Research

Associations of cigarette smoking with rheumatoid arthritis in African Americans
Research presented in the journal Arthritis and Rheumatism indicates that cigarette smoking is associated with both autoantibody-positive and autoantibody-negative rheumatoid arthritis (RA) in African Americans. In this case-control study, researchers determined the smoking status, pack-years of smoking, autoantibody presence, and HLA–DRB1 SE genotype of 605 RA patients and 255 healthy controls. These factors were used to assess whether smoking contributes to RA risk in African Americans and whether this risk is affected by the presence of a possible genetic risk factor for RA (HLA–DRB1 shared epitope). The results showed a positive association between having RA and a history of at least ten pack-years of smoking among both current and former smokers. Those with both the genetic risk factor and a history of smoking had even higher odds of having RA. These results are evidence of a biological interaction between the HLA-DRB1 genotype and heavy smoking to create risk for RA. The results are similar to those found in previous research describing populations of European ancestry. Click here to read the study abstract.

Association between smoking and chronic kidney disease: A case control study
A new cross-sectional case-control study presented in the journal BMC Public Health indicates that heavy smoking is a risk factor for chronic kidney disease (CKD). The results showed that current smokers were 1.63 times more likely to have CKD than nonsmokers, and those that had smoked more than thirty pack years were 2.6 more likely to have the disease. Smoking particularly increased the odds of CKD in those who had hypertension (odds ratio [OR] = 2.85) or diabetic nephropathy (OR = 2.24). There was not a significant association between CKD and past smoking. This study highlights the importance of smoking cessation and prevention to decrease the incidence of CKD, which in turn will decrease the number of patients with end stage renal disease. Read the study abstract here.

Reduced thickness of medial orbitofrontal cortex in smokers
Research published in the journal Biological Psychiatry shows that the brains of smokers exhibit cortical thinning in the left medial orbitofrontal cortex compared to the brains of nonsmokers. This area of the brain is responsible for reward, impulse, and decision-making responses, which are significant to smoking initiation, continuation, and cessation. Magnetic resonance imaging (MRI) scans were taken of 22 smokers and 21 never-smokers to measure cortical thickness, which has been found to be an indicator of cerebral function and cognition. The results indicated that smokers displayed a thinning in the left medial orbitofrontal cortex compared to never-smokers, with thickness decreasing with the amount of cigarettes consumed per day and lifetime exposure. Click here to read the abstract of this study.

Global surveillance of oral tobacco products: Total nicotine, unionized nicotine and tobacco-specific N-nitrosamines
A new study has found that there is wide chemical variation among different types of oral tobacco products, posing different exposure risks to users. Oral tobacco products vary in appearance and popularity throughout the world, and may be chewed, sucked, or held between the gum and teeth. Researchers analyzed 53 oral tobacco products from around the world to determine the concentrations of total nicotine, non-ionized nicotine (which is absorbed most easily), and five carcinogenic tobacco-specific N-nitrosamines (TSNAs). The results showed that total nicotine content ranged from 0.16 to 34.1 milligrams per gram of product and the non-ionized nicotine content ranged from 0.05 to 31.0 milligrams per gram of product, representing a 620-fold difference in concentration among products. TSNA concentrations varied from 4.5 to 516,000 nanograms per gram of product, representing a nearly 100,000-fold difference. The extreme variations in nicotine and TSNA contents among these oral tobacco products translates to differences in exposure risks; as such, the authors suggest that oral tobacco products should not all be grouped together when conducting health implication studies. Click here to access the abstract of the article in Tobacco Control.

e-Cigarettes warning: Safety evaluation urgently needed, researchers say
A new study suggests that electronic cigarettes may not be designed and labeled correctly, raising questions about their quality, regulation, and safety. Researchers purchased five brands of e-cigarettes and evaluated them based on design features, accuracy and clarity of labeling, and quality of instruction manuals and related print materials supplied by the companies. They found that in all five brands, there were design flaws and room for improvement in instructions and labeling. They observed that the e-cigarette cartridges often leak nicotine-containing solutions; the components of the devices did not contain important information or warnings regarding their content and use; there were no instructions for disposal; and the manufacturing, quality control, sales, and advertising of the devices are not regulated sufficiently. The authors suggest that regulators remove e-cigarettes from the market until these issues are addressed and the health effects of using them are known. Click here for more details, or click here to read the abstract of the study.

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