Cigarette smokers

There are no significant health hazards arising from exposure to poly(vinyl chloride) at ambient temperature (154—158). However, a British study has found a small decrease in breathing capacity for workers who smoked and were exposed to vinyl resin dust (159). This decrease was about one-seventh of that caused by normal aging and about equal to that expected with a one-pack-a-day cigarette smoker. 

The most recent RDA has included a vitamin C recommendation of 100 mg/day for cigarette smokers. An increasing number of investigators have concluded that the current RDA for vitamin C may not be adequate for elderly individuals. Plasma vitamin C level is generally accepted as an indicator of vitamin C status. 

Methylergonovine is contraindicated in patients with a known hypersensitivity to the drug, hypertension, and preeclampsia and should not be used to induce labor (Pregnancy Category C). Methylergonovine is used cautiously in patients with renal or hepatic impairment. When methylergonovine is administered concurrently with vasopressors or to patients who are heavy cigarette smokers, excessive vasoconstriction may occur. 

Efficacy. A pivotal study by Hurt et al. (1997) established the efficacy and safety of bupropion SRfor treatment of nicotine dependence, which led to its approval for this indication by the FDA in 1998. This study was a 7-week, double-blind, placebo-controUed, multicenter trial of three doses of bupropion SR (100 mg/day, 150 mg/day, or 300 mg/day in twice daily dosing). Patients were 6l5 cigarette smokers who smoked at least 15 cigarettes/day. The medication was administered in combination with weekly individual cessation counseling. End-of-trial 7-day point prevalence cessation rates were 19.0% for placebo and 28.8%, 38.6%, and 44.2% for the 100 mg/day, 150 mg/day, and 300 mg/day bupropion doses, respectively. At 1-year follow-up, cessation rates were 12.4% for placebo and 19.6%, 22.9%, and 23.1% for the 100 mg/day,... 

Side effects. The primary side effects reported with bupropion administration in cigarette smokers are headache, dry mouth, nausea and vomiting, insomnia, and activation. Although most of these adverse effects occur during the first week of treatment, insomnia can persist. Seizures are of exceedingly low occurrence (<0.5%) at doses of 300 mg daily or less, but a prior history of seizures or a seizure disorder contraindicate its use. 

Nonvolatile Nitrosamines In Tobacco Smoke. Although there are more than 10 million exsmokers in the U.S.A., 53 million adults continue to smoke cigarettes and an additional 10 million still smoke cigars or pipes (39). The cigarette smokers are exposed to about 10 ng of volatile nitrosamines, 20-40 ng of NDELA and, most importantly, to 1-10 pg of tobacco specific N-nitros-amines with each cigarette smoked (Table IV). Similar quantities of the TSNA are found in sidestream smoke. The quantities of TSNA in the smoke are dependent on nitrate, nitrite, tobacco alkaloids and on NNN, NNK and NAT in the tobacco itself (31)>... 

Alpha-l-antiprotease (ai-AP) limits tissue damage arising from the actions of the leucocyte protease, elastase (Carrell and Travis, 1985), and there is much evidence available for the oxidative inactivation of this protein by oxygen-derived free-radical species and hypochlorous acid/hypochlorite anion (HOCl/OCP). The mechanism of this inactivation appears to involve the oxidation of a critical methionine residue (Met-358) to its corresponding sulphoxide and methionine sulphoxide has been detected in ai-AP samples isolated from the lungs of cigarette smokers (Carp et al., 1982) and rheumatoid synovial fluids (Wong and Travis, 1980). 

Carp, H., Miller, F., Hoidal, J.R and Janoff, A. (1982). Potential mechanism of emphysema alpha-l-antiprotease inhibitor recovered from lungs of cigarette smokers contains oxidised methionine and has decreased elastase inhibitory capacity. Proc. Natl. Acad. Sci. USA 79, 2041-2046. 

Anderson, R., Theron, A.J. andRas, G.J. (1987). Regulation by the antioxidants ascorbate, cysteine, and dapsone of the increased extracellular and intracellular generation of reactive oxidants by activated phagocytes from cigarette smokers. Am. Rev. Resp. Dis. 135, 1027-1032. 

Dagher, A., Bleicher, C., Aston, J.A.D., Gunn, R.N., Clarke, P.B.S., Cumming, P. Reduced dopamine D1 receptor binding in the ventral striatum of cigarette smokers. Synapse. 42 48, 2001. 

Brauer, L., Behm, F., Westman, E., Patel, P., Rose, J. Naltrexone blockade of nicotine effects in cigarette smokers. Psychopharmacology. 143 339, 1999. 

Figure 5.2. Feelings of stress and arousal over a day in a regular cigarette smoker. Moods were self-rated immediately prior to each cigarette, then again immediately afterward. Thus, each arrow represents the mood effects of one cigarette. Dotted lines show the mood changes in-between cigarettes.

Parrott AC and Garnham NJ (1998). Comparative mood states and cognitive skills of cigarette smokers, deprived smokers, and non-smokers. Human Psychopharmacology, 13, 367-376. 

Parrott AC and Kaye FJ (1999). Daily uplifts, hassles, stresses and cognitive failures In cigarette smokers, abstaining smokers, and non-smokers. Behavioural Pharmacology, 10, 639-646. 

Cadmium is nutritionally non-essential, toxic and a ubiquitous environmental pollutant. It is found in leafy vegetables, grains and cereals, and since it is present in substantial amounts in tobacco leaves, cigarette smokers on a packet a day can easily double their cadmium intake. It has a long biological half-life (17-30 years in man), accumulates in liver and kidneys and its toxicity involves principally kidney and bone (Goyer, 1997).While Cd interferes primarily with calcium, it also interacts with zinc and can induce the synthesis of metallothionein. Cadmium bound to metallothionein in liver or kidney is thought to be non-toxic, but cadmium in plasma... 

Cholerton S et al. CYP2D6 genotypes in cigarette smokers and non-tobacco users. Pharmacogenetics 1996 6(3) 261— 263. 

Figure 1. The age-specific incidence of lung cancer deaths in male cigarette smokers and nonsmokers (Kahn, 1966, Appendix Table A). The lifetime incidence for nonsmokers includes lung cancers attributable to passive smoking, asbestos inhalation, and other occupational exposures.

Houses of cigarette smokers may have lower radon levels than houses of non-smokers. 

Clinical consequence hemolysis (breakdown of circulating red blood cells) from antimalarials, sulfonamides, nitrofurantoin, and other drugs. a-1 Antitrypsin deficiency, due to variants in this circulating plasma protein Frequency 1 /3000 Northern European Caucasians Clinical consequence predisposition to emphysema in early middle age, especially in cigarette smokers, due to failure to protect against trypsinlike enzymes in lung... 

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