alz. disease. Neurol 1990, 28:766-774.
Grossberg, GT, et al. Smoking as a risk factor for Alz disease. Am. Geriatric Soc. 1989, 37:819.
Hebert LE, et al. Relation of smoking and alcohol to Alz disease. Amer. J Epidemiol 1992, 135:347-355.
Heyman A, et al. Alz disease: a study of epidem aspects. Am Neurol 1984, 15:335-341.
Hofman A, van Duijn. Alz disease, Parkinson's disease, and smoking. Neurobiol Aging 1990, 11:295.
Jones GMM, et al. Smoking and dementia of Alz type. Neurol Neurosurg Psychiatry 1987, 50:1383.
Joya CJ, et al. Risk factors in clinically-diagnosed Alz disease. SA Neuroniol Aging 1990, 11:296.
Katzman R, et al. Develop of dementing ill. in 80 yr. old volunteer cohort. Am Neurol 1989, 25:317-324.
Kondo, K Yamashita I. Case study of Alz in Japan. Biol & Social advances. Excerpta Medica 1990, 49-53.
Shalat SL, et. al. Risk factors for Alz. disease. Neurology 1987, 37:1630-1633.
Soininen H, et al. Clinical and etiological aspects of senile dementia. Eur Neurol 1982, 21:401-410.
Korten AE, et al. Control informant agr. in case control studies of Alz. Int. J Epidie. 1992, 21:1121-1131.
Breteler MMB, et al. Epidemiology of Alz disease. Epidemiol Review 1992, 14:59-82.
Lee PN Statistics, Sutto, UK.


 

 

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