of Scientific Papers Relating to Tobacco Use
(Compiled and Described for Informational Purposes Only for The Council for Tobacco
Research-U S .A .,1 nc . The Summaiies Are Not I ntendetl to be Complete Scientifk Abstrxcts ./
Vol . 26, No . 2 February 1981
I. Heart and Circulation 1
2. Lung Cancer 2
3. Other Respiratory Conditions 5
4. Pregnancy . 10
5. Immunology . 11
6. other Systemic Conditions 12
7. Statistics 14
8. Carbon Monoxide 16
9. Nicotine 18
10 . Smoke Condensate and Constituents 19
11 . Smoking Habits 23
12 . Miscellaneous 26
13 . Rriefs from Meetings . 28
14 . Additional References 31
1 . HEART AND CIRCULATION
OIMSDALE, J .E ., GILBERT, J ., HIffTER, A .M ., Jr ., HACKETT, T .P . $ BLOCK, P .C .,
Massachusetts General Hospital 8 Harvard Medical School, Roston
"Predicting cardiac morbidity based on risk factors and coronary angio-
graphic findings ." (American Journal of Cardiology 47/7 : 73-6, January 1981)
"A cohort of 189 men was followed up for 1 year after performance of
coronary angiography and determination of risk factors to ascertain which
risk factors or clinical and laboratory findings could aid in predicting the
patients who would have a substantial cardiac .morbid event . Data on clinical
signs and symptoms, psychosocial assessments, angiographic findings and
presence of standard risk factors for coronary artery disease were collected
in each case .
"Twonty-five percent of the men experienced a substantial cardiac
~-_morbid event (hospitalization, myocardial infarction, resuscitation or death) .
With or without inclusion of the patients who underwent surgery, discriminant
analysis equations were successful in predicting morbidity on the basis of
risk factor data . For the whole sample such analysis was significant at
p< 0 .00005 and accurately predicted the fate of 78 percent of the subjects .
With exclusion of the surgically treated patients, the discriminant analysis
accurately predicted future morbidity 83 percent of the time (p < 0 .0001) .
The following risk factors for increased morbidity were common to both
• analyses : severity of angina, history of myocardial infarction, family
history of heart disease, fatigue and absence of type A behavior . . . .
"Type A behavior as a risk factor : At first glance these findings
seem to contradict the reports,relating type A behavior to both new and
recurrent coronary events . In the setting of fatigue, chest pain and both
a personal and a family history of heart disease, it may be that type B
scores relate to exhaustion and emotional depletion, which have elsewhere
been found to be harbingers of poor outcome in heart discase ." •
KLEINMAN, J .C ., DeGRUfTOLA, V .G ., COIIEN, B .B . E b1ADANS, J .H ., National Center
for Ilealth Statistics, Hyattsville, Maryland
"Regional and urban-suburban differentials in coronary heart disease
mortality and risk factor prevalence ." (Journal of Chronic Diseases 34/1 :
"This study examines the extent to which regional and urban-suburban
differentials in coronary heart disease (CHD) mortality can be attributed
to differences in three major risk factors -- smoking, serum cholesterol and
blood pressure .
"Levels of these risk factors were measured in the Health and
Nutrition Examination Survey for a representative sample of United States
adults for 1971-1975 . Each individual's probability of CHD death is estimated
by applying the logistic equation developed in the Framingham Heart Study
to his/her risk factor levels . By aggregating the individual estimates
according to place of residence, 'expected' CHD death rates by region and
metropolitan status are obtained . Vital statistics (1968-1972) are used to
generate actual CHD death rates by region and urban-suburban residence .
"Thc 'cxpected' rates do not generally follow the same patterns as
the actual CIID death rates . Thus, differentials in these risk factors
cannot account for the lower CHD death rates observed in the West as com-
pared to other regions or among suburban as compared to urban residents ."
LaPORTE, R .E . G CAULEY, J .A ., University of Pittsburgh, Pennsylvania
"Wine, age, and coronary heart disease ." (Letter : Lancet I : 105, January
"We correlated the age-adjusted 1970 CHD mortality for 48 States with
the 1970 per caput consumption of spirits, wine, beer, total alcohol, and
cigarette consumption (the rates for Alaska and Hawaii were not available) .
As the correlations show, there was little relationship between per caput
alcohol consumption and heart disease death rates . The primary determinant
was cigarette smoking . Although there is much evidence, both on an individual
and on a population basis, for lower heart disease mortality of moderate
consumers, one must be careful that the findings are not the result of the
vintage of the population or other confounding variables ."
2 . LUNG CANCER
HIRAYAMA, T ., National Cancer Center Research Institute, Tokyo, Japan
"Nonsmoking wives of heavy smokers have a higher risk of lung cancer : a study
from Japan ." (British Medical Journal 282 : 183-5, January 17, 1981) •
"In a study in 29 health center districts in Japan 91,540 nonsmoking
wives aged 40 and above were fpllowed up for 14 years (1966-79), and standard-
ized mortality rates for lung cancer were assessed according to the smoking
habits of their husbands . Wives of heavy smokers were found to have a higher
risk of developing lung cancer and a dose-response relation was observed .
The relation between the husband's smoking and the wife's risk of developing
lung cancer showed a similar pattern when analyzed by age and occupation of
the husband . The risk was particularly great in agricultural families when
the husbands were aged 40-59 at enrollment . The husbands' smoking habit did
not affect their wives' risk of dying from other disease such as stomach
cancer, cervical cancer, and ischcmic heart disease . The risk of developing
emphysema and asthma seemed to be higher in nonsmoking wives of heavy smokers
but the effect was not statistically significant .
"The husband's drinking habit seemed to have no effect on any causes
of death in their wives, including lung cancer .
"These results indicate the possible importance of passive or indirect
smoking as one of the causal factors of lung cancer . They also appear to
explain the longstanding riddle of why many women develop lung cancer al-
though they themselves are nonsmokers . These results also cast doubt on
the practice of assessing the relative risk of developing lung cancer in
smokers by comparing them with nonsmokers ."
HEELAN, R .T ., hD:LAMED, M .R ., ZAMAN, M .B .,'MARTINI, N . & FLEHINGCR, B .J .,
Memorial Sloan-Kettering Cancer Center, New York
"Radiologic diagnosis of oat cell cancer in a high-risk screened population ."
(Radiology 136/3 : 593-601, September 1980)
"A screening program of 10,040 cigarette-smoking men over 45 years
• of age was undertaken in an attempt to achieve earlier diagnosis, thereby
increasing the cure rate, of oat cell lung cancer . Of the 155 men who were
found to have lung cancer, 27 (17%) had confirmed oat cell cancer . Only one
case was diagnosed at the first examination . The other 26 cases (called
incidence cancer) were diagnosed by subsequent examinations . In 24 of the
26 patients, the tumor was not found until it was advanced (Stage III), and
of these patients, only one is alive at 21 months follow-up . Two tumors
were diagnosed as oat cell carcinoma at an early stage (Stage I), mid both
patients are alive with no evidence of disease at seven and 24 months . The
screening program used in this study did not succeed in detecting oat cell
cancer at an early stage ."
McDOWELL, E .M ., WILSON, T .S . & TRUMP, B .F ., University of Maryland, Baltimore
"Atypical endocrine tumors of the lung ." (Archives of Pathology & Laboratory
Medicine 105 : 20-8, January 1981)
' "Seven malignant peripheral lung tumors that were diagnosed using
light microscopy as large-cell carcinomas or as epidermoid or adenocarcinomas
were studied by light and electron microscopic histochemistry . All tumors
contained numerous dense-core granules . The cells were joined by desmosomes
and contained well-developed tonofilament bundles . Serotonin was demonstrated
in six of seven tumors and argyrophilic granules were demonstrated in five
of six tumors tested . Four tumors produced mucus . All tumors extended to
the visceral pleura and two invaded the chest wall . The existence of lung
tumors that contain serotonin and bear argyrophilic putative-endocrine granules,
but that do not have a light-microscopic histology characteristic of either
carcinoid or oat-cell carcinom3s, is confirmed . The presumptive endocrine
nature of such tumors usually passes unrecognized because they lack criteria
to allow diagnosis by routine methods ." [Six smokers, one ex-smoker .]
CIIALON, J ., TANG, C .K ., KLEIN, G .S ., RAMANATHAN, S ., PATEL, C . E TURNDORF, H .,
Ncw York University (CTR-grant)
"Routine cytodiagnosis of pulmonary malignancies ." (Archives of Pathology G .
Iaboratory Medicine 105 : 11-14, January 1981)
"Anesthesiologists normally discard the material routinely suctioned
from the tracheal tube of patients under general endotracheal anesthesia .
We preserved, and later examined microscopically, specimens from 10,621
patients . We found 11 cytologically abnormal smears from subjects with
unsuspected pulmonary involvement, an incidence slightly more than 1 :1,000 .
The accuracy of our method was assessed by calculation of the percent of
abnormal smears obtained from patients with prediagnosed bronchogenic car-
cinomas : 40% when suctioned material was immediately spread on slides,
and 67% when cellular concentration was achieved by mucolysis followed by
filtration or centrifugation . Secretions normally discarded can reveal
much information that would otherwise be missed . Our method may be useful
if applied to patients at risk (heavy smokers, workers with asbestos, nitros-
amine, or benzopyrine, miners of radioactive material, etc) who undergo
general anesthesia for incidental surgery ."
NETTESt1AIM, P ., KLEIN-SZANTO, A .J .P ., MARCHOK, A .C ., STEELE, V .E .,
TERZAGHI, M . F, TOPPING, D .C ., National Institute of Environmental Health
Sciences, Research Triangle Park, North Carolina
"Studies of neoplastic development in respiratory tract epithelium ." (Archives
of Pathology E Laboratory Medicine 105 : 1-10, January 1981)
"The dynamics of neoplastic development in conducting airways were
studied in an animal model using morphologic and tissue culture techniques .
Evidence for the regression of many metaplastic-dysplastic lesions, including
advanced 'preneoplastic' lesions, was provided . This regression of lesions
is not synonymous with reversion of the neoplastic process . The number of
'carcinogen-altered' cells and the number of cells with neoplastic potential
continued to increased as a function of time after carcinogen exposure .
19ith the cell culture methods developed for these studies, it is possible
to analyze qualitatively and quantitatively the progression of the neoplastic
process as it takes place in vivo and to detect and enumerate the progenitor
cells of later-appearing cancers . The investigations also provide strong
evidence suggesting that carcinogen-exposed organs contain many more cells
with neoplastic potential . This expression may, however, be sharply en-
hanced when permissive or promoting conditions prevail . The investigations
open up new avenues to develop means for detection of preneoplastic cell
populations and for therapeutic intervention during early phases of the
neoplastic disease process ."
SHEAR, C .L ., SCALE, D .B . E GOTTLIEB, M .S ., University of California Medical
Center, San Bernadino $ Tulane University, New Orleans, Louisiana
"Evidence for space-time clustering of lung cancer deaths ." (Archives of
Environmental Health 35/6 : 335-43, November/December 1980)
"One parish in Louisiana has the highest reported incidence of lung •
cancer in the United States . Statistically significant space-time clustering
(P < .01) was present among lung cancer deaths (1960-1975) in residents of the
urban portion of this parish . -The spatial distribution of cancer deaths in
the urban portion of the parish was compared to age, year of death, race,
and sex matched control deaths to determine the risk of lung cancer asso-
ciated with resi .dential proximity to industry . For industries with indi-
pendently increased risks, the combination of industries produced risks
• of 1 .9 to 3 .2 (I' C .05) for residing within 1 .2 km of one or more industries
to three or more industries, respectively . The results suggest residential
exposure to industrial effluents is a factor contributing to the rate of
lung cancer . . . .
"The results of this study suggest effluents from industry arc
associated with lung cancer deaths . Since death certificate information
formed the basis for this analysis, the effect of cigarette smoking, life-
time migration patterns, and other host and environmental factors on the
observed associations could not be evaluated, and therefore, are limiting
in this study . The following findings, however, indicate the validity of
the observed residential risks in the absence of information on the above-
mentioned variables : 1) the risks associated with industries which have
innocuous effluents were near unity ; 2) the risks were highest when con-
sidering cases and controls with known residence information ; 3) a'dese-
response' relationship was observed with exposure to increasing numbers of
industries ; and 4) cases tended to live at their residence (13 yr) longer
than controls (ll yr) ."
FORD, A .B . $ BIALIK, 0 ., Case Western Reserve University, Cleveland, Ohio
"Air pollution and urban factors in relation to cancer mortality ." (Archives
of Environmental Ilealth 35/6 : 350-9, November/December 1980)
• "Age adjusted mortality rates for the 1969-1971 adult population in
the United States reveal a consistent pattern of 13% excess cancer mortality
in the metropolitan counties with central cities compared to non-metropolitan
counties . Only 14% of all cancer death exhibit a different pattern . A
detailed analysis of cancer mortality in Cuyahoga County, (Cleveland), Ohio,
during the years 1969-1971, shows that apart from cancer mortality of the
respiratory tract, general air pollution characteristics correlate second-
arily with mortality, compared with socioeconomic factors . . . .
"Recent studies of the epidemiology of respiratory tract cancer
agree that smoking dominates as a precipitating or causative factor . It
seems unlikely, however, that differences in smoking related to residence
within a single metropolitan county can account for the mortality rates
observed in the present study . ,
'Differences in smoking rates among subunits of Cuyahoga County are
not available, but in a survey of smoking habits in the U .S . it has been
noted that 'within the urban area there are practically no differentials
by size of community, extending to urban fringe groups, in the proportion
of smokers for both sexes, including cigarette smokers ."'
3 . OTHER RESPIRATORY CONDITIONS
pAIRS1ITER, R .D . f, WILSON, A .F
., University of California, Irvine "Relationship between sites of airflow limitation and severity of chronic
airflow obstruction ." (American Review of Respiratory Disease 123/1 : 3-7,
January 1981) _ ,
. "We studied thc relationship between sites of airflow limitation and
severity of chronic obstructive pulmonary disease . Pre- and postbroncho-
dilator physiologic testing was performed in 30 subjects with chronic airflow
obstruction (CAO) . Pulmonary function, including the inereasein maximal
expiratory flow at 50% of vital capacity after helium-oxygen breathing
(/~VEmax50), was reduced before and after inhalation of 1 .3,Gmg of meta-
proterenol . Significant correlations were present between values for
L~1'Emax50 and measurements of expiratory flow (p< 0 .001) . In subject s
with severe CAO (one-second forced expiratory volume,<1 .2 L ; percentage
ratio of one-second forced expiratory volume to forced vital capacit y
( 50 %), AVEmax50 was always abnormally decreased . An inverse relation-
ship was present between initial AVEmax50 and changes in oVEmax50 after
inhalation of inetaproterenol (p< 0 .001) . These results suggest that the
site of airflow limitation becomes progressively more peripheral as CAO
worsens, and that severe CAD is usually associated with peripheral sites
of airflow limitation . . . .
"Thirty subjects (55 .6 + 11 .3 yr of age, mean + SD ; 16 men, 14 women)
referred to our pulmonary function laboratory for physiologic testing com-
prised the study group . All subjects had a history of at least 10 yr of
cigarette smoking . The average amount of smoking was 53 .4 + 22 .8 pack-yr .
None of the subjects had clinical evidence of asthma or reversibility of
FEVI,>15$ after bronchodilator administration . All of the subjects had
evidence of expiratory airflow obstruction at high and/or low lung volumes
on the basis of spirometric testing ." .
"Respiratory symptoms and disease related to alcohol consumption ." (American
Review of Respiratory Disease 123/1 : 16-19, January 1981 )
"It was found that alcohol consumption affected respiratory symptoms
and lung function, even when age, smoking habits, and other risk factors
were taken into account . The effect of alcohol was most consistently noted
among male present heavy drinkers who were also heavy smokers . Smoking is
a far more important contributor to respiratory symptoms, but alcohol con-
sumption is a significant risk factor as well . . . .
"The population included approximately 3,800 white non-Mexican
Americans in about 1,600 households in the Tucson area who were enrolled
in the study in 1972 . "
htiRRILL, W .W ., GOODMAN, M ., MATTDAY, R .A ., NAF.GF.L, G .P ., VANDEVOORDE, J .P .,
MYL, A .D . g REYNOLDS, N .Y ., Department of Internal Medicine, New Haven,
Connecticut (CTR-grant )
"Quantitation of carcinoembryonic antigen in the lung lining fluid of normal
smokers and nonsmokers ." (American Review of Respiratory Disease 123/1 :
29-31, January 1981 )
"Sronchoalveolar lavage was performed in 47 volunteers : 19 nonsmokers
and 28 smokers . Total protein, albumin, immunoglobulins C and A, and
carcinoembryonic antigen (CEA) were measured in the concentrated lavage
effluent . Although a significant increase (p < 0 .0m1) in the ratio of CE A
to total protein recovered from the group of smokers was found, this in-
crease primarily reflected the greater increase that occurred in a subgroup
of 7 smokers . Ilowever, the increases in lavage CEA correlated weakly
(p = 0 .096) with smoking history in pack-years, and not at all with
plasma CEA concentrations . Results regarding the number of cells re-
covered and immunoglobulin-to-albumin concentration ratios in these
subjects were similar to those reported by others . Thus, CEA was in-
creased in the Javage fluid of a subgroup of otherwise normal young
smokers . It is possible that CEA might serve as a useful indicator
of future airway disease in certain young smokers ."
HOIDAL, J .R ., FOX, R .B ., LeMARBE, P .A ., PERRI, R . E REPINE, J .E ., University
of Minnesota, Minneapolis
"Altered oxidative metabolic responses in vitro of alveolar macrophages
from asymptomatic cigarette smokers ." (American Review of Respiratory
Disease 123/1 : 85-9, January 1981)
"Supcroxide anion (027) release by alveolar macrophages (A14) from
young asymptomatic cigarette smokers was greater than that by AM from
age-matched nonsmokers . Greater 02z release by Abl from cigarette smokers
was observed before and after stimulation by bacteria or phorbol myristate
acetate (PMA) . In contrast, oxygen uptake and glucose (1-14C) oxidation
by unstimulated or stimulated AM from cigarette smokers was the same as
thatt by AM from nonsmokers . The selective increase of 02> release by AM
from cigarette smokers was not due to .a lack of 02-- scavenging agent within
the cells, since intracellular superoxide di.smutase (SOD) was increased
in AM from smokers . The potential importance of enhanced 02 : release
by AM from cigarette smokers was confirmed by demonstrating that lysis
of fibroblasts induced by AM from smokers was completely prevented by
• addition of SOD and catalase . . . .
"Recent reports have suggested that 027 from phagocytes can impair
antiprotease activity of dl-antitrypsin, and that p[1-antitrypsin activity
is impaired in the lung lavage of smokers . Any of these factors could
perpetuate tissue destruction and/or augment 4he inflammatory cycle ob-
served in some cigarette smokers . All of these previously observed changes
in the lungs of cigarette smokers could be mediated or at least facilitated
by the increased 02-- release from AM in cigarette smokers ."
DOSMAN, J .A ., COTTON, D .J ., GRAHAM, B .L ., HALL, D .L ., LI, R ., FROH, F . g
BARNETT, G .D ., University Hospital, Saskatoon, Canada
"Sensitivity and specificity of early diagnostic tests of lung function in
smokers ." (Chest 79/1 : 6-11, January 1981)
"What are the relative sensitivities and specificities of the 'early'
tests of .lung dysfunction? We describe the findings from a study of virtually
the entire population [4,240] of a rural pollution-free community . Using
abnormal spirometry as a marker of obstructive disease, we evaluated the
two tests obtained from the single-breath nitrogen curve, closing volume
(CV/VC) and the slope of the alveolar plateau (d N2/L), as well as combi-
nations of the two tests . While CV/VC is highly specific (92 .3 percent
in male and 94 .0 percent in female subjects), it lacks sensitivity (36 .8
percent in male and 13 .3 percent in female subjects) and is abnormal in
only 10 .0 and 6 .5 percent of male and female smokers, respectively, a
percentage not dissimilar from the percentage with abnormal spirometry .
However AN2/L, abnormal in 24 h percent of male smokers and 28 .8 percent
of female smokers, rates reasonably well with regard to both sensitivity
(63 .2 percent in male and 66 .7 percent in female subjects) and specificity
(79 .3 percent in male and 74 .0 percent in female subjects) . The group of
smokers with abnormal AN2/L did include fair numbers with abnormal spiro- •
metry (20 .7 percent in male and 16 .1 percent in female subjects) . A
combination of the two tests (abnormal in either dN2/L and/or CV/VC)
has good sensitivity (68 .4 and 80 .0 percent for male and female subjects,
respectively) and specificity (74 .3 and 69 .0 percent for male and female
subjects, respectively) ."
YORK, E .L . 4 JONCS, R .L ., University of Alberta, Edmonton, Canada
"Effects of smoking on regional residual volume in young adults ." (Chest
79/1 : 12-15, January 1981)
"Tests of overall lung function often reveal abnormalities in
elderly smokers, but lung function is less consistently deranged in young
smokers . Since airway closure at higher than normal lung volumes is thought
to be an early indicator of lung dysfunction in asymptomatic smokers, we
used 133xenon to measure regional residual volume, which is affected by
airway patency, with the expectation that any abnormalities present in
young smokers may be more apparent if searched for on a regional basis .
We found no significant difference in overall lung function between II
nonsmokers and 20 smokers (mean age = 23 .8 years), but residual volume .
was significantly higher in the lower-lung regions of the smokers . The
results indicate that even in young persons the lungs are functionally
disturbed by smoking, and the pattern of abnormality is similar to that
seen in patients with chronic obstructive lung disease ."
GERMAN, A .K ., RELOBLOTSKY, G .A . E BONDARENKO, V .P ., Zaporozhe, USSR
"Disorders in ventilation function of the lungs in tobacco smokers ." (Klin-
icheskaia Meditsina [Moscow] 58/4 : 33-6, 1980 : authors' English summary)
"Using the pulmonary and adrenaline functional tests the authors
studied ventilation function of the bronchi in 68 practically healthy
young persons smoking tobacco . A considerable number of the smokers
showed ventilation insufficiency, mainly of an obstructive nature, its
incidence being increased in parallel to the duration of smoking . The
adrenaline test helped reveal latent bronchospasm not manifesting either
clini .c.ally or in the functional tests in the group of the smokers under
examination . The results of the studies significantly indicate the
pernicious role of tobacco smoking in the development of chronic bron-
chitis, they are of practical importance and can be used in antitobacco
smoking campaign ."
BUIST, A .G ., ADAMS, B .E ., AZZAM, A .H . g SEXTON, G .J ., National Heart, Lung
and Blood Institute g University of Oregon, Portland (CTR-grant)
"Pulmonary function in young children with alphal-antitrypsin deficiency .
Comparison with matched control subjects .^ (American Review of Respiratory
Disease 122/6 : 817-22, December 1980) •
"In this paper we report the initial cross-sectional data from a
prospective study of pulmonaryfunction in children with moderately severe
and severe IX1-antitrypsindeficiency . Using a case-control design, our
cases were 19 children 3 to 7 years of age with2r~-antitrypsin deficiency,
Pi phenotype ZZ or SZ . Control subjects were selected from healthy children
participating in a study to establish reference values for functional
• residual capacity and maximal expiratory flow at functional residua]
capacity, using a 1 :1 match for sex, height, age, and weight .
"We found no significant difference between the cases and their
matched control subjects with respect to functional residual capacity
and maximal expiratory flow at functional residual capacity .
"We conclude that through 7 years of age there is no gross impair-
ment in overall pulmonary function in children with moderately severe and
severe xj-antitrypsin deficiency, Pi phenotypes ZZ and SZ ."
BURROWS, B. g TAUSSIG, L .M ., Arizona Health Sciences Center, Tucson
`As the twig is bent, the tree inclines' (perhaps) ." (Editorial : American
Review of Respiratory Disease 122/6 : 813-15, December 1980)
"Studies of lower respiratory tract illnesses (LRI) during child-
hood havc focused primarily on predisposing factors (e .g ., breast feeding,
parental smoking), and on the acute aspects of these illnesses (which
include laryngotracheobronchitis or croup, pneumonia, and bronchiolitis) . . . .
"Based on cross-sectional observations, it has been postulated that
these susceptible children enter adult life with very slightly impaired
lung function and then show an excessive decline in function with age or
have chronic or intermittent respiratory symptoms, especially if they smoke .
• Even if this 'model' can be shown to be correct by longitudinal observations,
one would expect the childhood illnesses to predispose to an asthmatic
bronchitis type of disorder during adult life
. There is no evidence at present that childhood illnesses are related to the emphysematous type of
chronic airways obstruction that is seen primarily in elderly male smokers ."
KLASS, D .J ., University of Manitoba, Winnipeg, Canada
"Cigarette smoke exposure in vivo increases cyclic GMP in rat lung ." (Archives
of Environmental Health 35/6 : 347-50, November/December 1980)
"The enzyme guanylate cyclase is stimulated to produce cyclic guanosine
3',5'-monophosphate (GMP) when lung tissue is exposed to cigarette smoke in
vitro . These experiments tested whether in vivo exposure in rats to cigarette
smoke produces a similar response . Adult rats were anesthetized with pento-
barbital and ventilation with mixtures of air and cigarette smoke at 10 cm
H20 inspiratory pressure was achieved after a tracheotomy was performed .
Lung tissue samples were taken at intervals during the 20-min exposure
period and analyzed for levels of cyclic adenosine 3',5'-monophosphate (AMP)
and cyclic GM4' . Blood carboxyhemoglobin (COHb) levels at 5 min and 15 min
of exposure showed high, but sublethal levels of COHb . Lung tissue cM1P was
unchanged with this exposure, but cGMP levels rose dramatically . Rat lungs
showed no changes related to ventilation under similar conditions in the
absence of smoke . This observed response of cGMP to cigarette smoke may
• represent an important pulmonary defense mechanism . . . .
"The levels of blood COHb in these rats at the end of the exposure
period is rather high . However ; by 5 min of exposure, lung cGI4' levels
are already significantly elevated, at levels of COHb which are similar to
those secn in tobacco smokers and in workers exposed to contaminated environ-
nients . It is likely, therefore, to anticipate that cigarette smokers have
elevated lung levels of cGMP . Whether these increased levels are associated
with the pathophysiology of cigarette smoking remains to be shown ." •
REZNIK-SCIIIILLF:R, II .M ., NCI Frederick Cancer Research Center, Maryland
"Acutc effects of cigarette smoke inhalation on the Syrian hamster lungs ."
(Journal of Environmental Pathology $ Toxicology 4/1 : 285-91, August 1980)
"Syrian golden hamsters were exposed to the smoke from a number of
experimental cigarettes which contained differing amounts of nicotine and
carbon monoxide . Pulmonary hemorrhages were induced, the number of which
were clearly dependent on the nicotine content of the cigarette smoke .
Electron microscopy revealed cytoplasmic swelling and ruptured cell mem-
branes in alveolar type 1 cells and endothelial cells ."
4 . PREGNANCY
DAMK, CII ., LEITIINER, CH ., SINZINGER, H . E SILSERRAUER, K ., University of
"Diminished prostacyclin formation in umbilical arteries of babies born to
women who smoke ." (Letter : Lancet 1 ; 94, January 10, 1981)
"16 women, 8 smoking more than 10 cigarettes a day throughout the
pregnancy (group A) and 8 nonsmokers (group 6) were studied . None had •
taken aspirin-like drugs for the previous 2 weeks . They were free from
disease, especially diabetes mellitus and pre-eclampsia, and there had
been no problems during pregnancy and the perinatal period . Between both
groups there were no significant differences in maternal age, blood pressure,
plasma lipids, and increase in weight during pregnancy, in Apgar indices,
or in birthweight . We examined prostacyclin synthesis in the umbilical
arteries immediatcly after delivery, using Moncada's bioassay, with a syn-
thetic PGI2 standard kindly provided by Dr . John E . Pike . . . .
"Our findings indicate that umbilical arteries in neonates of smoking
mothers exhibit not only morphological but also functional disturbances . A
similar alteration of prostacyclin synthesis in thcse vessels has been reported
in pre-eclampsia by Remuzzi et al . Since prostacyclin is a potent vasodilator
and plays an important role in blood flow maintenance, the harmful effects
of smoking on the fetus may be in part caused by reduced prostacyclin for-
mation . We do not yet know whether the whole arterial system of the fetus
is similarly affected . However, our findings suggest that smoking during
pregnancy is a risk for the developing baby, and one which pregnant women
should always be told abmrt ."
SAER, U .S ., McCLEARN, G .E . g WILSON, J .R ., University of Colorado, Roulder(CTR-grant)
"Fertility, maternal care, and offspring behavior in mice prenatally treated
with tobacco smoke ." (Developmental Psychobiology 13/6 ; 643-52, 1980) •
"Female mice from lines selectively bred for differences in open-
field activity were exposed to tobacco smoke during gestation . Smoke-treated
females were less likely than controls to have produced litters by 23 days
after observation of a vaginal plug . Within the high-active line, fewer
pups of smoke-treated dams survived to weaning . Regardless of treatment,
fewer high-active than low-active offspring survived to weaning . Results
of a 4-day series of open-field activity tests administered to offspring
beginning at 28 days of age indicated that tobacco smoke administered
prenatally and/or during testing depresses open-field activity in both
lines . Other activity tests administered at 50 days of age gave similar
results . Tissue nicotine levels after nicotine injection tended to be
higher in high-active and control groups than in low-active and smoke-
treated groups, respectively . Liver weight expressed as percentage of
body weight was 11 .9% greater in smoke-treated animals than in controls . . . .
"We conclude that this study (1) confirms previous work in showing
detrimental effects of smoke inhalation on offspring production ; (2) reveals
a depressant effect of prenatal or acute smoke treatment on activity ; and
(3) indicates that smoke-induced behavioral, metabolic, and/or anatomical
changes may be genotype-dependent . We wish to emphasize that the differences
reported herein were sequelae of tobacco smoke administered in the apparatus
and manner described . Although the results may be attributable to the
actions of nicotine, other tobacco components (or hypoxia) may have been
5 . IbP1UN0LOGY
BERGMANN, K-C ., Berlin, Germany
"Zur Wirkung des Rauchens auf die Immunfunktion ." (Effect of smoking on
immune function) (A]lergie $ Immunologie [Lepizig] 26 : 3-14, 1980 :
• author's English summary)
"Several tobacco antigens have been isolated inducing both precipitating
and reaginic antibodies in humans and experimental animals . Chronic smoking
leads to histological changes in the respiratory tract . -- Alterations of
humoral immunity have been demonstrated in the respiratory tract of smokers .
Smoking may impair the systemic humoral immunity both in vitro and in vivo .
Cell-mediated immunity are alterated locally and systematically in smokers .
-- The clinical incidence of tobacco allergy is not sure, but there are
evidences that allergic individuals are more sensitive to the nonspecific
noxious effects of active or passive smoking than healthy individuals ."
ZUSSMAN, B .M ., University of Tennessee, Memphis
"Tobacco sensitivity in the allergic population : a review with resuls of
desensitization with 10 percent whole leaf tobacco extract ." (Review : Annals
of Allergy 45/5 : 304-9, November 1980)
"'1'obacco sensitivity is seen in atopic patients who are nonsmokers
but who have clinical symptoms on exposure to tobacco smoke . It is estimated
that 8,000,000 persons with common allergies are also clinically sensitive
to tobacco . Females outnumber males by about 4 :1 and children are affected
as well as adults . The specificity of tobacco sensitivity in 16 atopic
patients is confirmed in this study by positive skin reactions, passive
• transfer and gel diffusion studies . Further purification studies, using
saline extracts of cured tobacco leaves, has shown the active antigenic
material in tobacco to be a glycoprotein, with molecular weight of 18,000
and other known physical and ohemical characteristics including amino acid
analysis . The results of desensitization with 10% whole leaf tobacco
extract in a larger series of 100 tobacco sensitive patients is discussed .
The criteria for making the diagnosis of specific clinical tobacco sen-
sitivity is outlined ."
BYLIN, G ., Huddingc Hospital
"Tobaksallergi -- finns den?" (Tobacco allergy -- does it exist?) (Lakartid-
ningen 77/16 : 1530-2, April 16, 1980)
"'Sbbacco smoke can provoke asthma as an allergic reaction .' This
theory was proposed by Ingvar Stahle and Lita Tibbling in consequence of a
study at Kolmarden Ilospital in 1978 . A scrutiny of this study shows,
however, that the result does not constitute proof of the existence of a
tobacco allergy . The investigation does not differentiate non-specific
and allergic reaction in evaluation of skin tests and bronchial provocation .
The presentation of a completed hyposensitization treatment is too scanty
to allow any conclusions . The interest in the studies of a possible allergy
to tobacco is primarily associated with the question of whether tobacco
smoke contains allergenic substances ."
6 . OTHER SYSTEMIC CONDITIONS
M1IARTTILA, R .J . B RINNE, U .K ., University of Turku, Finland
"Smoking and Parkinson's disease ." (Acta Neurologica Scandinavica 62/5 :
322-5, November 1980)
"A total of 443 patients with Parkinson's disease and a similar number
of age and sex matched controls were interviewed as regards their smoking
habits . A lower proportion of the patients (26 .4%) had smoked when compared
with the controls (32 .7%) . Similarly, the patients had more often stopped
smoking (76 .1%) than the controls The difference in the proportions
of persons who smoked in these two groups may be explained by selective
mortality, or alternatively, by premorbid behavior of Parkinson's disease
patients . . . .
"The low frequency of smoking in Parkinson's disease patients has been
tentatively connected with the metabolism of brain biogenic amines . According
to this proposal, in susceptible persons the ingested nicotine is degraded
to nicotinic acid which in turn might interfere with the tryptophan and
tyrosine metabolism and alterates brain dopamine content . This hypothetical
metabolic error could also result in undesirable effects of smoking thus
limiting the formation of a more permanent smoking habit . Admittedly, our
present knowledge does not permit any conclusions in this respect . Never-
theless, more detailed investigations of smoking and metabolism of nicotine
in relation to Parkinson's disease might uncover data pertinent even to the
pathogenesis of the disease ."
CONRIN, J ., University of Florida, Gainesville
"The EEG effects of tobacco smoking -- a review ." (Clinical Electroencephalo-
graphy 11/4 : 180-7, 1980) •
"In summary, smoking does produce obvious changes in EEG activity . Human
studies have been limited to surface electrodes . These have provided evidence
of the alpha, evoked potential, and CNV effects of smoking . Changes in
alpha and evoked potential activity have been statistically analyzed
across subjects . These analyses indicated statistically significant
arousal effects . However, large individual differences in responding
• were observed but not analyzed . Analysis of individual data in the
Ashton, et . al . (1974) study indicated some arousal effects and some
sedative effects, depending on the personality characteristics of the
individual subject . Differential effects might have been detected in
other studies had individual subject data been adequately analyzed .
"In research with nonhuman subjects, nicotine and tobacco smoke
produced cortical arousal and sometimes a biphasic effect of arousal
followed by apparent sedation . Behavioral effects accompanied the cor-
tica] arousal, including eyelid opening, head movements, and eye movements .
During the synchronization phase, crouching, low mobility, and closed eyes
occurred . Both the limbic and reticular activating systems seem to be
affected by nicotine and smoking with the hippocampus most noticeably
BEGEhWJN, F ., SCHWOY, M . $ SCHOMPELICK, V ., Hamburg University, Germany
"Zigarettenrauchen und duodenogastraler Reflux ." (Cigarette smoking and
duodenogastric reflux) (Innere Medizin 7/5 : 165-8, 1980 : authors' English
"In 10 persons, intragastric bile acids, lysolecithin and lecithin
increased significantly 2 .3-, 2 .9-, 1 .6 fold to reach 0 .43, 0 .109, 0 .07¢.2
mol/m] on average in 1 h-aspirates after cigarette smoking . Thus, intra-
• gastric phospholipids additionally contained larger proportions of lyso-
lecithin (56 vs . 43 .5%) . There was no significant change of volume or pH .
Cigarette smoking increases duodenogastric reflux and indirectly adds to
toxic constituents by higher lysolecithin formation ."
ALI, B ., KAUR, S ., KUMAR, A . $ BHARGAVA, K .P ., King George's Medical
College, l.ucknow, India
"Comparative evaluation of stimulatory effects of oral tobacco and
nicotine consumption on hepatic microsomal N-demethylations ." (Biochemical
Pharmacology 29/22 : 3087-92, November 15, 1980)
"The present study was designed to investigate and compare the
effects of chronic oral tobacco and nicotine consumption on hepatic micro-
somal drug metabolizing enzymes (DME) responsible for N-demethylation of
amidopyrine, morphine and pethidine in rat . Chronic administration of
tobacco for 28 days resulted in a marked increase in the rate of N-demethyl-
atiun of amidopyrine, morphine and pethidine . Such tobacco trcatmcnt
stimulated amidopyrine and pethidine N-demethylations about 2 .5-fold but
that of morphine less than 2-fold . The N-demethylation of these drugs
was not affected by tobacco treatment for 2 and 7 days . Attempts were
made to evaluate the role of nicotine in stimulation of DME by oral
tobacco intake . Tobacco was found to contain 4 .3 + 0 .18% nicotine on
a dry weight basis . Although the magnitude of elevation in microsomal
• N-demetlrylations of these drugs by chronic oral intake of nicotine for
28 days was comparable to that obtained by tobacco treatment, there was
marked difference in the substrate specificity in stimulation of amido-
pyrine and morphine N-demethylations . Nicotine treatment for 2 and 7
days, like tobacco, was also devoid of any influence on the microsomal
N-demethylations . Both tobacco and nicotine inhibited in vitro biotrans-
Tbrmations of amidopyrine, morphine and pethidine to the'ar demethylated
metabolites and the degree of inhibition in the two cascs did not differ
much when compared for different substrates . Preincubation studies •
demonstrated that the inhibition of amidopyrine N-demethylation by
tobacco increased with time but remained unaffected by nicotine . The
nature of inhibition of amidopyrine N-demethylase by tobacco and nicotine
was non-competitive and competitive respectively . The activities of
hepatic microsomal N-demethylases were unaffected in rats killed after 1
hr of a single oral dose of tobacco or nicotine . Therefore, it may be
interpreted that stimulation of DME is possibly due to de novo synthesis
of DME ." - -
LUSCOMBE, D .K . 6 JOHN, V ., Welsh School of Pharmacy, Cardiff, Wales
"Influence of age, cigarette smoking and the oral contraceptive on plasma
conecntrations of clomipramine ." (Postgraduate Medical Journal 56 : Suppl 1,
"The influence of age, cigarette smoking and the oral contraceptive
on the plasma profile and tolerability of clomipramine has been studied in
depressed patients given the drug daily for four weeks .
"0]der patients tend to have higher plasma concentrations of .
clomipramine than the younger and tolerate clomipramine less wel] ; this
latter is considered to be at least partly due to the increased plasma
concentrations of the drug . Clearly elderly patients need a lower dose
than the young if a high incidence of side effects is to be avoided .
"Patients smoking 15 or more cigarettes a day were found to tolerate
daily doses of 75 mg clomipramine far better than nonsmokers . Perhaps
surprisingly, this was not reflected in lower plasma clomipramine concen-
trations in smokers, possibly owing to the high drop-out rate amongst
nonsmokers, which biased these data . Finally, no interaction was observed
in females between clomipramine and oral contraceptives, the concomitant
administration of which did not influence either plasma clomipramine con-
centrations or its tolerability ."
7 . STATISTICS
KARK, J .D ., SMITH, A .11 ., SWITZER, B .R . P HAMES, C .G ., University of North
Carolina, Chapel Hill G University of Otago, Wellington, New Zealand
"Serum vitamin A(retinol) and cancer incidence in Evans County, Georgia ."
(Journa] of the National Cancer Institute 66/1 : 7-16, January 1981)
"A total community sample of 3,102 individuals from Evans County,
Georgia, was followed for 12-14 years . During this period, 129 documented
new cases of cancer were ascertained from medical records and death certi-
ficates . Cases were considered for inclusion only if documented at least
12 months after subjects were inducted into the cohort study . . . .
"As compared to controls, persons that eventually developed cancer •
had significantly lower mean serum retinol levels at least 12 months before
the cancer diagnosis . The association was in the same direction for all 4
race-sex groups, although stronger overall for males than females, and was
consistent for the various cancer sites and cell types . Both matched and
regression residual analyses were used to control for the confounding vari-
ables considered : age, race, sex, obesity, social class, and smoking . . . .
• "Smoking information was missing for 9 patients and 16 controls .
Smoking data, although collected in detail, were dichotomized due to the
small numbers within some of the smoking categories . Comparisons were
made between regular smokers and 'never ,' past, or occasional (<1
cigarette/day) smokers grouped together .
"Females (both white and black) were almost entirely nonsmokers
between 1960 and 1962 in Evans County . Of 104 females, only 6 had ever
smoked . Considering males separately, cancer patients were more often
regular smokers than were controls (50 .0% vs . 36 .0&), as expected . Retinol
residuals appeared to be higher in all never, past, and occasional smokers
(+1 .2,yg/100 ml) than in regular smokers (-2 .9 qg/100 ml) and in males
when considered separately (+2 .O,ug/100 ml vs . -3 .0,«g/100 ml, respectively ;
P= 0 .10) . R'hen retinol was adjusted for Quetelet's index in addition to
age, the smoking relationships were unchanged .
"Within both categories of smoking, the difference between cases and
controls remained . A putative confounding effect of smoking was evidently
not spuriously producing the lower retinol levels in cancer patients as
compared with controls . The suggestion of an interaction of retinol with
smoking, the retinol difference between patients and controls being larger
in nonsmokers than in smokers, could not be adequately dealt with due to .
small numbers ."
h'ILLIAMS, R .R ., SORLIE, P .D ., FEINLEIB, M ., McNAMARA, P .M ., KANNEL, W .B . 6
• DAWBER, T .R ., National Institutes of Health, Bethesda, Maryland
"Cancer incidence by levels of cholesterol ." (Journal of the American
Medical Association 245/3 : 247-52, January 16, 1981)
"In 5,209 subjects studied for 24 years in Framingham, Mass, 691
cases of cancer were documented, with histological confirmation for 94§ .
Predetermined personal characteristics were tested for associations with
subsequent occurrence of cancer at specific sites using multiple logistic
regression . Significant associations of various cancer sites with cigar-
ette smoking, alcohol use, education, height, weight, and parity agreed
with other studies . Serum cholesterol level was inversely associated with
incidence of colon cancer and with other sites only in men ; these inverse
associations were statistically significant after adjustment for age,
alcohol consumption, cigarette smoking, education, systolic blood pressure,
and relative weight . Associations may reflect effects of competing lethal
discases, underlying pathophysiological mechanisms that promote or inhibit
development of cancer in men, biologic or social response to earJy and
undiagnosed states of cancer . . . .
"Table 3 also shows a statistically significant (P ( .05) inverse
association between cigarette smoking level and colon cancer . The magnitude
of this association in men is seen in Fig 1 where smokers of a pack or more
of cigarettes per day had almost one fourth the rate of colon cancer as
nonsmokers . However, lest cigarette smoking be considered beneficial,
• the extreme magnitude of risk for other cancers, such as lung or larynx,
needs to be pointed out . In Framingham, male smokers of more than one pack
per day had 19 times the rate of lung cancer as nonsmokers ."
CAMPBELL, 11 ., University of Cardiff, Wales
"Pfortalite par cancer en Europe . Structures et tendances pour dcs localisations •
determinees -- 1955 a 1974 ." (Cancer mortality in Europe . Site-specific
patterns and trends 1955 to 1974) (World Health Statistics Quarterly 33/4 :
"The age-standardized mortality for each sex for 24 countries in
Europe for each year during 1955-1974 is recorded for the five sites of
cancer -- lung, stomach, large intestine (excluding rectum), prostate and
breast . The trends in the changing rates are examined between countries
and over time ; the trends in the two sexes are compared and general patterns
of cancer mortality for these specific sites throughout Europe are demon-
"Limg cancer mortality has increased for both sexes, stomach cancer
has decreased for both sexes, cancer of the large intestine has had a
variable pattern, and mortality from cancer of the prostate and female
breast bas increased ."
HAKAMA, M ., University of Tampere, Finland
"Prevision de ]'incidence du cancer : presentation des experiences realisees
en Finlande et de que]ques resultats ." (Projection of cancer incidence :
experiences and some results in Finland) (World Health Statistics Quarterly
33/4 : 228-40, 1980 : author's English summary)
"The prediction of the effects of known or postulated intervention is
an important administrative (and sometimes scientific) problem, which can be
successfully handled by the presently available methodological means . The
long-term prediction of cancer risk is a challenging problem without a
general solution . Direct extrapolation of past trends of cancer incidence
or mortality may lead to grossly erroneous results . The long latent period
from the beginning of exposure to the diagnosis of cancer can be utilized
in making predictions . The risk factors used as auxiliary variables have
two prerequisites : (1) they should be preponderent enough and (2) they
should not be subject to unpredictable intervention during the period of
"Some primary sites can be thought to meet these general conditions,
but it is unlikely that overall cancer risk or risk of cancer at all
specific primary sites could be predicted in this way ."
8 . ( :ARBON MONOXIDE
ASHTON, 11 ., STEPNEY, R . & TIIOh P SON, J .W ., University of Newcastle upon Tyne,
"Should intake of carbon monoxide be used as a guide to intake of other smoke
constituents?" (British Medical Journal 282 : 10-13, January 3, 1981)
"The relation between blood carboxyhemoglobin (COHb) and plasma •
nicotine concentrations was studied in a group of 12 smokers smoking cigar-
ettes of three levels of standard delivery . While the intake of carbon
monoxide from a single cigarette was unrelated to the intake of nicotine,
presmoking 'trough' concentrat ;ons of the two substances (reflecting longer-
term exposure) were highly"correlated . Various other measures of nicotine
exposure were at best only moderately correlated with blood nicotine concentrations .
"Thus trough COHb concentrations might be used to provide a reliable
indication of the exposure to nicotine of individual smokers smoking the
same type of cigarette, and of the relative exposure to nicotine of popu-
lations smoking cigarettes of different standard dcliveries ."
KAM, J .K ., University of California, Berkeley
"Carboxyhomoglobin levels between jogging and non-jogging smokers ."
(Experientia 36/12 : 1397-8, December 1980)
"The hypothesis that regular jogging diminishes blood carboxyhemo-
globin levels was tested . 63 smokers were chosen, with 30 of them regular
joggers for 3 years and 33 of them sedentary non-joggers . Blood samples
were taken and carbon monoxide levels measured by a gas chromatograph .
Results showed that smoking joggers had significantly lower carbon mono-
xide levels than smoking non-joggers, with values of the former comparable
to nonsmokers . . . .
'°fhe results are summarized in the figure . The sedentary non-joggers
had an average carhon monoxide value of 8 .5$ (maximum 10 .1, minimum 7 .5 ;
SD=1 .1%), as opposed to joggers with a value of 4 .7% (maximum 5 .8, minimum
3 .9 ; SU=0 .3%) . . . .
"'fhe effects of jogging could be explained by more rapid gas exchange,
increased capillary movement and adaptive carboxyhemoglobin transport to and
from muscular tissue . Since the formation of carboxyhemoglobin is a rever-
sible process, pinpointing the exact pulmonary physiologica] mechanisms
responsible for such a lowering effect awaits further study ."
VANUXEM, D ., GUILLOT, C . G GRIMAUD, C ., Salvator Hospital, Marseille, France
"Tabagisme et monoxyde de carbone ." (Smoking and carbon monoxide consumption)
(Respiration 40/3 : 136-41, 1980 : authors' English abstract)'
"Among 2,069 patients subjected to pulmonary function tests, 20%
were smokers with a mean oxyhemoglobin (IIbCO) level of 5 .2% . Similar values
for HbCO (2 .4%) were found in nonsmokers and ex-smokers . A positive corre-
lation was observed between daily tobacco consumption and HbCO level, i .e .
HbCO = 0 .123 (g/day) + 3 .433 . For a similar consumption (16 g/day), smokers
who inhaled the smoke had a significantly higher level of HbCO than smokers
who did not (5 .8 vs . 4 .7%) . The interval separating the time when the last
cigarette was smoked from HbCO measurement is of utmost importance : for a
similar tobacco consumption (10 g/day) HbCO ranged from 6 .5 + 0 .5% when the
interval was 1 h to 4 .6 + 0 .3% when it was 3 h (p C0 .005) . In some cases,
there were discrepancies between the number of cigarettes smoked as indi-
cated by the subjects and the measured levels of HbCO . Possible inhalation
of exogenous CO from other sources than smoking or increased production of
endogenous CO could amount for these differences ."
KALMAZ, E .V ., CANTER, L .W, g HAMPTON, J .W ., Oklahoma Medical Research Found-
ation, Oklahoma City
• "Effect of long-term low and moderate levels of carbon monoxide exposure on
platelet counts of rabbits ." (Journal of Environmental Pathology 8 Toxicology
4/1 : 351-8, August 1980) 1 .
"Most of the traditional studies of carbon monoxide (CO) toxicology
have emphasized the dramatic effects of heavy exposure, therefore, remarkably
little information is available about the consequences occurring after expo-
sure to low concentrations similar to those found in the polluted community
air . In previous studies hypoxia has been reported to cause a decrease in •
platelet counts in experimental animals . In an effort to investigate the
nbnormalities of circulating platelets in rabbits exposed to low and mode-
rate levels of C0, three groups of animals were studied . The first (control)
group of rabbits breathed ambient air whereas the second was exposed to
low level CO (50 ppm by volume) for 24 hr continuously for 8 weeks . The
third group was exposed to 300 ppm for 4 weeks (8 hr/day for 5 days) .
Per cent oxyhemoglobin (Hb02), per cent hemoglobin (Hb) and per cent
carboxyhcmoglobin (HbCO) and circulating platelet counts were monitored
in all groups . A consistent pattern of change in circulating platelet
quantity was found at the observed time intervals in CO exposed animals .
No changes were observed in the same tests in rabbits exposed to ambient
air . Prolonged low level CO exposure may influence change in circulating
platelet counts and/or congenital platelet function disorders in man through
this mechanism ."
9 . NICOTINE
MALCOLM, R .f. ., SILLETT, R .W ., TURNER, T .A .M . g BALL, K .P ., Central Middlesex
Ilospital, London, England
"The use of nicotine chewing gum as an aid to stopping smoking ." (Psycho-
pharmacology 70/3 : 295-6, 1980)
"Two hundred and ten subjects entered a trial to test the use of a
chewing gum containing nicotine as an aid to stopping smoking . They were
divided into three groups : nicotine chewing gum, placebo chewing gum, and
contro] . The trial was double blind between the two chewing gum groups .
After 1 month the percentage of confirmed nonsmokers in the nicotine gum
group was 34%, in placebo chewing gum group 37% and the control group 24% .
By 6 months most of the nonsmokers had relapsed, but the nicotine gum
group (23%) was more successful than the placebo (S% or the control group
(14%) . . . .
"At present there is no effective means of stimulating the high peak
levels of nicotine produced by tobacco inhalation, although aerosol sprays
have been tried . It is difficult to know whether the marginally greater
success rate of those in the present study using the nicotine gum was due
to the effect of nicotine or chance . However, it is possible that if a
more acceptable 4 mg nicotine gum could be produced this might be helpful
to some smokers who wish to stop ."
IIATCIIELL, P .C . E COLLINS, A .C ., University of Colorado, Boulder
"The influence of genotype and sex on behavioral sensitivity to nicotine
in mice ." (Psychopharmacology 71/1 : 45-9, 1980)
"'fhe influences of genotype and sex on spontaneous motor activity
in a Y-maze after nicotine administration and on nicotine concentrations
in liver and brain were assessed in three inbred mouse strains . The rank •
order of liver nicotine elimination rates in these strains was found to be
C57> C3H = DBA for females and DBAA C3H = C57 for males . Within the C57
and C311 strains, females climiqated nicotine significantly faster than males,
while I16A females and males eliminated nicotine at similar rates . The rank
order of motor depression at early time points after nicotine administration
was found to be DBA = C57>C311 for both males and females . Females of all
three strains demonstrated less sensitivity to nicotine's depressant effects
than males . There did not appear to be any consistent association between
rate of liver nicotine elimination or brain nicotine level and motor de-
pression as measured in the Y-maze . Although variability in liver nicotine
elimination and in brain nicotine content may account for some of the ob-
served behavioral effects, these data suggest that strain and sex differ-
ences in tissue sensitivity to nicotine are of primary importance ."
DAIILSTROhI, A ., BOOJ, S ., HEIWALL, P .-0 . G LARSSON, P .-A ., University of
"The effect of chronic nicotine and withdrawal on intra-neuronal dynamics
of acetylcholine and related enzymes in a preganglionic neuron system of
the rat ." (Acta Physiologica Scandinavica 110/1 :-13-20, September 1980)
"The effect of chronic nicotine treatment, given in the drinking
water for 8-10 weeks in a dose equivalent to that of a heavy cigarette
smoker, and of withdrawal 2 days on acetylcholine (ACh), choline acetyl-
transferase (CAT) and ACh-esterase (AChE) activities in the preganglionic
cervical nerve and the superior cervical ganglia (SCG) of rats, were
studied . Control rats were housed and handled as the nicotine rats .
After cutting the preganglionic nerve 7-19 h before dissection, ACh, CAT .
and AChE accumulated in the nerve part proximal to the cut (relative to
the nerve cell bodies in the spinal cord) . A clearance of these sub-
stances was observed in the nerve distal to the cut . This indicates that
a11 3 substances are transported proximo-distally in this preganglionic
• cholinergic nerve . In the SCG, ACh was decreased already by 7 h (to about
60$), while CAT and AChE-activities were lowered to 60% and 80%, respectively,
at 19 h after cutting the nerve . Chronic nicotine treatment caused an
increased ACh accumulation (by about 35%) and a decreased CAT accumulation
(by about 20%) in the cut nerve, while the ganglionic levels of all 3
substances were essentially unchanged . Withdrawal of nicotine for 2 days
prior to the final experiments caused a reduced ACh-accumulation (by about
30%) in the nerve and normalized the CAT accumulation . The AChE-activity
of intact nerve was markedly increased to about 175% of control, and the
transportable fraction of AChE (clearance distal to the cut) was about
twice as large as in control . In the SCG withdrawal caused marked changes
in the ACh content, which was decreased to 62% of control . CAT-activity
was increased to 117% of control while AChE was unchanged . Our hypothesis
to explain the results is that chronic nicotine treatment and in particular
withdrawal of nicotine may cause marked alterations in the activity of the
preganglionic neuron . This may induce changes in the intra-axonal transport
of the 3 substances and an increased turnover of ACh in the nerve terminals
of the SCG after withdrawal of nicotine ."
10 . SMOKE CONDENSATE P CONSTITUENTS
BOGDEN, J .D ., KEMP, F .W ., BUSE, M ., THIND, I .S ., LOURIA, D .B ., FORGACS, J .,
LLANOS, G . P TERRONES, I .M ., .New Jersey Medical School, Newark g University
of Guadalajara, Mexico
"Composition of tobaccos from countries with high and low incidences of lung
cancer . 1 . Selenium, polonium-210, Alternaria, tar, and nicotine ." (Journal
of the National Cancer Institu(s 66/1 : 27-31, January 1981)
"Tobaccos from countries with high and low incidences of lung cancer
were analyzed . Tobacco concentrations of polonium-210 were similar in
cigarettes from high- and low-incidence countries, as were levels of
cigarette smoke tar and nicotine . Tobaccos from low-incidence countries
had significantly lower Alternaria spore counts . Mean selenium concen- •
trations of tobaccos from the high-incidence countries (0 .16 + 0 .05,yg/g)
were significantly lower than those of tobaccos from the low-incidence
countries (0 .49 . 0 .22Ag/g) .
"In spite of impressive reductions in smoke tar and nicotine, it
can be anticipated that considerable new research directed to the develop-
ment of a safer cigarette will be undertaken . Additional studies on sele-
nium and Alternaria might contribute to such efforts . In particular, the
association between low lung cancer incidence and high tobacco selenium
contentt reported in this study should be further investigated to deter-
mine if any causal relationship exists ."
BAVEJA, A .K . E GUPTA, V .K ., Ravishankar University, Raipur, India
"Toxicity of selenium and its detection in cigarette smoke using a new
reagent ." (International Journal of Environmental Studies 16/1 : 35-6, 198D)
"The method reported is very simple, fast and reliable . OneAg
of selenium/m] in a 5 ml sample of the absorbing solution could be easily
detected without any interference from,the other constituents of cigarette .
smoke . . . .
"Hardly two minutes were required for the extraction of selenium .
Several brands of cigarettes were tried and all of them gave this test
for sclcnium in their smoke . Ilowever, the amount of selenium varied with
different brands . It was also noted that filter-tip cigarette and a fast
rate of suction gave a better test, probably due to reduced interference
from nicotine which normally makes the absorbing solution brown and has to
be decolorized by heating with nitric acid . . . .
"The method reported cannot be used for the quantitative determination
of selenium in cigarette smoke because of the fact that the selenium liberated
does not form a clear uniform suspension in the extracting medium ."
HECHr, 5 .5 ., CARb1ELLA, S ., MORI, H . E HOFFMANN, D ., Naylor Dana Institute for
Disease Prevention, American Health Foundation, Valhalla, New York
"A study of tobacco carcinogenesis . XX . Role of catechol as a major cocarcino-
,gen in the weakly acidic fraction of smoke condensate ." (Journal of the
National Cancer Institute 66/1 : 163-9, January 1981)
"The weakly acidic fraction of cigarette smoke condensate was frac-
tionated by preparative high-pressure liquid chromatography into major
subfractions l-IV . Major subfractions II and III were fractionated further
into subfractions A-J . Subfractions A-J were tested for cocarcinogenicity
on the skin of noninbred Ha :ICR Swiss albino mice by application with 0 .003%
benzo[a]pyrene . Subfractions A-C and F-J showed significant cocarcinogenic
activity ; subfractions A, F, and H were the most active . Catechol was a
niajor component of subfraction A and was also detected in subfractions B-D •
and F . Major components of the other subfractions included hydroquinone
(B), coniferyl alcohol (C and H), hydroxyphenyl alcohols (D), alkyl-2-
hydroxy-2-cyclopenten-l-ones (C ; D, and F), hydroxyacetophenones (F),
phenolic cyano compounds (F), and fatty acids (F) . The results demonstrate
the importance of catechol as a cocarcinogen in the weakly acidic fraction
of cigarette smoke condensate and indicate the presence of other cocarcino-
REZNIK, G . E SAMEK, M ., National Institutes of Health, Bethesda, Maryland G
Ilannover, Federal Republic of Germany
"Deposition and clearance of 14C-labelled cigarette smoke particles in
Syrian hamster respiratory and digestive tract ." (Journal of Environmental
Pathology E Toxicology 4/1 : 371-81, August 1980)
"Eight week old male and female Syrian golden hamsters .inhaled smoke
of Dotriacontane-16, 17-14C-labelled research cigarettes . The investigation
consisted of 4 experiments and each experiment involved 4 groups of 10
animals each . Eighty of the animals (40 males :40 females) were killed
immediately after exposure to the 14C-labelled smoke of 30 cigarettes (10
.qCi/cigarette) and the organs of the respiratory and digestive tract were
measured for their 14C-activity . Non-acclimatized Syrian golden hamsters
inhaled quantitatively more condensate/g organ weight than acclimatized
animals . There was no difference between males and females . Nearly 50%
of the retained 14C-activity was found in the digestive tract, half of
the amount was in the forestomach . The distribution in the respiratory
tractt showed no difference between acclimatized and non-acclimatized
animals . More than 75% of the measured activity in the total respiratory .
tract was found in the lung . The highest concentration was measured in
the lobus dexter caudalis and lohus sinister . The clearance of the lung
was slower in acclimatized hamsters than in non-acclimatized animals .
When animals inhaled the smoke of labelled cigarettes for five days the
• clearance of the lung was slower in acclimatized hamsters than in non-
acclimatized animals ."
KBAST, D . $ A1'RE, D ., University of Western Australia, Nedlands
"Effects of chronic tobacco smoke exposure from high-tar or low-tar cigar-
ettes on the systemic clearance mechanisms of mice ." (Environmental Research
23/2 : 429-43, December 1980)
"Mice were exposed to high-tar (IIT) (16 mg tar/cigarette) or low-tar
(LT) (5 mg tar/cigarette) filtered cigarettes for 8 min per day for up to
30 weeks . Phagocytic and degradative properties of the liver and spleen
were assessed using unopsonized and opsonized radioactive sheep erythro-
cytes (SRBC) inoculated intravenously into naive or immune animals .
Initially phagocytosis of unopsonized SRBC was shown to be compromised
in 11T-tobacco smoke-exposed animals of both the Balb/c and C57Black strains
of mice but not for LT-exposed animals of the BALB/c strain of mice . Later
phagocytosis was also affected in some instances with opsonized SRBC .
Degradation of phagocytosed material did not appear to be compromised
until after 18 weeks of chronic exposure . There was clear evidence of the
C57Rlack strain of mice being more generally affected by tobacco smoke expo-
sure than the BALB/c strain of mice ."
LUB.ANY, P' .C . G ISAAC, R .S ., University of Kentucky, Lexington
"Influence of pretreatment with tobacco smoke condensate or 3-methylchol-
anthrene on [14C] benzo(a)pyrene metabolism in thc isolated perfused rabbit •
lung ." (Toxicology Letters 7/2 : 153-9, 1980)
"Pretreatment 24 h before sacrifice with i .p . tobacco smoke con-
densate (TSC) or 3-methylcholanthrone (3MC) increased the rate of dis-
appearance of [14C] benzo(a)pyrene (BP) from an isolated perfused rabbit
lung model . Both pretreatments significantly increased the amount of
most metabolites formed . This study indicates that rabbits tend to
resemble rats, mice and hamsters in that increased rates of pulmonary BP
metabolism are a consequence of exposure to TSC . . . .
"To mimic the chronic human smoker, rabbits should be exposed to
tobacco smoke components via inhalation . Unfortunately, rabbits are
obligatory nose breathers with a highly efficient nasal filtration network .
They also possess a respiratory reflex that results in a period of apnea
whenever cigarette smoke or other substances with local irritating activity
come in contact with the nasal epithelium . For these reasons it is not
possible to expose rabbits to cigarette smoke components via ihhalation
as is easily done with rodents, and therefore smoke condensate injections
were given ."
CORBHRAND, J ., LAUARRAGUE, P ., NGUYEN, F ., DUTAU, G ., FONTANILLES, A .M .,
GLEIZES, B . E GYRARD, E ., Toulouse, France
"In vitro effect of tobacco smoke components on the functions of normal
human polymorphonuclear leukocytes ." (Infection F, Immunity 30/3 : 649-55, •
"The function of polymorphonuclear leukocytes (PhMs) has previously
been shown to be impaired in smokers in comparison with healthy nonsmokers .
Potent inhibition of PM chemotaxis has been achieved with xfiole tobacco
smoke, the gas,phase of smoke, and a water-soluble extract of whole smoke .
In the present work several aspects of PM function were studied after
exposure to water-soluble fraction of the particle phase of tobacco smoke
collected on glass fiber filters . These tests included capillary tube
random migration, chemotaxis under agarose, phagocytosis of yeasts, Nitro
Blue Tetrazolium dye reduction, and whole-blood bactericidal activity .
The water extract of the particle fraction of smoke had a high content
of nicotine when compared with the levels achieved 'an plasma of smokers and
a much lower concentration of aldehydes when compared with the gas phase
of smoke . It had no cytotoxic effect and did not affect phagocytosis,
oxygen consumption, or bactericidal activity . Nitro Blue Tetrazolium
reduction of both resting and stimulated PFWs was significantly decreased
only with the most concentrated solution . The tested solutions exerted
a dose-related depressive effect an capillary tube random migration,
whereas the random migration measured in the agarose chemotaxis test
was normal . Nevertheless, the chemotactic response to a caseine solution
was significantly decreased . The same tests wore performed in the presence
of several concentrations of a nicotine solution and the only test to be
affected was the capillary tube random migration, and, that only at a
very high concentration . The results of this study contribute to the •
more precise delineation of the extent of the dysfunction of P4LNs exposed
to tobacco smoke components and indicate that deleterious products are
released from the particle phase of the smoke, which deposits all along
the respiratory tree .'! "
PARIRA, M ., RiCIITER-REICHIIELM, H-B ., SC1tNEI0ER, P . $ MOtIR, U ., Hannover,
Fcdcral Republic of Germany
"Sensitivity of Syrian golden hamster fetal lung cells to benzo[a]pyrene
• and other polycyclic hydrocarbons in vitro ." (Toxicology 17/2 : 149-55,
"Dose responses were compared of cultured fetal Syrian golden
hamster lung cells (FS11L) to the toxic and transforming effects of benzo[a]pyrene
(B[a]P), benzo[b]fluoranthene (N[b]F), benz[aJanthracene (R[a]A), indeno
[1,2,3-c,d]pyreno (I[c,d]P), benzo[k]fluoranthene (B[k]F) and benzo[e]
pyrene (R-(e]P) . Effort was first given to standardizing the techniques
for evaluating B[a]P dose-responses . These polycyclic aromatic hydro-
carbons (PA11) were then tested at concentrations of up to 1~ig/ml, and
only B[a]P showed clear cytotoxicity . The transforming effects of B[b]F,
B[a]A and I[c,d]P at 1,qg/ml appeared comparable to those of R[a]P at
0 .05,[~_g/ml ."
IISU, S .C ., POLLACK, R .L ., IISU, A .C . $ GOING, R .E ., Temple University School
of Dentistry, Philadelphia, Pennsylvania
"Sugars present in tobacco extracts ." (Journal of the American Dental
Association 101/6 : 915-18, December 1980)
"The presence of fructose, glucose, sucrose, maltose, and isomaltosb
in commercial tobacco products was identified and quantitated . Gas-liquid
chromatographic studies showed that these five types of sugar were present
in the water-soluble extracts of pouch and plug chewing tobacco, yet only
fructose and glucose were found in extracts of snuff and unprocessed
natural tobaccos . The amount of sucrose present in pouch chewing tobacco
was twice that in plug chewing tobacco . No detectable amount of sucrose
was found in snuff or unprocessed natural tobaccos . The content of maltose
and isomaltose was much less than the content of fructose, glucose, or
sucrose . All unprocessed natural tobacco leaves studied as controls con-
tained low amounts of fructose and glucose, and no detectable amounts of
sucrose, maltose, or isomaltose . The larger amounts of fructose and
glucose, and the additional sucrose, maltose, and isomaltose present in
pouch and plug chewing tobaccos are probably added during the manufacturing
11 . SMOKING HABITS . . ..
SCIIROLL, M ., University of Copenhagen, Denmark
. "Smoking habits in the Glostrup population of men and women, born in 1914 .
Implications for health, evaluated from ten-year mortality, incidence of
cardiovascular manifestations and pulmonary function, 1964 1974 ." (Acta
Medica Scandinavica 208/4
: 245-56, 1980) "Of a total population of S14 men and 461 women, born in 1914,
from seven municipalities in Copenhagen County, 87% were examined in 1964
and 1974 . Smoking habits (inhalation, kind of tobacco, amount, duration of
smoking and changes over a decade) have been described in this age-specific,
• general population . The health implications were examined . Tobacco con-
sumption was in this population the most important risk factor for overall
mortality, cardiovascular manifestations, peripheral arterial disease,
decline in pulmonary function and symptoms of ulcer . The results are
consistent with other prospective epidemiological studies . The relative risk
of death, of fatal and nonfatal cardiovascular manifestations, and of decline
in pulmonary function increased gradually with the amount of tobacco smoked .
Inhalation roughly doubled the risk . The excess risk for pipe/cheroot •
smokers was less than that for cigarette smokers . Ex-smokers reduced their
risk about 50% . The risk associated with smoking was independent of other
factors . The excess risk attributable to smoking was as great in women as
in men, but the community problem of smoking-related diseases was mostt
pronounced in men, among whom smoking habits are more widespread and mor-
bidity is higher . The results from the 1914 population study suggest that
almost one third of all deaths and heart attacks in middle-aged Danes might
be avoided, if all 50-year-olds would have given up smoking ."
BACfm1AN, J .G ., JOHNSTON, L .D . E 0'MALLEY, P .M ., University of Michigan,
"Smoking, drinking, and drug use among American high school students :
correlates and trends, 1975-1979 ." (American Journal of Public Health 71/1 :
59-69, January 1981)
"This paper uses findings from five nationally representative surveys
of high school seniors from 1975 through 1979 to examine the correlates of
licit and illicit drug use, and to consider whether recent changes in youth-
ful drug use are linked to any changes in the correlates . Males still exceed
females in use of alcohol and marijuana, but no longer in cigarette smoking .
Black seniors now report less drug use than Whites . Other dimensions of
family background, region, and urbanicity show only modest associations
with drug use . Above average drug use occurs among those less successful
in adapting to the educational environment, as indicated by truancy and •
low grades ; those who spend many evenings out for recreation ; and those with
heavy time commitments to a job and/or relatively high incomes . Drug use
is below average among seniors with strong religious commitments and con-
servative political views . Prom 1975 through 1979, among seniors cigarette
use peaked and subsequently declined, marijuana use rose and then levelled
off, and the (still infrequent) use of cocaine rose rapidly . However, these
shifts in drug use were not accompanied by substantial shifts in the above
correlates of use . The findings thus suggest that the kinds of young people
most at risk remain much the same, while the types and amounts of substances
they use shift somewhat from year to year ."
REINF:RT, M ., Saarbrucken, Germany
"Rauchgewohnheiten von 8-16 jahrigen Schulern ." (Smoking habits in children
aged 8-16 years) (Praxis und Klinik der Pneumologie 34/10 : 620-7) 1980 :
author's English summary)
"316 pupils of 2 primary and one secondary school wrote essays on
smoking . These essays served as the basis for a questionnaire which was
answered by 195 and 151 children of a primary and secondary school respective-
ly . 27 per cent of children in the 8-10 years age group and 33 per cent of
the 12-years old smoked occasionally . At the age of 13 24 .3 per cent smoked
occasionally or regularly at least one cigarette per day ; at the age of 15
years the proportion of smokers had increased to 51 .3 per cent . The younger •
children got their cigarettes from their older friends ; the older ones
bought them with their pocket money . 10 per cent of the children were given
them by members of their family . . The reason given for smoking was that it
was 'fun' . The children were aware of the dangers of smoking, particularly
of the risk of lung cancer . There was a negative correlation between smoking
habits and the social class of the children and their parents . Health
education should already begin when the child starts school and regular
television programs should make parents and children aware of the risks
attendant on smoking ."
SILVORSTEIN, B ., FLLD, S . F, KOZLOWSKI, L .T ., SUNY, Stony Brook f Addiction
Research Foundation, Toronto, Canada
"The availability of low-nicotine cigarettes as a cause of cigarette smoking
among teenage femalcs ." (Journal of Health and Social Behavior 21/4 : 383-8,
"'fhe incidence of cigarette smoking among teenage females has greatly
increased during the past decade . We suggest that this increase has been
encouraged by the increasing availability of low-nicotine cigarettes .
Recent research has shown that physiological response to nicotine level is
an important factor in whether and when people choose to smoke cigarettes .
Analysis of a survey of students [574 males, 626 females] in a suburban
high school suggests that females (as compared .with males) experience both
a greater social pressure to smoke and a greater physiological pressure
not to smoke stemming from a higher sensitivity to nicotine . Females
apparently resolve these conflicting pressures by becoming lighter smokers
than males and by switching to low-nicotine cigarettes . An implication of
this process is that if low-nicotine cigarettes were less available, it
is likely that many females would chodse not to smoke rather than experience
unpleasant nicotine-overdose reactions ."
• SUTTON, G .C ., Western General Hospital, Edinburgh, Scotland
"Assortetive marriage for smoking habits ." (Annals of Human Biology 7/5 :
449-56, September/October 1980)
"Assortative marriage for smoking habits was studied in 68 engaged
couples, 112 newly wed couples, and 223 couples married for six years or
more . All thPee groups showed a fairly strong correlation between couples
for smoking, r= 0 .332 + 0 .047 (mean • SD) . Smoking habits were highly
intercorrelated with social class and education but the correlation for
smoking remained highly significant, even when correction was made for
these factors . Because this correlation was present even in those who
have not yet married, smoking habits may well be an important factor in
choosing a marriage partner .^
HOLROYD, J ., University of California, Los Angeles
"Hypnosis treatment for smoking : an evaluative review ." (International
Journal of Clinical 8 Experimental Hypnosis 28/4 : 341-57, 1980)
"17 studies of hypnosis for treatment of smoking pub]ished since
1970 were reviewed . Abstinence after 6 months posttreatment ranged from
4% to 88% . Effectiveness of treatment outcome was examined in terms of :
S population, individual versus group treatment, standardized versus in-
dividualized suggestions, use of self-hypnosis, number of treatment sessions
and time span covered by the treatment, and use of adjunctive treatment .
At 6 months follow-up, more than 50% of smokers remained abstinent in
programs in which there were ~everal hours of treatment, intense inter-
personal interaction (e .g : ;-individual sessions, marathon hypnosis, mutual
group hypnosis), suggestions capitalizing on specific motivations of
individual patients, and adjunctive or follow-up contact . The 17 studies
are presented in sufficient detail to permit clinicians to follow the
published procedures, and recommendations are made for future research ." •
KIIALATBARI, F. ., DCLORWI, P ., DELORME, S . F, SBPCTJAN, M ., Lyon, France
"Une methode d'aide personnalisee a In desintoxication tabagique comportant
une seance unique d'acupuneture ." (Help to stop smoking by a single acu-
puncture session) (Lyon Medical 244/17 : 273-6, November 15, 1980 : authors'
"In the context of the methods for helping to tobacco detoxication,
a study, dealing with 308 smokers treated by a single session of acupune-
ture with a follow-up period from 18 months to 3 years, was carried out .
The effectiveness of the method was checked thanks to 241 telephone inter-
views and 67 written responses to a questionnaire . The global rate of
smokers who definitely stopped smoking after 18 months was 25% with im-
portant variations depending on the sex .
"The results obtained show that for a motivated patient stopping
smoking takes place with the greatest comfort and the least difficulties .
"The method proposed here is smooth, efficient and economic ."
12 . MISCELLANEOUS
SELIKOFF, I .J ., Mount Sinai Medical Center, New York
"Smoking and the workplace," (Letter : Ameri.can Journal of Public Health
71/1 : 92, January 198])
"In the limited confines of an editorial comment, Dr . Kotin has
focused on one important aspect of the smoking-hazardous agent problem .
But there are others, including controlling the workplace exposure that
makes the smoking particularly dangerous . . . .
"It is of additional interest that hazardous agents may have effects
that are not associated with smoking, and avoidance of cigarettes won't
help . Among the asbestos workers, for example, mesothelioma, cancer of the
stomach, cancer of the colon-rectum and cancer of the kidney occurred with
approximately equal excess among smokers and nonsmokers . Only effective
control of asbestos exposure would have helped .
"Both approaches are needed . Let's do all we can to explain the
hazards of smoking to workers . And let's do all we can to avoid hazard-
ous work cxposures ."
R'IISON, D ., Maryland Committee on Occupational Safety & Health, Baltimore
"Smoking and the workplace ." (Letter : American Journal of Public Health 71/1 :
92-3, January 1981) •
"Few in the public health commwnity would disagree with Kotin's concern
regarding health hazards associated with cigarette smoking . However, to
confuse this private behavior, practiced by large and varied segments of
the population, with the environmental conditions in the workplace, is a
serious error with grave implications for remedial action
. "Chemical, biological, and physical hazards mark the terrain of
today's workplace ; whether the site be a grain elevator, steel mill, or
slaughterhouse . . . .
"Civcn the magnitude of the problem, and the dearth of current efforts
to control environmenta] hazards, it is an affront to pose smoking cessation
as an answer to our current occupational disease epidemic . Although Dr . Kotin
cites impressive statistics and discloses reputable studies linking the
interaction of smoking and workplace hazards to disease outcomes, his
analysis clearly overemphasizes the role of smoking ."
KOTIN, P ., Johns-Manville Corp ., Denver, Colorado
"Smoking and the workplace ." (Letter : American Journal of Public Ilcalth 71/1 :
93, January 1981)
"The slightly increased risk to lung cancer in nonsmoking asbestos
workers that has been reported in some studies, and is implicit in the
figures given by Dr . Selikoff, still needs to be analyzed on the basis of
histological diagnosis, anatomical site of tumor, so as to verify the con-
clusions as to etiology . The reports of this slight increase, as well as-
reports of a similar relative risk to lung cancer for both smoking and
nonsmoking asbestos workers such as that by Enterline, have been used as
a basis for denigrating attempts to control smoking in the workplace . . . .
"What should the regulatory agency do about situations like asbestos
where smoking can transform a nonhazardous exposure into a hazardous one?
The issue needs more attention and evaluation than it is getting now,
especially as technology in many industries is reaching the point of con-
trolling exposures to virtually undetectable levels . Although U .S . regu-
latory agencies seem unwilling to tackle this problem, it is noteworthy
that a'Oirective on Worker Protection from Asbestos Exposure' just
approved for transmission to the European Economic Commission has, along
with many specific and strong directives for workplace environmental
control and work practices, the statement 'It will be forbidden to smoke
in places where asbestos is used .' To repeat Dr . Selikoff's comment,
'Both approaches are needed .t"
ELLIOTT, 11 .L . E REID, J .L ., Stobhill General Hospital, Glasgow, Scotland
"The clinical pharmacology of a herbal asthma cigarette ." (British Journal
of Clinical Pharmacology 10/5 : 487-90, November 1980)
"In view of increasing evidence of abuse, there appears to be good
reason to restrict the availability of these preparations . Although a
herbal cigarette might possible be recommended for the asthmatic who in-
sists on continuing to smoke, for the great majority of asthmatic patients
alternative, effective anticholinergic bronchodilator therapy with a
standardized, metered aerosol (ipratropium) is available and offers
distinct advantages in therapeutic practice ." -
"A resoluti°n ." (New Scientist 89 : 88, January 8, 1981)
"Here's a puzzler for the New Year . One of the quotes below is
from an article which Professor Philip Burch wrote for New Scientist_ in
1974 . The other is from llans Eysenck's recent book The Causes and
Effects of Smoking . See if you can spot the crucial mistake in one of
them -- and say who perpetrated the error . All we will say is that some-
one ought to make a New Year's resolution to improve his proof-reading .
`Each well-defined natural disease with a reproducible age-pattern
results from a specific breakdown in the central system that, in health,
regulates growth and controls the size of tissues .I
'-'A11 well-defined natural diseases with a reproducible age pattern
result from some specific breakdown in the central nervous system that,
in health, regulates growth and controls the size of tissues ."'
n repeating Burch's statement, Eysenck apparently added the modifying
word "nervous" to Burch's original "central system ."]
13 . BRIEFS F'ROM MEETINGS
International Association for Dental Research, Sydney, 28
Australia, August 27-29, 1979 •
Anierican Federation for Clinical Research, Carmel, 29
California, February 4-6, 1981
Society for Investigative Dermatology, Inc ., 30
(:armel, California, F'ebruary 4-6, 1981
International Association for Dental Research, Sydney, Australia, August
The following abstracts appeared in Journal of Dental Research 59 :
November 1980 on the pages indicated .
., University of Melbourne "Salivary immunoglobulin A(SIgA) in smokers and nonsmokers ." (p .1786)
"F'revious studies have indicated that oral mucous membrane carcinoma
occurs more frequently in smokers than nonsmokers although a causal relation-
ship between tobacco smoking and oral cancer has not been established . It
has becn shown that chronic exposure to tobacco smoke causes immunosuppression
in animals and a proposition has been developed that local suppression of
the immune response mightt allow the development of neoplastic disease in
that situation . It was the purpose of this study to determine SIgA levels
in aged edentulous males not medically ill or regularly taking therapeutic
drugs and to relate these levels to tobacco smoking . Twenty-one subjects •
aged 65-74 years were studied, 8 of whom were cigarette smokers for at
least 40 years and 13 nonsmokers . Mixed unstimulated saliva was collected
at least 2 hr following intake,-of food or beverages, centrifuged at .200xg
for 10 min at 4°C and stored at -20oC . The concentration of SIgA w•as
estimated by a modification of the Mancini single radial immunodiffusion
technique where the area of the precipitate produced against a standard
anti-human serum IgA was measured and converted to a concentration of mg/100
ml by reference to a standard curve developed from the use of dilutions of
a standard human serum 1gA . Contrary to the reported findings the results
of this study indicate that SIgA levels of chronic cigarette smokers are
lower than that of nonsmokers (a mean value of 2 .67 mg/100 ml compare d
with 5 .84 mg/100 ml where p C 0 .001) which supports the proposition of a
local suppression of immunological reactivity by tobacco smoking . "
RAP1IS, C .N ., POhERS, J .M . g FAN, P .L ., University of Michigan, Ann Arbor
"Staining of composite resins by cigarette smoke ." (p .1849 )
"Clinical observations suggest that cigarette smoke may be responsible
for discoloration of composite restorations in vivo . This study measured
quantitatively color changes in composite resins in a controlled smoking
chamber as a function of material, surface finish, and cleaning . Concise
(C), Simulate (S), and Isopast (I) were evaluated . For each product, three
samples were polymerized against a mylar surface and three were finishe d
by a 600-grit aluminum oxide paper . The samples were subjected to smoke
in a chamber which provided a continuous flow of smoke from 40 cigarettes
at a rate of one cigarette/4 min . The contrast ratio (CR), luminous
reflectance (LR), dominant wavelength _(DW), and excitation purity (EP
)foreachsmplebforestain g,aftersain g,andfterclanigwer e
calculated from reflectance curves obtained with a reflectance spectro-
photomcter . The data were analyzed by a three-way analysis of variance
at the 95% level of confidence . Smoke stain caused a decrease in LR from
63 .7 (0 .5) to 55 .2 (1 .3) for C, and from 66 .7 (1 .3) to 61 .3 (2 .0) for S .
After staining, HP increased from 0 .325 (0 .004) to 0 .400 (0 .012) for C
and from 0 .321 (0 .008) to 0 .379 (0 .012) for S . CR and DW remained un-
changed for all materials after staining . The color of I was not affected
by the smoke stain . Cleaning the composite samples with a detergent
resulted in values of EP and LR that were not statistically differen t
from t e ase line values . Surface prepa ti
major or rne comp osites not
have a effect on the retention of stain or on
r cleaning . Two conven-
tional composites stained more in vitro than a microfilled composite . "
American Federation for Clinical Research, Carmel, California, February
4-6, 198 1
The following abstract appeared in Clinical Research 29/1 : 35, February 1981 .
R079ER, J .l ., ELASIIOFF, J .D ., KURATA, J .H ., WONG, F,L ., REEDY, T .J ., GOLDBERG ,
G . g SAMLOFF, I .M ., University of California-Los Angeles, Santa Monica
"Smoking, a risk factor for peptic disease ; demonstration of an effect on
serum pepsinogen I levels . "
"We examined the relationship between smoking and peptic ulcer in
a cross-sectional study of participants in two health insurance programs .
Responses to questionnaire items about smoking and ulcer history obtained
from 564 males and 663 females over the age of 15 showed a positive asso-
ciation : among males, peptic ulcer was reported in 9% (36/393) of smokers
and 2% (4/171) of nonsmokers (p< .01) ; among females, the respective
values were 8% (27/350) and4 .58 (14/313) . To examine the potential
mechanisms of this association, the incidence, duration, and amount of
smoking were compared with serum pepsinogen I (PG I) levels . Mean PG I
levels were 17% lower in women than in men . The mean . SIl PG I was
77 • 29 ng/ml in male smokers and 66 + 29 in male nonsmokers (p <,01) .
For females, the values were 64 t 32 and 56 + 26 respectively (p< .01) .
Serum PG I levels increased progressively with increasing duration of
smoking, from 69 ng/ml in males with <2 years of smoking to 83 after
10 to 20 years, and from 40 to 73 ng/ml in females . PG I levels fell in
heavy long term smokers (> 20 years) . This correlation is similar to
that found between serum PG I and the degree of gastritis, namely an
increase with mild gastritis and a decrease with increasing severity of
gastritis . PG I levels were umrelated to age, weight, height, ponderal
index, blood group, secre[or status, and urinary pepsinogen phenotype .
We conclude that ]) smoking is a risk factor for peptic ulcer, and 2) serum
I'G I levcl is related to the incidence and duration of smoking . tJe propose
that PG 1 levels reflect the degree of inflammation of the gastroduodenal
mucosa, and speculate that this may predispose to u]cer ."
Society for Investigative Dermatology Ine . Carme] California February
The following abstract appeared in Clinical Research 29/1 : 155,
February 1981 .
KASSAI, M .M ., ORENBERG, E .K . $ BARTHOIAMEW, J .C ., University of California,
Berkeley 8 Stanford University School of Medicine
"Comparative study of metabolism of some polycyclic aromatic hydrocarbons
in human epidermis •
." "The in vivo difference in carcinogenic potentials of various
polycyclic aromatic hydrocarbons(PAII) lie with their metabolic activation
or with their subsequent binding to cellular macromolecules . In in vivo
mouse skin tumorigenicity studies the widespread environmental pollutant
PAH benzo(a)pyrene (B[a]P) has been established as a potent carcinogen,
while its structural isomer benzo(e)pyrene (B[e]P) was found to have
very little activity . In this study the metabolism of B(a)P and B(e)P
were compared in human primary epidermal cells in culture . Radioactive
label experiments show that both 3H-B(a)P and 3H-B(e)P are converted to
ethylacetate soluble metabolites as well as to water soluble conjugates .
The time course of this conversion suggests that B(e)P is metabolized
both by constitutive and inductive activity while e(a)P . .is metabolized
by only inductive activity .
"The metabolic profile of both compounds was studied by HPLC . In
case of B(a)P the radioactivity cochromatographs with the fluorescence
traces of the standard B(a)P mctabolitesidihydrodiols,phenols and dial-
epoxides . The B(e)P metabolites elute with similar retention time as the
B(a)P dihydrodiols and phenols, and early eluting radioactive fractions in
the tetrol and triol region suggests that B(e)P may be metabolized to a
diolepoxide in these human skin cells . The chemical identification of
these B(e)P metabolites is under way .
"In conclusion, the present study reveals that human epidermal cells
convert B(a)P and B(e)P to metabolites that may have carcinogenic activity ." •
14 . ADDITIONAL REFERENCES
ALThL1N, D .G . (England), "Statistics and ethics in medical research . VIII .
lmproving the quality of statistics in medical journals," Brit Med J 282 :
• 44-7, January 3, 1961
AXELSON, 0 . E SUNDELL, L . (Sweden), "Mining, lung cancer and smoking,"
Letter : Scand .1 Work Env HIth 6/3 : 228-30, Sept 1980 (Reply to FELDSTEIN 8
BAND . Defends results that showed more LC deaths among nonsmoking miners
than among those who smoked)
BAR1S, Y .1 . et al (Turkey), "Clinical and radiological study in sepiolite
workers," Arch Env Hlth 35/6 : 343-6, Nov/Dec 1980 (No rel betw pul fibrosis
G sepiolite inhal found . All fibrotic patients were smokers and came from
dusty rural regions where tremolite [asbestos] and zeolites were present)
BECK, K .H . 8 DAVIS, C .M . (Syracuse U, NY), "Predicting smoking intentions
and behaviors from attitudes, normative beliefs, and emotional arousal,"
Soc Behavior $ Personality 8/2 ; 185-92, 1980
BLUM, A . (Doctors Ought to Care, Chicago), "Cessation of smoking," Letter :
JANA 245/4 : 347, Jan 23-30, 1981 (Defends his criticism of TICHENOR 8
-SOLOMON's nicotine neutralization treatment)
BROICH, J .R . et al (SUNY College of Optometry, NYC), "Isolation and identi-
fication of biologically active contaminants from soft contact lenses .
I . Nicotine deposits on worn lenses," Investigative Ophthalmology 8 Visual
Sci 19/11 : 1328-35, Nov 1980
• BURCII, P .R .J . (England), "Exercise and the heart," Letter : Lancet 1 : 36,
Jan 3, 1981 (Comment on Morris et al . Although it is possible that exercise
protects against IHD, it is also possible that incipient heart dis tends to
prevent office workers from exercising, or it is possible that m genetically
predisposed to IHD tend also to be genetically predisposed to sedentary
BURCII, P .R .J . (England), "Smoking out censorship," Letter : New Scientist 89 :
94-5, Jan 8, 1981 (Critical of causal hypothesis of smoking and lung cancer)
DYER, A .R . et al (Northwestern U, Chicago), "Heart rate as a prognostic
factor for coronary heart disease and mortality : findings in three Chicago
epidemiologic studies," Am J Epidem 112/6 : 736-49, Dec 1980 (Data from
Chicago Peoples Gas Co ., Chicago Western Elec, and Chicago Heart Ass'n
Detection Project . Heart rate signif RP for sudden CHD death 8 non CVD
death in 2 of the 3 studies used)
ELKIND, A .K . (England), "Nurses' smoking behavior : review and implications,"
Int'l J Nursing Studies 17/4 : 261-9, 1980
FELUSTEIN, M .L . $ BAND, P .R . (Harvard/Canada), "Mining, lung cancer and
smoking," Letter : Scand J Work Env Hith 6/3 : 227-8, Sept 1980 (Comment on
AXELSON and'SUNDELL . Conclusions that among miners, nonsmokers are more
apt to develop LC than smokers and that after induction, LC develops more
quickly among smokers than nons unwarranted)
GLASS, R .I . et al (CDC, Atlanta, Ga), "Risk factors for myocardial infarction
associated with the Chicago snowstorm of Jan 13-15, 1979, " JAMA 245/2 :
164-5, Jan 9, 1981 (M with nonfatal MI after snowstorm were indistinguish-
able on the basis of previous cardiovas hist or cor RFs -- smkg, BP, diabetes, •
obesity, gout -- from others having an M1 in a nonblizzard period . liyper-
cholesterolemia 4 times as common among MI cases)
GLAT7, IL R . et al (Germany), "Improvement of the correlation of bacteria]
mutagenicity with carcinogenicity of benzo(a)pyrene and four of its major
metabolites by activation with intact liver cells instead of cell homo-
genate," Cancer Res 41/1 : 270-7, Jan 1981 (Poor correlation betw whole-
animal c :.rcinogenicity and mutagenicity in the Ames assay of BP metabolites
is duo to differences in metabolism of the compounds in the 2 systems rather
than to differences in the biological end points of bact mutagenicity vs .
GORI, G .R ., Editor (NCI), Report No . 4 . Toward Less Hazardous Cigarettes .
The Fourth Set of Experimental Cigarettes, March 1980 . National Cancer
Institute, Smoking and Health Program, 213pp (Incl sections on leaf analysis,
chemical characteristics, mouse dermal bioassays of smoke condensates, correl
betw chem composition and biolog activity)
GRAFSTROM, R . & IIOLMBERG, B . (Sweden), "The effect of long-term treatment
with disulfiram on content of cytochrome P-450 and on benzo(a)pyrone mono-
oxygenase activity in microsomes isolated from the rat small intestinal
mucosa," Toxicology Letters 7/1 : 79-85, Nov 1980 -
I1i6GINS, M . (D Mich, Ann Arbor), "A public health issue," Book review :
Science 211 : 160-1, Jan 9, 1981 (Rev of A Safe Cigarette, Banbury Report 3)
HOLMES, D .R ., Jr . et al (Mayo Clin, Rochester, MN), "Association of risk
factor variables and coronary artery disease documented with angiography,"
Circulation 63/2 : 293-9, Feb 1981 (Discrimination did not provide sufficient
separation of the groups to give results useful diagnostically in individual
pts, although highly signif assoc betw RF B presence of CAD found . RFs
incl smkg, age, family hist, BP, diabetes, weight)
INGLE, J .1 . (Palm Springs, CA), "Smokeless tobacco," Letter : J Am Dental Ass'n .
101/6 : 896, Dec 1980 (Comment on A .G . CHRISTEN . Warns of dangers of snuff)
KIRK, C .J .C . et al (England), "The effect of advice to stop smoking on
arterial disease patients, assessed by serum thiocyanate levels," 3 Cardiovas
Surg 21/5 : 568-9, 1980 (12 of 32 stopped smkg . Serum thiocyanate did not
support claims of pts who said they reduced c'ette consumption . Serum
thiocyanate discriminated well between smokers $ nonsmokers)
LANCET (UK), "Oxides of nitrogen and health," Lancet 1 : 81-2, Jan 10, 1981
(Comments on N02 pollution in the home from gas cooking)
LAZARATOU, 11 . et al (Greece), "The pharmacological effect of fractions obtained
by smoking cannabis through a water-pipe . II . A second fractionation step,"
Experientia 36/12 : 1407-8, Dec 1980
LIPPMANN, M . et al (NYU Med Ctr, NYC), "Deposition, retention, and clearance
of inhaled particles," Brit J Ind Med 37/4 : 337-62, Nov 1980 (General review •
incl eff pollutants including c'ette smke, lung disease, alveolar clearance
mechanism, translocation of particles w/in the lungs, aerosols, alveolar
clearance kinetics) I
L1'NCII, 11 .1 . et al (Creighton U, Omaha, Neb), "Familial excess of cancer of
the ovary and other anatomic sites," JAMA 245/3 : 261-4, Jan 16, 1981
MOKIINACHEV, I .G . et al (USSR), "Selective filtration of smoke components,"
Izv Vyss . Uchebnykh Zav . Pishch . Tek 4 : 82-6, 1980 (In Russian)
NATIONAL CANCER INSTITUTE, Division of Cancer Control and Rehabilitation .
Annual Report, 1980 . 354pp (Incl sections on environmental carcinogenesis,
NATIONAL CANCER INSTITUTE, Smoking and Health Program . Report No . 5 .
Toward Less Hazardous Cigarettes . Summary : Four Skin Painting Bioassays
Using Condensate from Experimental Cigarettes . September 1980, 29pp .
OSSIP, D .J . ot al (U Pittsburgh), "Modeling, coffee drinking, and smoking,"
Psychological Rpts 47/2 : 408-10, 1980
RONDAIIL, L . (Sweden), "Synthetic analogues of nicotine . X . Synthesis and
biological testing of some N-(arylmethyl)azacycloa]kanes," Acta Pharm
Sueeica 17/6 : 347-51, 1980
RUNCK, B . (NIP91), Biofeedback-Issues in Treatment Assessment . US Dept HHS,
Alcohol, Drug Abuse, E Mental Health Admin, NIMH, 1980, 99pp (DIiI1S Publ
No . [ADM] 80-1032)
SF:F:MAN, 3 .3 . ot al (Philip Morris, Richmond, VA), "Steric effects in con--
formationally mobile systems . The iodomethylation of 1-methyl-2-aryl-
pyrrolidines related to nicotine," J Am Chem Soc 102/26 : 7741-7, Dec 17, 1980
• SEEMAYER, N .H . 6 MANOJLOVIC, N . (Germany), "Cytotoxic effects of air
pollutants on mananalian cells in vitro," Toxicology 17/2 : 177-82, 1980
(Extract and fractions of city smog collected from a heavy industrialized
area caused in vitro dose-dependent reduction of cell survival of mouse
macrophagcs, and a growth inhibition of human fetal diploid lung fibro-
SELIKOFF, I .J . et al (Mt . Sinai, NYC), "Latency of asbestos disease among
insulation workers in the United States and Canada," Cancer 46/12 : 2736-40,
Dec 15, 1980 (l .ung cancer peaked at about 30-35 yrs from onset and asbes-
tosis at 40-45 years)
SIIEKCLLE, R .B . ot al (Northwestern U, Chicago), "Diet, serum cholesterol,
and death from coronary heart disease . The Western Electric Study," Now
England J Med 304/2 : 65-70, Jan 8, 1981 (Pos assoc betw diet E serum cholest
at the initial examination, and a pos assoc betw change in diet E change in
serum cholest from the initial to the second examination . There was a pos
assoc prospectively betw diet and 19 yr risk of death from CIID)
STEPNEY, R . (England), "Smoking behavior : a psychology of the cigarette
habit," Brit J Dis Chest 74/4 : 325-44, Oct 1980 (Review incl sections on
nicotine, stress, smkg as a psychological tool)
SULLIVAN, J .M . et al (St . Louis U, MO), "The effects of nicotine on the
rat adrenal medulla," IRCS Med Sci 8/11 : 805-6, Nov 1980 (NE cells were in
the majority and the E cells in the minority . Nic caused stress in the exp
animals and catecholamines were released in order to maximize the organisms
response to stressful stimuli, maintain homeostasis)
TICIIENOR, M .S . G SOLOMON, N . (Baltimore), "Cessation of smoking," Letter :
JM1A 245/4 : 341, Jan 23-30, 1981 (Defends nicotine neutralization treatment)
WALKER, R,B . (Australia), "Medical aspects of tobacco smoking and the anti- •
tobacco movement in Britain in the nineteenth century," Med History 24/4 :
391-402, Oct 1980
hALLIN, 1 . et al (Sweden), "Two new acyclic diterpenoids from Nicotiana
sylvcstris," Acta Chem Scand B 34/6 : 391-6, 1980
WEATIICRSBEE, P.S . (U Cal, Irvine), "Nicotine and its influence on the female
reproductive system," J Reproductive Med 25/5 : 243-50, Nov 1980 (Incl off
on ovulation and implantation, the fetus)
WIIITE, K . (US), "Screening smokers pays off in lung cancer detection :
Sloan-Kettering," Med Trib 21/39 : 23, Dec 3, 1980 (Prospective study of
10,000 middle age male smokers . 38% of these being detected have early
stage I dis, with an excel]ent chance of cure)
WITTER, F . B KING, T .M ., "Cigarettes and pregnancy," Drug 8 Chemical Risks
to the Fetus and Newborn, Progress in Clinical and Biological Res 36 :
83-92, 1980 (Review incl fetal growth, pregnancy wastage, long term effect
on the child)
WORLD HEALTH (WHO, Geneva), "Kenya Govt . bans smoking in putilic," World
Health Oct 1980, pp30-31 . (Incl excerpts from an interview in which Dr . R .
h1AS1RONI of WHO discusses the cost to society of the tobacco industry)
ZUCKF:RMAN, M . F, NEEB, M . (U Delaware), "Demographic influences in sensation •
seeking and expression of sensation seeking in religion, smoking and
driving habits," Personality and Indiv Diffs 1/3 : 197-206, 1980