• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6875-6881
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• 2013

Background: Studies evaluating smoking cessation treatment outcomes in cancer patients are scarce, despite smoking cessation importance in cancer care. We sought to add to the literature by evaluating smoking cessation in a challenging group of cancer patients (medium-to-heavy smokers) visiting an out-patient smoking cessation clinic (SCC) in a cancer center in Amman, Jordan. Materials and Methods: Patients smoking >9 cigarettes per day (CPD) and referred to the SCC between June 2009 and May 2012 were studied. Clinic records were reviewed to measure demographic and baseline clinical characteristics, and longitudinal (3-, 6- and 12- month) follow-up by phone/clinic visit was conducted. At each follow-up, patients were asked if they experienced medication side-effects, if they had returned to smoking, and reasons for failing to abstain. Descriptive and multivariable logistic regression analyses were performed. Results: A total of 201 smokers were included in the analysis. The 3-month abstinence was 23.4% and significantly associated with older age, being married, and presenting with lower (${\leq}10ppm$) baseline carbon monoxide (CO) levels. On a multivariable level, lower CO levels, a higher income (relative to the lowest income group), being older, and reporting severe dependence (relative to dependence reported as 'somewhat' or 'not') were significant predictors of higher odds of abstinence at three months. Reasons for failing to quit included not being able to handle withdrawal and seeing no value in quitting. Long-term ARs did not reach 7%. Conclusions: In a sample of Jordanian smokers (>9CPD) with cancer and receiving smoking cessation treatment, ARs were low and further declined with time. Results underscore the need for more aggressive patient management and rigorous follow-up during and after smoking cessation treatment, particularly when this takes place in challenging settings. Observed reasons for failure to abstain should be used to tailor counseling practices.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4421-4426
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• 2016

Background: Smoking is recognized as a main leading preventable cause of mortality and morbidity worldwide. It is responsible for a considerable financial burden both on the health system and in society. This study aimed to examine the effect of smoking on cost of hospitalization and length of stay (LoS) among patients with lung cancer in Iran in 2014. Materials and Methods: A total of 415 patients were included in the study. Data on age, sex, insurance status, type of hospitals, type of insurance, geographic local, length of stay and cost of hospitalization was extracted by medical records and smoking status was obtained from a telephone survey. To compare cost of hospitalization and LoS for different smoking groups, current smokers, former smokers, and never smokers, a gamma regression model and zero-truncated poisson regression were used, respectively. Results: Compared with never smokers, current and former smokers showed a 48% and 35% increase in hospitalization costs, respectively. Also, hospital LoS for current and former smokers was 72% and 31% higher than for never smokers, respectively. Conclusions: Our study indicated that cigarette smoking imposes a significant financial burden on hospitals in Iran. It is, however, recommended that more research should be done to implement and evaluate hospital based smoking cessation interventions to better increase cessation rates in these settings.

• Molecular & Cellular Toxicology
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• v.5 no.3
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• pp.230-236
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• 2009

Acrolein, a known toxin in cigarette smoke, is the most abundant electrophilic $\alpha$, $\beta$-unsaturated aldehyde to which humans are exposed in a variety of environmental pollutants, and is also product of lipid peroxidation. Increased unsaturated aldehyde levels and reduced antioxidant status plays a major role in the pathogenesis of various diseases such as diabetes, Alzheimer's and atherosclerosis. The findings reported here show that low concentrations of acrolein induce heme oxygenase-1 (HO-1) expression in RAW 264.7 macrophages. HO-1 induction by acrolein and signal pathways was measured using reverse transcription-polymerase chain reaction, Western blot and immunofluorescence staining analyses. Inhibition of extracellular signal-regulated kinase activity significantly attenuated the induction of HO-1 protein by acrolein, while suppression of Jun N-terminal kinase and p38 activity did not affect induction of HO-1 expression. Moreover, rottlerin, an inhibitor of protein kinase $\delta$, suppressed the upregulation of HO-1 protein production, possibly involving the interaction of NF-E2-related factor 2 (Nrf2), which has a key role as a HO-1 transcription factor. Acrolein elevated the nuclear translocation of Nrf2 in nuclear extraction. The results suggest that RAW 264.7 may protect against acrolein-mediated cellular damage via the upregulation of HO-1, which is an adaptive response to oxidative stress.

• Journal of the Korean Society of School Health
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• v.19 no.2
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• pp.75-88
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• 2006

Purpose : This study are the secondary data of Global Youth Tobacco Survey(GYTS) developed by the WHO and United State Center for Disease Control(CDC) and Prevention to trace tobacco use among youth in youth in countries across the world. This study was carried out to serve for a basis for antismoking campaigns and to prevent adolescents from smoking by analyzing the smoking by analyzing the smoking realities factors. Methods : This study is a cross-sectional school-based survey, which employed a two-stage cluster sample design to produce a nationally representative sample of middle school students aged 13 to 15 years olds. Seventy-five schools were selected. All schools containing grade 1, 2 and 3 that contained 40 or students were included in the sampling frame. Results : The results of this study were as follows ; 1. The proportion of smoking students in middle school was 6.4% and the rate of smoking in male students(7.4%) was higher than it of in female students(5.5%). 2. 26.5% of all respondent had a experience to try smoke and the results showed that the rate of trying smoking in male students was increased by grade more than female students. 3. According to test of significance in regression analysis, the independent variables such as sex, school grade, smoking parents, friends distinction, pocket money and others showed statistical significance. 4. There was a statistical significance between smokers and nonsmokers in proportion to the completing the preventive education for nonsmoking(p=0.0023) and the acquirement of knowledge on smoking(p<.0001). 5. Finally there was a statistical significance between the exposure to anti-smoking campaign(p=0.0053) and tobacco advertisement in the mass media and the smoking(p=0.0036). Conclusion : All things considered, the health education for tobacco control in school need to be developed from an elementary school. I suggest that prevent smoking program in school need to be revitalized and be made more accessible for everyone who wish to quit. And the government should develop the regulation on total banning promoting cigarette advertising and smoking scene in the movie for young people.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.139-145
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• 2016

Environmental tobacco smoke (ETS) is a major public health problem for all ages. Despite the high prevalence of smoking among the Saudi population, there is limited information about levels of urinary cotinine in Saudi children exposed to SHS. The aim of the study was to assess the exposure of schoolchildren to ETS, and measure their urinary cotinine levels. Multistage cluster sampling was carried out, where schoolchildren from 4 schools were randomly chosen from primary schools in Taif city. A questionnaire including questions on SHS exposure and smoking rules in the residence were sent to students parents/guardians. Urine samples were taken and analyzed for total cotinine using chemiluminescent immunoassay. Of the studied children, 38.4% had a smoking father, 61.8%, 41.2% and 49.3% of them were exposed to ETS indoors, outdoors and both indoors and outdoors respectively. The mean urinary cotinine was significantly higher among children exposed to ETS compared to unexposed children. Urinary cotinine levels in children with both indoor and outdoor exposure was significantly higher compared with its level in children with single exposure. A significant positive correlation was found between urinary cotinine concentrations and the number of cigarette packs smoked by parents, and the number of smokers in the residence. The mean urinary cotinine level was significantly higher in children who reported no smoking rules at the residence.. The study revealed a high exposure of Saudi children to ETS. An antismoking media awareness campaign on the harmful effects of ETS should be carried out, in addition to family counseling programs targeted to parents to protect their children from ETS.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5427-5432
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• 2015

Background: Oral cancer stands among the 10 top causes of cancer death in the world. Considering the role of epidemiologic information on planning and effective interventions, the present study aimed to investigate the epidemiology of oral cancer in Iran. Materials and Methods: The required information for this systematic review study was obtained from PubMed, Google Scholar, CINAHL,SID, Medlib, Magiran and Iranmedex databases, using key words "cancer", "oral cancer", "squamous cell carcinoma", "oral cavity carcinoma" and their Persian equivalents in combination with keywords of epidemiology, prevalence, etiology, frequency, and Iran from 1990 to 2014. From 1,065 related studies found, finally 25 were included to the study. Results: The mean age of 8,248 patients in 25 studies was $54.0{\pm}15.1years$. The male/female ratio for oral cancer was 1.91. Tongue with average percentage of 29.9 was the most involved site. Regarding microscopic grade, 65.7% of cases were grade 1. SCCs, accounting for an average of 70.0%, was the most common among all types of oral cancer. In the majority of studies, smoking including cigarette, hookah, and tobacco consumption was found to be a risk factor. Conclusions: The epidemiological pattern of oral cancer in Iran is somewhat similar to that of other countries. Yet the information on hand in this field is limited and considering the role of epidemiological data we suggest conducting more accurate studies to catch data that is required for effective programs and interventions.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.4927-4935
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• 2015

Northeastern India is a major nasopharyngeal carcinoma (NPC) high risk-area although the rest of the country has very low incidence. A case-control study of 105 NPC cases and 115 controls was conducted to identify the potential risk factors for NPC development in this region. Information was collected by interviewer about socio-demographic characteristics, cigarette smoking, alcohol consumption, dietary history, occupational history, and a family history of cancer. Epstein-Barr viral load was assayed from the blood DNA by real time PCR. Associations between GSTs genotypes, cytochrome P450 family including CYP1A1, CYP2E1 and CYP2A6 polymorphisms and susceptibility to relationship between the diseases were studied using PCR-RFLP assay. Results indicate that Epstein-Barr virus load was significantly higher in patients compared to controls (p<0.0001). Furthermore, concentration of blood EBV-DNA was significantly higher in advanced stage disease (Stage III and IV) than in early stage disease (Stage I and II) (p<0.05). Presence of CYP2A6 variants that reduced the enzyme activity was significantly less frequent in cases than controls. Smoked meat consumption, exposure to smoke, living in poorly ventilated house and alcohol consumption were associated with NPC development among the population of Northeastern India. Thus, overall our study revealed that EBV viral load and genetic polymorphism of CYP2A6 along with living practices which include smoked meat consumption, exposure to smoke, living in poorly ventilated houses and alcohol consumption are the potential risk factors of NPC in north eastern region of India. Understanding of the risk factors and their role in the etiology of NPC are helpful forpreventive measures and screening.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.1913-1918
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• 2014

Background: The study is the first of its kind to be conducted in Saudi Arabia (KSA), aiming to analyze the effectiveness of an intervention program in improving the knowledge of oral cancer among the youth. Materials and Methods: A total of 1,051 young Saudis (57% males and 43% females with a mean age of $20.4{\pm}1.98$) were selected using multi-stage cluster sampling. Knowledge assessment was accomplished using a closed-ended questionnaire which was subjected to reliability tests. Prevalence of risk factors in relation to gender was analyzed using the chi-squared test. Effectiveness was calculated by comparing the pre- and post-intervention means, using the two-tailed paired t-test. Multiple logistic regression was employed in order to determine factors associated with awareness of risk habits, signs/symptoms and prevention of oral cancer. The significance level in this study was set at 0.05. Results: Females were seen to be more into the habit of sheesha smoking (3.3% rather than the use of other forms of risk factors. Prevalence of diverse risk factors such as cigarette smoking (20%), sheesha (15.3%), khat (27%) and shamma (9%) was seen among males. Gender and the use of modifiable risk factors among the study sample were significantly (p<0.001) associated with effectiveness of the intervention. The intervention program was highly effective (p<0.001) in improving the knowledge of oral cancer among the youth in Jazan, KSA. Multivariate analysis revealed that age and gender are the most significant factors affecting knowledge. Conclusions: The study gives a direction for further public health initiatives in this oral cancer prone region.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4819-4822
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• 2013

Background: Lung cancer is the leading cause of cancer mortality in the world. Many factors can protect against or facilitate its development. A TNF family member TRAIL, has a complex physiological role beyond that of merely activating the apoptotic pathway in cancer cells. Vitamin D is converted to its active form locally in the lung, and is also thought to play an important role in lung health. Our goal was to investigate the possible clinical significance of serum sTRAIL and 1,25-dihydroxyvitamin D(3) levels in patients with non-small cell lung cancer (NSCLC). Materials and Methods: Totals of 18 consecutive adenocarcinoma and 22 squamous cell carcinoma patients with stage-IV non-small cell lung cancer referred to our institute were included in this study. There were 12 men and 6 women, with ages ranging from 38 to 97 (mean 60.5) years with adenocarcinoma, and 20 men and 2 women, with ages ranging from 46 to 80 (mean 65) years with squamous cell carcinoma. Serum levels of sTRAIL and 1,25-dihydroxyvitamin D(3) were measured in all samples at the time of diagnosis. Results: sTRAIL levels in NSCLC patients were higher than in the control group. Although there was no correlation between patient survival and sTRAIL levels, the highest sTRAIL levels were correlated with age and cigarette smoking in the adenocarcinoma patients. sTRAIL level in healthy individuals were correlated with serum 1,25-dihydroxyvitamin D(3). Conclusions: Serum sTRAIL concentrations were increased in NSCLC patients, and correlated with age and smoking history, but not with overall survival.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup3
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• pp.197-200
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• 2016

On an international scale, the burden of cancer in absolute numbers continues to increase, mainly due to aging of population in many countries, the overall growth of the world population, changing lifestyle with increasing cancer-causing behavior, like cigarette smoking, changing dietary habits and sedentary life. Cancer is the second-leading cause of death and disability in the world, after only heart disease. Recently, increasing incidence and mortality of cancer have also become evident in the developing world. In Iraq and particularly in Basrah in the southern part of the country, the burden has definitely increased and deserves extensive research. The present paper is part of an extensive household survey carried out in Basrah in 2013. Among the objectives was to validate official cancer registration in the governorate. The cross-sectional survey had a retrospective component to inquire about the incidence of cancer and cancer-related deaths during the three years preceding the date of inquiry (2010-2012). A convenient sample of 6,999 households with 40,688 inhabitants using multistage cluster sampling was surveyed involving all urban and rural areas of Basrah. The official cancer registration activities in Basrah seemed to have attained a high level of registration coverage (70-80%) but the gap, represented by missed cases, is still high enough to criticize the system. Most of the missing cases were either not notified by treating facilities or they were diagnosed and treated outside Basrah. Using a set of parameters, the pattern of cancer was consistent based on data of the household survey and data of the cancer registry but a gap still existed in the coverage of incident cancer and mortality by cancer registration. Integrated serious steps are required to contain the risk of cancer and its burden on the patient through improving the registration process, improving early detection, diagnostic and management capabilities and encouraging scientific research to explore the hidden risk factors and possible causes of low registration coverage. Periodic household surveys seemed feasible and essential to support routine registration.