Η νικοτίνη είναι ένα φυσικό συστατικό, αλκαλοειδές που συναντάται στην οικογένεια των φυτών Solanaceae και πήρε το όνομά της από το φυτό Nicotiana tabacum. Είναι ένα δηλητήριο που προσβάλει το ΚΝΣ και το ΠΝΣ. Εισέρχεται στον οργανισμό από τους πνεύμονες, κυρίως, αλλά και από το μάσημα του καπνού ή τσιχλών που την περιέχουν. Έτσι, εισέρχεται στο κυκλοφορικό σύστημα και φτάνει μέχρι τον αιματοεγκεφαλικό φραγμό, τον οποίο διαπερνά για να προχωρήσει στο ΚΝΣ (μέσα σε 10-20 δευτερόλεπτα μετά από την εισπνοή). Εκεί, ενεργοποιεί τους νικοτινικούς υποδοχείς της Ach, δρώντας ως αγωνιστής. Η νικοτίνη διεγείρει τη βιοδιαθεσιμότητα των νευροδιαβιβαστών ντοπαμίνη και σεροτονίνη, με αποτέλεσμα να επιταχύνει τη λειτουργία της καρδιάς και να αυξάνει την πίεση του αίματος. Επίσης, η νικοτίνη δρα στους εγκεφαλικούς μηχανισμούς ανταμοιβής, εμμέσως με την ενεργοποίηση των ενδογενών οπιοειδών (opioids) και άμεσα μέσω μηχανισμών της ντοπαμίνης. Οι μηχανισμοί αυτοί είναι το αίτιο εθισμού προς το κάπνισμα, αλλά και κάθε άλλου είδους εθισμού. Η διακοπή του καπνίσματος είναι μια δύσκολη διαδικασία και ενώ υπάρχουν τρόποι και θεραπείες, δεν βοηθούν όλα τα άτομα που θέλουν να διακόψουν το κάπνισμα. Τα πιο αξιοσημείωτα φάρμακα που χρησιμοποιούνται για την διακοπή του καπνίσματος είναι η βαρενικλίνη και η βουπροπιόνη. Στην παρούσα εργασία, μελετήθηκε η γενετική συσχέτιση πολυμορφισμών που πιθανώς εμπλέκονται στον εθισμό στη νικοτίνη (rs1329650), στην προδιάθεση της έναρξης (rs6265) και διακοπής (rs3025343) του καπνίσματος, αλλά και στην ανταπόκριση στη θεραπεία με βαρενικλίνη (rs2072659). Το πληθυσμιακό δείγμα, τόσο των καπνιστών (101 άτομα), όσο και της ομάδας αναφοράς - μη καπνιστών (75 άτομα) που χρησιμοποιήθηκε, προέρχεται από τον ελληνικό πληθυσμό. Οι μέθοδοι γονοτύπησης που εφαρμόσθηκαν περιλαμβάνουν τον προσδιορισμό αλληλουχίας κατά Sanger, την PCR-RFLP και την ARMS-PCR, σε συνδυασμό με ηλεκτροφόρηση σε αγαρόζη. Μια στατιστική τάση συσχέτισης (p=0,0279) ανιχνεύθηκε για τον πολυμορφισμό rs1329650 μεταξύ των καπνιστών και τον μη καπνιστών για την προδιάθεση στην εξάρτηση στη νικοτίνη. Για τους υπόλοιπους πολυμορφισμούς που μελετήθηκαν, δεν παρατηρήθηκαν στατιστικά σημαντικές συσχετίσεις με τα ερωτήματα που τέθηκαν στην παρούσα εργασία. / Nicotine is a natural ingredient (alkaloid), which is found in the plant’s family Solanaceae. Nicotine is named after the plant Nicotiana tabacum. Nicotine is a poison that affects both the CNS and PNS. It enters the body mainly through the lungs, though chewing tobacco or a nicotine-containing gum also helps on nicotine “administration”. Nicotine comes into the circulatory system, overcomes the blood brain barrier and reaches the CNS (within 10-20 seconds after inhalation), where it activates the nicotinic acetylcholine receptors (nicotine is an agonist). Nicotine stimulates the bioavailability of neurotransmitters dopamine and serotonin and therepy, it accelerates the heart rate and increases the blood pressure. Also, nicotine acts on the brain reward mechanisms, indirectly by the activation of the endogenous opioids and via the mechanisms of dopamine. These mechanisms are the cause of addiction to smoking, but also to any other type of addiction. Quitting smoking is a difficult process and while there are several ways and treatments, they do not help all the people who want to stop smoking. The most notable drugs being used for smoking cessation is varenicline and bupropion. Herein, we study the genetic correlation of polymorphisms that are possibly involved in nicotine addiction (rs1329650), the predisposition of individuals to begin (rs6265) or quit (rs3025343) smoking and response to varenicline treatment (rs2072659). The sample population studied involved two groups; smokers (101 people), and non-smokers (75 people) derived from the Greek population. The genotyping methods applied include Sanger sequencing and PCR-RFLP or ARMS-PCR followed by agarose gel electrophoresis. A statistical trend (p = 0.0279) becomes evident regarding rs1329650, when smokers and non-smokers were compared. The rest polymorphisms studied showed no statistically significant correlation.

Σκοπός: Επειδή η μεγαλύτερη συχνότητα της αναπτυξιακής δυσπλασίας του ισχίου στα θήλεα νεογνά μπορεί να οφείλεται σε ενδοκρινικούς παράγοντες και επίσης έχει βρεθεί ότι το κάπνισμα στη διάρκεια της εγκυμοσύνης προκαλεί ενδοκρινικές διαταραχές, αποφασίσαμε να μελετήσουμε την ανατομία του ισχίου σε νεογνά των οποίων οι μητέρες κάπνιζαν ή δεν κάπνιζαν στην διάρκεια της εγκυμοσύνης. Μεθοδολογία-σχεδιασμός μελέτης: Εξετάσθηκαν κλινικά και υπερηχογραφικά 2066 ισχία, εκ των οποίων 521 αρένων και 512 θηλέων νεογνών. Εξ’ αυτών 48 ήταν άρρενα και 53 θήλεα νεογνά, των οποίων οι μητέρες κάπνιζαν κατά την διάρκεια της εγκυμοσύνης. 93 Αποτελέσματα : Η μέση τιμή ±ΣΑ της γωνίας α στα άρρενα νεογνά των μητέρων οι οποίες δεν κάπνιζαν ήταν 62,3ο ± 5,1ο και των μητέρων οι οποίες κάπνιζαν κατά την εγκυμοσύνη ήταν 62,1ο ± 4,9ο (η διαφορά δεν είναι στατιστικά σημαντική). Στα θήλεα νεογνά των μη καπνιστριών και καπνιστριών μητέρων η α γωνία ήταν 60,7ο ± 5,3ο και 61,9ο ± 4,9ο αντίστοιχα (η διαφορά είναι σημαντική, p= 0,02). Η διαφορά μεταξύ αρρένων και θηλέων νεογνών, τα οποία γεννήθηκαν από μη καπνίστριες μητέρες είναι σημαντική (p<0,000001), ενώ δεν υπήρχε στατιστικώς σημαντική διαφορά μεταξύ αρρένων και θηλέων νεογνών που γεννήθηκαν από καπνίστριες μητέρες. Μεταξύ των θηλέων νεογνών, των οποίων οι μητέρες δεν ήταν καπνίστριες, ο αριθμός των νεογνών με ισχίο τύπου ΙΙα ή χειρότερου ήταν σημαντικά μεγαλύτερος από ότι μεταξύ εκείνων των θηλέων νεογνών, των οποίων οι μητέρες κάπνιζαν. Τα ευρήματα της κλινικής εξέτασης ήταν προς την ίδια κατεύθυνση με εκείνη των υπερηχογραφικών ευρημάτων, γεγονός το οποίο δείχνει ότι το μητρικό κάπνισμα κατά την εγκυμοσύνη προστατεύει το ισχίο στα θήλεα νεογνά. Συμπεράσματα: Το κάπνισμα της μητέρας κατά την διάρκεια της εγκυμοσύνης μειώνει την συχνότητα της υπερηχογραφικής και πιθανότατα της κλινικά διαπιστούμενης αναπτυξιακής δυσπλασίας του ισχίου στα θήλεα, αλλά όχι στα άρρενα νεογνά. Η προστασία του ισχίου η οποία προκαλείται από τον καπνό του τσιγάρου, μπορεί να έχει ενδοκρινική βάση. / Objective: Because the greater frequency of developmental dyplasia of the hip (DDH) in the female could have an endrocrine etiology and maternal smoking in pregnancy causes fetal endocrine disequilibrium, we investigated the anatomy of the hip in neonates of smoking (SM) and nonsmoking mothers (NSM). Study design: Clinical – sonographic examination was performed on 2066 hips of 521 male and 512 female neonates. In 48 male and 53 female neonates the mothers smoked during pregnancy. Results : The mean + SD a angle in the male neonates of the NSM was 62.3ο ± 5.1ο and of the SM 62.1ο ±4.9ο (NS). In the female neonates 95 of the NSM and the SM it was 60.7ο ±5.3ο and 61.9ο ±4.8ο, respectively (p=0.02). The difference between the male and the female neonates of the NSM is significant (p<0.000001), but there is no significant difference between the female neonates of the SM and the male neonates. Among the female neonates whose mothers were nonsmokers the number of those with hip Type IIa or worse was significantly greater that among those whose mothers were smokers. The clinical findings were in the same direction as those of the sonographic findings suggesting hip protection by maternal smoking in the female. Conclusions: Maternal smoking during pregnancy reduces the frequency of sonographic and possibly clinically detected DDH in female but not in male neonates. The tobacco – induced hip protection may have an endocrine basis.

The main focus of bone loss and Osteoporosis (OP) research has been limited almost entirely to women, but OP has become increasingly common in older men and the impact of hip fracture on mortality may actually be greater in men. OP is a major cause of morbidity and mortality in developed countries, at a cost that currently exceeds $10 billion per year in the United States (US) alone. Osteoporotic fractures affect 50 % of women and 20-30% of white men and 4% of black men over the age of 50 years. These statistics may even increase because of increasing life expectancy. Few studies focusing on Blacks have been published to date and very little is known regarding the bone health and the aetiology and prevalence of OP and fractures among older South African blacks. From the above information it is clear that OP is of considerable clinical and economic importance. Without information on the patterns and determinants of bone loss, the formulation of rational prevention and treatment strategies in these groups is not possible. The aim of the study described in this thesis was to investigate the influence of the dietary factors (iron, vitamin C, and protein) and lifestyle factors (alcohol and tobacco smoking) on osteoporotic fractures and bone mineral density in older South African black men using a case-control study design. Sixteen black male patients with fractures of the proximal femur, the proximal humerus or the distal radius and who conformed to the inclusion and exclusion criteria were included in the study. An equal amount of age-matched (K? years), apparently healthy black men with no previous fracture (of the proximal femur and humerus and distal radius), were recruited as a control group. Dual energy X-ray absorptiometry (DEXA) was used for the measurement of the lumbar vertebrae and the proximal femur (hip). Questionnaires were used to gather demographic and medical information, data on physical activity and dietary intakes. Anthropometric measurements and blood samples were taken. Appropriate biochemical analyses were done with standard methods. Both the cases and controls were osteoporotic according to the mean lumbar spine BMD determined in both groups. The BMD was only marginally lower in the cases than in the controls and therefore not statistically significant. The mean tobacco pack years of the cases (13.29) [95% CI: 4.44; 22.141 were almost double that of the controls (7.43) [1.83; 13.031 but it was not statistically significant (p=0.55). Tobacco pack years were negatively associated with BMD of the lumbar spine (p=0.008) even after controlling for possible confounding SUMMARY factors (p=0.001). Malnutrition, as indicated by the low dietary intakes of energy, protein, vitamin C, iron and low BMI, could play a role in the lower bone mineral density (BMD) observed in the cases. The mean protein intakes of the cases (56.1 19) [46.49; 65.741 were very low compared to the recommended 639 per day. This low protein intake was also significantly less compared to the controls (739) [58.28; 88.311. lron intake tended to be lower in the cases compared to the controls (p=0.09). lron intake was not associated with BMD, however, in the stepwise regression analysis; iron intake came out as a possible predictor of BMD of both the lumbar spine and hip, although it was not statistically significant. The BMI was c 19 kg/m2 in 50% of the cases and the controls. S-GGT, a marker of alcohol intake, was significantly increased in the cases with a mean value of 65.88ulL opposed to the 36.33UIL in the control group. S-GGT was the most important predictor of BMD in both the hip and the lumbar spine. There was a significant statistical correlation between lumbar spine BMD (p=0.04); hip BMD (p=0.02) and s-GGT. In conclusion it can be said that malnutrition played a vital role in the low BMD aggravated by the use of tobacco from a young age and alcohol in excessive amounts over weekends. From the results of this study it can be recommended that any intervention programme should focus on alcohol abuse, tobacco smoking and improvement in nutritional status. Children should be encouraged not to smoke and be educated on the detrimental effects of alcohol. It is important to address dietary risk factors associated with OP, namely to increase the overall nutrition of the South African black male with low cost protein and calcium products. Vitamin C enhances iron absorption and may be beneficial for bone collagen. The increased intake thereof by using seasonal fruit can therefore be recommended. / Thesis (M.Sc. (Dietetics))--North-West University, Potchefstroom Campus, 2004.

Background: As the number of smokers in industrialized nations declines the number of smokers in developing countries increases. Many of the nations that are experiencing an increase in smoking prevalence are poor, politically unstable countries. The smoking rates among adolescents are increasing at an especially alarming rate. The tumultuous sociopolitical conditions such as civil unrest, the overthrowing of government regimes and the presence of political violence makes adolescents in these environments susceptible to engagement in high risk behavior such as smoking as a means of self- medicating the symptoms of mental disorder or unhealthy coping mechanisms. The purpose of this study was to analyze the difference in smoking behaviors and beliefs among adolescents in politically unstable countries compared to those in more stable areas. Methods: The West Bank, Gaza Strip, Yemen, Iraq, United Arab Emirates, Oman, Qatar and Kuwait were selected for inclusion in the study based on their World Bank Indicators. Stable countries were defined by their ranking in the 50th percentile or higher on the Political Stability and Absence of Violence Index, whereas unstable countries were defined as being in the 10th percentile or lower. Using secondary data from the 2001, 2002, 2003, 2004, 2005 and 2006 Global Youth Tobacco Survey (GYTS) for eight countries, univariate and multivariate analyses were conducted to assess the factors associated with smoking behaviors. Cases were truncated for 13- 15 year old respondents. A p- value of < .05 and 95% confidence intervals was used to determine statistical significance through the various analyses performed. Results: The univariate and multivariate analysis found that living in an unstable country and being male was associated with increased odds of smoking and experimentation among 13- 15 year old adolescents. Conclusion: The study results suggest that political stability may be associated with smoking behaviors and beliefs among adolescents. Since the factors that create political instability are multi-factorial and beyond the scope of this study, interventions should be designed to address smoking and other risk behaviors within this unique sociopolitical context. Previous interventions in similar settings have found programs integrating mental health dimension and religious leaders have been successful in staving off the onset of smoking among study populations. INDEX WORDS: teens, adolescents, trauma, political instability, risk behavior, tobacco, smoking, interventions,

In 1999, the Federal Government sued the tobacco companies in an attempt to recover expenses used to treat diseases caused by smoking. The 2006 verdict required the dissemination of corrective statements intended to inform the public of the dangers of smoking. This study analyzes smokers' perceptions of these statements. Statements were tested from November 5 to December 5, 2007. Results indicate: (1) messages created by public health intervenors and tobacco companies tended to have higher mean scores than those created by the DOJ, (2) statements on nicotine being addictive had significantly higher mean scores than the other two sets tested, (3) that all statements were rated higher in terms of believability than in terms of other factors, and (4) light smokers rated statements higher in terms of motivating and likelihood to quit than did medium or heavy smokers. These results will be used to refine the development of corrective statements.

Tobacco use is responsible for millions of preventable illnesses and deaths throughout the world. Nevertheless, multitudes of people begin smoking every day, most before reaching the age of 18. Previous research suggests that parental smoking status is a significant predictor of adolescent smoking. Furthermore, parental smoking status may also be associated with a younger age of smoking initiation, which increases a person’s risk of nicotine dependence, cancer, and death. This study examines the association between parental smoking and adolescent age of smoking initiation in 14 African countries. Data for this study was obtained from the Global Youth Tobacco Survey from 2003 – present. Parental smoking status was significantly associated with a younger age of adolescent smoking initiation; maternal smoking had a greater influence than paternal smoking. Gender was also significantly associated with age of initiation; girls are smoking at a younger age than boys. In addition, parental smoking was significantly associated with current smoking among adolescents. The tobacco industry is increasingly targeting these countries to market products to women and adolescents, among whom smoking prevalence is currently low. More rigorous examinations of the association between parent and adolescent smoking in developing countries are needed. Immediate and compelling interventions in the areas of education for parents and adolescents on the health consequences of smoking, access to cessation benefits, and policies to reduce the visibility of smoking are critical steps to preventing tobacco-related death and disease.

Tobacco use is the leading cause of preventable death in the world. Nevertheless, the global tobacco epidemic continues to spread throughout much of the world, particularly in developing countries. Previous research suggests that smoking status may be associated with a variety of social, economic, and cultural factors. This study examines the impact of development, tobacco taxation, and tobacco prices on estimates of global adult male smoking prevalence. Data for this study was obtained from the United Nations’ Human Development Indices: A Statistical Update, 2008 and the World Health Organization’s Report on the Global Tobacco Epidemic, 2009: Implementing Smoke-free Environments. Global adult male smoking prevalence was significantly associated with development, tobacco taxation, and tobacco prices. More rigorous examination of the link between male smoking prevalence and development, tobacco taxation, and tobacco prices is needed to strengthen tobacco control policies and interventions in developing and developed countries.

The Association of Hypertension Diagnosis with Smoking Cessation: Application of Multiple Logistic Regression Using Biostatistical and Epidemiological Methods by LaTonia A. Clay Under the Direction of Yu-Sheng Hsu, PhD. ABSTRACT Hypertension and smoking are two major issues threatening the nation’s health. Previous studies examining their relationship have resulted in conflicting reports. The aim of this study is to determine if a relationship exists between smoking cessation and hypertension diagnosis. Data from the Third National Health and Nutrition Examination Survey (NHANES III) were used in this investigation. Physical examination measurements of blood pressure and self-reported diagnosis and smoking behavior were used to define hypertension and smoking status. The odds of prior hypertension diagnosis associated with smoking cessation was estimated from a multivariate logistic regression model, adjusting for gender, age, ethnicity, BMI, physical activity, HDL cholesterol, and alcohol use. Results of the investigation found that unsuccessful smoking cessation was associated with a decreased odds of prior hypertension diagnosis, adjusting for the presence of confounders (OR=0.816, p<.001). Thus, hypertension diagnosis may indeed lead to the decision to quit smoking. Future studies on this finding are encouraged. INDEX WORDS: hypertension, smoking, cessation, diagnosis, logistic regression, NHANES

Prostate cancer is the most commonly diagnosed cancer in Canadian males, and is the third most common cause of cancer related deaths with decreasing mortality in men. Previous studies have suggested that an increased risk of prostate cancer among men may be associated with rural environment. The etiology of prostate cancer is not precisely known among men in rural Saskatchewan. We investigated the prevalence of prostate cancer and the putative relationship between rural exposures (occupational i.e. farming and environmental), personal smoking history, family history of cancer and prostate cancer. A baseline mail out survey was conducted in 2010-2011 of 11,982 households located in four geographic regions (South West, South East, North West, and North East) of Saskatchewan, Canada. Completed questionnaires were obtained from 4,624 households (8,261 individuals). The questionnaires collected information on individual (demographic factors, exposure to pesticides including insecticides, herbicides and fungicides) and contextual (household characteristics such as income, smoking) determinants from a rural population. In total 2,938 males (114 prostate cancer cases) were included for this analysis who were older than 45 years. Logistic regression analysis was used to analyze the relationship between independent variables and prostate cancer. Among prostate cancer cases, 46% of men lived on farms of rural Saskatchewan. The age standardized prevalence of prostate cancer was 3.32% (3.81% (n=52) and 2.95% (n=61) among farm and non-farm resident men). Farming job and farming duration did not have a statistically significant association with prostate cancer. A trend was observed for men who had work place exposure to insecticides and fungicides collectively and radiation to have an increased risk in comparison to men without these exposures. Personal smoking history, history of smoking pack years and family history of cancer modified the relationship between residence and prostate cancer. Age of an individual (≥ 65 years) was the strongest and most consistent risk factor of prostate cancer. Other factors such as marital status, household income adequacy, history of cardiovascular disease may also be associated with prostate cancer. The results may help research professionals by directing the focus of their research towards rural population examining prostate cancer.

Darbo tikslas Ištirti kosulio reflekso jautrumo pokyčius metus rūkyti sveikiems asmenims ir sergantiems lėtine obstrukcine plaučių liga. Darbo uždaviniai 1. Ištirti ir įvertinti rūkymo metimo poveikį sveikų asmenų kosulio reflekso jautrumui. 2. Ištirti ir įvertinti metusių ir vėl pradėjusių rūkyti sveikų asmenų kosulio reflekso jautrumą. 3. Ištirti ir palyginti sergančių lėtine obstrukcine plaučių liga rūkorių ir sergančių lėtine obstrukcine plaučių liga buvusių rūkorių kosulio reflekso jautrumą. 4. Palyginti sergančių lėtine obstrukcine plaučių liga rūkorių ir sergančių lėtine obstrukcine plaučių liga buvusių rūkorių bei sveikų rūkorių ir sveikų nerūkančiųjų kosulio reflekso jautrumą 5. Ištirti bronchoalveolinio lavažo skysčio ląstelių sudėtį ir uždegimo žymenų (interleukino-8, leukotrieno B4, leukotrieno E4) koncentraciją sergantiems lėtine obstrukcine plaučių liga rūkoriams, sergantiems lėtine obstrukcine plaučių liga buvusiems rūkoriams ir sveikiems rūkoriams. 6. Įvertinti galimas kosulio reflekso jautrumo sąsajas su uždegimo ląstelių kiekiu ir uždegimo žymenų (interleukino-8, leukotrieno B4, leukotrieno E4) koncentracija bronchoalveolinio lavažo skystyje sergantiems lėtine obstrukcine plaučių liga rūkoriams, sergantiems lėtine obstrukcine plaučių liga buvusiems rūkoriams ir sveikiems rūkoriams. Šiame darbe pirmą kartą ištirtas rūkymo metimo poveikis sveikų asmenų kosulio reflekso jautrumui ir sveikų asmenų kosulio reflekso jautrumas jiems metus ir vėl... [toliau žr. visą tekstą] / The aim of the study To evaluate changes of cough reflex sensitivity after smoking cessation in healthy subjects and patients with chronic obstructive pulmonary disease (COPD). Objectives of the study 1. To evaluate the effect of smoking cessation on cough reflex sensitivity changes in healthy subjects. 2. To investigate cough reflex sensitivity changes after cessation and resumption of smoking in healthy subjects. 3. To evaluate and compare cough reflex sensitivity in COPD smokers and COPD ex-smokers. 4. To compare cough reflex sensitivity in COPD smokers and COPD ex-smokers with the cough reflex sensitivity in healthy smokers and healthy never smokers. 5. To evaluate the inflammatory cells count and the concentration of inflammatory mediators (IL-8, LTB4, LTE4) in bronchoalveolar lavage (BAL) fluid from COPD smokers, COPD ex-smokers and healthy smokers. 6. To investigate probable association between cough reflex sensitivity and inflammatory cells count and concentration of inflammatory mediators (IL-8, LTB4, LTE4) in BAL fluid in COPD smokers, COPD ex-smokers and healthy smokers. This is the first study, where the effect of smoking cessation on cough reflex sensitivity in healthy subjects was evaluated and this is the first time, when cough reflex sensitivity in COPD smokers and COPD ex-smokers was evaluated and compared.