Displaying publications 1 - 20 of 176 in total

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  1. Wee LH, Chan CM, Yogarabindranath SN
    Med J Malaysia, 2016 06;71(Suppl 1):29-41.
    PMID: 27801386 MyJurnal
    Two hundred and seventy one original published materials related to tobacco use were found in a search through a database dedicated to indexing all original data relevant to Medicine and Health in Malaysia from 1996 - 2015. A total of 147 papers were selected and reviewed on the basis of their relevance and implications for future research. Findings were summarised, categorised and presented according to epidemiology, behaviour, clinical features and management of smoking. Most studies are cross-sectional with small sample sizes. Studies on smoking initiation and prevalence showed mixed findings with many small scale studies within the sub-groups. The majority of the studies were related to factors that contribute to initiation in adolescents. Nonetheless, there are limited studies on intervention strategies to curb smoking among this group. There is a lack of clinical studies to analyse tobacco use and major health problems in Malaysia. In addition, studies on the best treatment modalities on the use of pharmacotherapy and behavioural counselling have also remained unexplored. Reasons why smokers do not seek clinic help to quit smoking need further exploration. A finding on the extent of effort carried out by healthcare providers in assisting smokers to make quit attempts is not known. Studies on economic and government initiatives on policies and tobacco use focus mainly on the effects of cigarette bans, increased cigarettes taxes and the influence of the tobacco industry. Recommendations are given for the government to increase efforts in implementing smoke-free legislation, early and tailored interventions. Clinical studies in this area are lacking, as are opportunities to research on ways to reduce smoking initiation age and the most effective quit smoking strategies.
    Matched MeSH terms: Smoking/epidemiology*
  2. Smith J, Togawa K, Dresler C, Hawari F, Zain ZM, Stewart B, et al.
    Cancer Epidemiol, 2022 Aug;79:102210.
    PMID: 35785684 DOI: 10.1016/j.canep.2022.102210
    Matched MeSH terms: Smoking/epidemiology
  3. Santhna LP, Khalid Z, Selamat S, Ho SE, Mat S
    Clin Ter, 2013;164(6):507-12.
    PMID: 24424214 DOI: 10.7417/CT.2013.1628
    BACKGROUND: Smoking has always been a huge problem in Malaysia and its surrounding nations. The purpose of this study was to determine the prevalence of cigarette smoking and to identify the influencing factors associated with smoking habits among adolescents.

    MATERIALS AND METHODS: This cross-sectional study was carried out on 226 respondents, using a questionnaire which had 4 sections: socio-demographic data, personal information, family information and social information. Data was analyzed using SPSS® version 16. For categorical variables, comparisons were made using Chi-square and for numerical variables a t-test was performed.

    RESULTS: The current smoker prevalence rate was 20.8% which showed a significant association between smoking and individual factors: level of knowledge on the effects of smoking (p < 0.05), significant association was seen between smoking and marital status of parents, smoking status of male siblings and various other aspects of the individuals themselves.

    CONCLUSIONS: Concerted efforts involving various parties should be taken to curb or prevent this problem or the number of teenage smokers in the country will increase. This in the long run will invite problems to the well being of the adolescents themselves, their families, community and the nation as a whole.

    Matched MeSH terms: Smoking/epidemiology*
  4. Lim KH, Amal NM, Hanjeet K, Mashod MY, Wan Rozita WM, Sumarni MG, et al.
    Trop Biomed, 2006 Jun;23(1):75-84.
    PMID: 17041555 MyJurnal
    Smoking among adolescent is a public health concern in Malaysia. Multiple studies on smoking prevalence and its related factors have been conducted in Malaysia, however, they were specific to either urban or rural areas alone. Studies in mixed settlement areas (urban, rural, land development area) had not been intensively investigated. This study reports the prevalence, demographic and factors related to smoking amongst form four students in the district of Kota Tinggi, Johor. A cross-sectional study of 16-year old secondary school students in Kota Tinggi district was conducted using two-stage stratified, proportionate sampling in July 2005. The study instrument used was a validated structured questionnaire on smoking and its related factors. Smoking prevalence was found to be 29.7%. More than 50% of male students were smokers. Prevalence was highest in FELDA (Federal Land Development Authority) settlement areas. Smoking was associated with having a brother or friend who smokes and poor academic performance. The study revealed that smoking prevalence was high, especially among male students in land development schemes. This situation will contribute to high smoking-related health problems in the future if proper preventive measures are not taken accordingly.
    Matched MeSH terms: Smoking/epidemiology*
  5. Woodcock AA
    Med J Malaysia, 1979 Sep;34(1):3-5.
    PMID: 542147
    Matched MeSH terms: Smoking/epidemiology*
  6. Evenhuis A, Occhipinti S, Jones L, Wishart D
    Glob Health Action, 2023 Dec 31;16(1):2216068.
    PMID: 37254873 DOI: 10.1080/16549716.2023.2216068
    BACKGROUND: Offering cessation support to health professionals who smoke to ensure optimal implementation of cessation support for patients is a key recommendation of the WHO Framework Convention on Tobacco Control Article 14 guidelines. However, direct efforts to support this population to quit are limited. Although numerous articles on the topic of tobacco use among health professionals have been published, the factors associated with their own cessation have not been systematically synthesised.

    OBJECTIVE: We sought to synthesise existing literature on the predictors and processes informing attitudes and beliefs of smoking health professionals' own cessation.

    METHODS: A five-step methodological framework for scoping reviews was followed. We conducted a systematic search of EMBASE, PubMed, Web of Science, and PsycINFO databases, as well as Google Scholar for relevant articles. Titles, abstracts, and full texts were screened against predefined criteria: research published between 1990 and 2021, in English-language peer-reviewed journals; participants included doctors, nurses, medical, and student nurses who smoke.

    RESULTS: The initial search yielded 120, 883 articles, with 27 selected for synthesis. Prevalence estimates and predictors of smoking behaviour have remained the primary focus of smoking health professional research. Few studies explicitly examined the relevant predictors of quit attempts and quit attempt success. There is evidence that age and work environment factors predict quit attempt success in some health professional groups. There is also some evidence of tobacco smoking stigma experiences among nurses and nursing students who smoke.

    CONCLUSION: Although cessation support is desperately needed for health professionals who smoke, the evidence for factors predicting quit success remains limited. To better guide future research, first, more theoretical work is required to identify the relevant predictors. Second, these should be tested using prospective research designs that take a multi-focal perspective to clarify the targets for change.

    Matched MeSH terms: Smoking/epidemiology
  7. Billy TJ, Sreeramareddy CT, Oo PS, Aye SN
    Nicotine Tob Res, 2024 Mar 22;26(4):508-511.
    PMID: 37819726 DOI: 10.1093/ntr/ntad198
    INTRODUCTION: Exposure to tobacco imagery creates a positive impression about smoking and is associated with youth smoking uptake.

    METHODS: From the list of movies released during 2015-2019, we selected the top 10 movies per year rated by the Malaysian Film Development Corporation. Two researchers coded tobacco imagery in each movie considering 5-minute time intervals as a unit. The 5-minute interval coding was adopted from previous research for comparability. Frequencies and the average occurrence of tobacco imagery were compared by movie language, genre, and age categorization.

    RESULTS: In 50 movies analyzed, there were a total of 1037 five-minute intervals of which 26 (52%) movies and 277 (26.7%) of intervals tobacco imagery were present. Brand appearances were absent and health warnings about tobacco use were present in just one movie. The proportions of intervals containing actual use, paraphernalia, and implied use were 63.5%, 22.0%, and 14.5%. Tobacco imagery of actual use, paraphernalia, and implied use was present in 25, 20, and 10 movies, respectively. In those movies with tobacco imagery, the average number of occurrences of actual use, paraphernalia, and implied use was 3 (interquartile range [IQR] 2-11.5), 2.5 (IQR 1.3-4.0), and 1 (IQR 1-4), respectively. Movies classified as "p13" (median 6, IQR 6-13) and "18" (median 5, IQR 0-15) had higher average occurrences of tobacco imagery than "U" movies (median 0, IQR 0-2; p = .028).

    CONCLUSIONS: The lack of health warnings despite the presence of tobacco imagery in Malaysian movies calls for measures to regulate tobacco-related content and reclassify such movies as "for adults-only."

    IMPLICATIONS: Tobacco imagery was prevalent in Malaysian movies that are allowed viewing by individuals aged 13 years and above. A review of the age categorization of Malaysian movies and the placement of health warnings in movies is needed. A comprehensive implementation of the ban on tobacco advertisements, promotion, and sponsorship should also include a ban on tobacco imagery in movies.

    Matched MeSH terms: Smoking/epidemiology
  8. Ismail N, Hassan N, Abd Hamid MHN, Yusoff UN, Khamal NR, Omar MA, et al.
    Int J Infect Dis, 2022 Mar;116:189-196.
    PMID: 35021062 DOI: 10.1016/j.ijid.2022.01.011
    OBJECTIVE: This study aims to investigate the association between smoking and the severity of COVID-19 infection during the initial wave of this pandemic in Malaysia.

    METHODS: This is a multi-center observational study using secondary hospital data collected retrospectively from February 1, 2020, until May 30, 2020. Clinical records of all real-time polymerase chain reaction (RT-PCR)-confirmed COVID-19 cases with smoking status, co-morbidities, clinical features, and disease management were retrieved. Severity was assessed by the presence of complications and outcomes of COVID-19 infection. Logistic regression was used to determine the association between COVID-19 disease severity and smoking status.

    RESULTS: A total of 5,889 COVID-19 cases were included in the analysis. Ever smokers had a higher risk of having COVID-19 complications, such as acute respiratory distress syndrome (odds ratio [OR] 1.69; 95% confidence interval [CI] 1.09-2.55), renal injury (OR 1.55; 95% CI 1.10-2.14), and acute liver injury (OR 1.33; 95% CI 1.01-1.74), compared with never smokers. However, in terms of disease outcomes, there were no differences between the two groups.

    CONCLUSION: Although no significant association was found in terms of disease outcomes, smoking is associated with a higher risk of having complications owing to COVID-19 infection.

    Matched MeSH terms: Smoking/epidemiology
  9. Navaratnam V, Foong K
    Curr Med Res Opin, 1990;11(10):611-9.
    PMID: 2311417
    In a study of 249 opiate (mainly heroin) addicts special attention was paid to adjunctive drug use. Generally, nicotine (cigarette smoking), alcohol and cannabis preceded the use of heroin, and continued to be used as adjunctive drugs after the establishment of heroin addiction. Nicotine was the most common substance used together with opiates. Alcohol and cannabis were used as adjunctive drugs in about two-thirds of the cases. In the late stages of heroin addiction, benzodiazepines were also used concomitantly with opiates. The most frequently reported reason for the use of adjunctive drugs was to intensify the effect of the opiate. Three-quarters or more of the addicts had used different adjunctive drugs to boost the euphoric feeling derived from the primary drug, i.e. heroin. Attempt at self-treatment of withdrawal symptoms was a less frequently reported reason for adjunctive drug use. The findings show that heroin addiction is the major problem. The use of adjunctive drugs, especially benzodiazepines, can be partly explained on economic grounds. They must be clearly distinguished from the primary drug of abuse, heroin. For policy-making decisions, it is important that the elimination of heroin abuse through effective prevention measures would ultimately wipe out the problem of adjunctive drug use, while reduction of the overall supply of heroin without reduction in actual demand might result in an increasing trend to adjunctive drug use.
    Matched MeSH terms: Marijuana Smoking/epidemiology*; Smoking/epidemiology*
  10. Kabir MA, Goh KL, Khan MH
    BMC Public Health, 2013;13:379.
    PMID: 23617464 DOI: 10.1186/1471-2458-13-379
    BACKGROUND:
    Tobacco consumption (TC) among youths poses significant public health problem in developing countries. This study utilized the data of Global Youth Tobacco Survey (GYTS), 2007 to examine and compare youth TC behavior in Bangladesh, Nepal and Sri Lanka.

    METHODS:
    The GYTS covered a total of 2,242 Bangladeshi, 1,444 Nepalese and 1,377 Sri-Lankan youths aged 13-15 years. They represented response rates of 88.9%, 94.6%, and 85.0% for the three countries, respectively. Socioeconomic, environmental, motivating, and programmatic predictors of TC were examined using cross tabulations and logistic regressions.

    RESULTS:
    Prevalence of TC was 6.9% (9.1% in males, 5.1% in females) in Bangladesh, 9.4% (13.2% in males, 5.3% in females) in Nepal and 9.1% (12.4% in males, 5.8% in females) in Sri Lanka. The average tobacco initiation age was 9.6, 10.24 and 8.61 years, respectively. Cross tabulations showed that gender, smoking among parents and friends, exposure to smoking at home and public places, availability of free tobacco were significantly (P < 0.001) associated with TC in all three countries. The multivariable analysis [odds ratio (95% confidence interval)] indicated that the common significant predictors for TC in the three countries were TC among friends [1.9 (1.30-2.89) for Bangladesh, 4.10 (2.64-6.38) for Nepal, 2.34 (1.36-4.02) for Sri Lanka], exposure to smoking at home [1.7 (1.02-2.81) for Bangladesh, 1.81 (1.08-2.79) for Nepal, 3.96 (1.82-8.62) for Sri Lanka], exposure to smoking at other places [2.67 (1.59-4.47) for Bangladesh, 5.22 (2.76-9.85) for Nepal, 1.76 (1.05-2.88) for Sri Lanka], and the teaching of smoking hazards in schools [0.56 (0.38-0.84) for Bangladesh, 0.60 (0.41-0.89) for Nepal, 0.58 (0.35-0.94) for Sri Lanka].

    CONCLUSIONS:
    An understanding of the influencing factors of youth TC provides helpful insights for the formulation of tobacco control policies in the South-Asian region.
    Matched MeSH terms: Smoking/epidemiology*
  11. Sirirassamee T, Sirirassamee B, Borland R, Omar M, Driezen P
    PMID: 21323185
    The objective of this study was to examine the smoking behavior among adolescents in Thailand and Malaysia. Population-based, national surveys were conducted among 1,704 adolescents between the ages of 13 and 18 from Thailand (n = 927) and Malaysia (n = 777). Respondents were selected using multistage cluster sampling. Respondents were asked to complete self-administered questionnaires. Approximately 5% of Thai and Malaysian adolescents were current smokers, while an additional 8.6% of Thai and 8.1% of Malaysian adolescents reported being beginning smokers. On average, Thai smokers reported first smoking a whole cigarette at 14.6 years old (SD = 1.9), while Malaysian smokers at age 13.9 years (SD = 2.2). More than half of Thai smokers (60.4%) reported they bought cigarettes themselves and 29.9% got cigarettes from friends. In Malaysia, most smokers (68.3%) reported they bought cigarettes themselves, only 20.7% got cigarettes from friends. Seventy-six percent of Thai adolescent smokers smoked factory-made brands as their usual brand compared to 27.7% of Malaysian adolescent smokers. Eight percent of Thai adolescents and 10% of Malaysian adolescents reported smoking hand-rolled cigarettes. Approximately half of Thais and more than 40% of Malaysian smokers reported they tried to quit smoking within the past month. The smoking prevalence of Thai adolescents is close to that of Malaysian adolescents. Factory-made cigarette consumption is an important problem in Thai adolescents and needs to be targeted.
    Matched MeSH terms: Smoking/epidemiology*
  12. Lee LK, Paul CY, Kam CW, Jagmohni K
    Asia Pac J Public Health, 2005;17(2):130-6.
    PMID: 16425658 DOI: 10.1177/101053950501700212
    This study was done to determine the prevalence of smoking and factors influencing cigarette smoking among secondary school students in Negeri Sembilan, Malaysia. This is a cross-sectional school survey conducted on 4500 adolescent students based on a structured questionnaire. Data was collected using the supervised self-administered questionnaire the Youth Risk Behaviour Surveillance in the Malaysian National Language Bahasa Malaysia. The prevalence of smoking among the students was 14.0%. About a third of the students (37.8%) started smoking at 13 to 14 years of age. The prevalence of smoking among the male students was higher (26.6%) compared to the female students (3.1%). Adolescent smoking was associated with (1) sociodemographic factors (age, ethnicity, rural/urban status); (2) environmental factors (parental smoking, staying with parents); (3) behavioural factors (playing truant and risk-taking behaviours such as physical fighting, drug use, alcohol use, sexual activity, lack of seatbelt use, riding with a drunk driver); (4) lifestyle behaviours (being on diet and lack of exercise); (5) personal factors (feeling sad and suicidal behaviours). In conclusion, smoking is a major problem among Malaysian adolescents. Certain groups of adolescents tend to be at higher risk of smoking. This problem should be curbed early by targeting these groups of high risk adolescents.
    Matched MeSH terms: Smoking/epidemiology*
  13. Liber AC, Ross H, Omar M, Chaloupka FJ
    Tob Control, 2015 Jul;24 Suppl 3:iii83-iii87.
    PMID: 25808666 DOI: 10.1136/tobaccocontrol-2014-052028
    Study the effects of the 2011 Malaysian minimum price law (MPL) on prices of licit and illicit cigarette brands. Identify barriers to the MPL achieving positive public health effects.
    Matched MeSH terms: Smoking/epidemiology
  14. Naing NN, Ahmad Z
    PMID: 11556602
    A cross-sectional study was conducted to identify the factors related to smoking habits of secondary school teachers in Kelantan, Malaysia. A total of 180 male teachers and trainee teachers from four secondary schools in Kelantan and a Teachers' Training College were interviewed by using a structured questionnaire. Cluster sampling was applied. The significant findings found were current smokers were found as high as 40.56%. Mean duration of smoking was 6.8 years and mean initiation age was 16.5 years. Trainee teachers had a significantly higher proportion of current smokers. There was a significant association between smoking status of teachers and their fathers' and perception of the hazards of smoking on health. Peer influence was found to be the major reason for smoking among smokers. Religious belief and care for health attitude prevented non-smokers from smoking. About 3/5 of smokers thought of quitting smoking and of these 1/4 had tried at least once. There was a significant difference of proportion of attempted quitting between regular and occasional smokers. Mass media was the best source of information on knowledge about smoking hazards. Anti-smoking campaigns should start as early as possible in schools. Lectures and talks on smoking should be included in the curriculum of teachers' training courses.
    Matched MeSH terms: Smoking/epidemiology*
  15. Ashraf H
    Lancet, 2002 Aug 24;360(9333):627.
    PMID: 12241947
    Matched MeSH terms: Smoking/epidemiology
  16. Hashami B, Abdul Halim O, Yusoff K
    Med J Malaysia, 1994 Jun;49(2):149-57.
    PMID: 8090094
    A total of 209 randomly selected Malaysian university students (128 from Universiti Kebangsaan Malaysia, 81 from the University of New South Wales) completed a self-filled questionnaire enquiring about their smoking behaviour and psychosocial characteristics. The prevalence of smoking was 26.6 per cent among students in Malaysia and 18.8 per cent among students in Australia (average 23.4%). Both samples have similar patterns in terms of age of starting smoking, time of the day when they smoked, family and peer history of smoking, and whether or not they inhaled deeply during smoking. The smokers tend to be male, studying beyond the first year, staying with peers outside the hostel, having financial sources other than a scholarship, and abnormal mental health score. However, the smokers from the Australian samples were noted to smoke less and made fewer attempts at quitting the habit.
    Matched MeSH terms: Smoking/epidemiology*
  17. Salari N, Hasheminezhad R, Abdolmaleki A, Kiaei A, Shohaimi S, Akbari H, et al.
    Arch Womens Ment Health, 2022 Dec;25(6):1021-1027.
    PMID: 36445469 DOI: 10.1007/s00737-022-01281-1
    The increased number of female smokers is considered a global health challenge in recent years. One of the detrimental effects of smoking is sexual hormone fluctuation causing female sexual dysfunction (FSD). This systematic review and meta-analysis aimed to investigate the effects of smoking leading to FSD. Electronic databases (PubMed, Scopus, Web of Science, Embase, Science Direct, and Google Scholar) were hired for systematic searching. Until June 2022, whole qualified studies reporting the consequences of smoking on FSD were gathered for data analysis based on the random effects model (CMA software, v.2). Study heterogeneity and publication bias were also assessed using I2 index and Egger test, respectively. Ten eligible studies with a sample size of 15,334 female smokers (18-79 years) were selected. Following data analysis, the odds ratio representing the effects of smoking on FSD was found 1.48 (95%CI: 1.2-1.83), indicating that female smokers were 48% more susceptible to FSD than non-smokers. Also, the publication bias was reported as non-significant (p = 0.178). Since smoking is an increasingly common phenomenon in females and women smokers are 48% more susceptible to the FSD, preparation of necessary health measures by the health policymakers to reduce the number of female smokers and subsequent health services seems necessary.
    Matched MeSH terms: Smoking/epidemiology
  18. Mat Rifin H, Jane Ling MY, Robert Lourdes TG, Saminathan TA, Rodzlan Hasani WS, Ab Majid NL, et al.
    Int J Environ Res Public Health, 2022 Sep 23;19(19).
    PMID: 36231349 DOI: 10.3390/ijerph191912051
    Background: Small cigarette pack sizes contain less than 20 cigarette sticks in a pack. Smaller packs may suggest lower costs, increasing affordability among lower-income users, especially the younger generation, which could lead to tobacco-related diseases and economic costs, including human capital lost results from tobacco-attributable morbidity and mortality. This concern has caused many countries to ban the sale of single cigarette sticks or kiddie packs. However, small cigarette pack sizes were proposed recently to be reintroduced by the tobacco industry with an excuse to prevent consumers from buying illicit cigarettes. This would demean efforts in combating tobacco consumption based on the existing tobacco control policies to prevent minors from purchasing cigarettes. Given the competing influences of affordability and availability of tobacco on consumption and the dearth of evidence-based review on the impact of pack size on smoking, this systematic review was conducted to identify the link between kiddie packs and smoking specifically on the initiation of smoking, urge/tendency to buy cigarettes among the general population and attempt to reduce cigarette consumption and prevalence of smoking using kiddie packs among current smokers. Methods: We include all studies except for reviews, guidelines, conference papers, commentaries, editorials, or opinion pieces. A database search was conducted in PubMed, EMBASE, CENTRAL, Web of Science and Scopus on 27 November 2021. The results were presented in the form of narrative synthesis under four groups: initiation of smoking; urge/tendency to buy cigarettes; the prevalence of smoking, and attempt to reduce cigarette consumption. The literature search identified 1601 articles, of which 21 articles had met the inclusion criteria. The methodological quality of all included articles was determined using a validated 16-item quality assessment tool (QATSDD). The average quality score for all papers was 34.8%. Discussion: Given the diverse study settings of the articles and despite the challenges of the methodological quality of some articles, this review provides some evidence that kiddie packs may increase the urge/tendency to buy cigarettes and mixed evidence on the attempt to reduce cigarette consumption. This review also found some evidence that kiddie pack purchasing among teenage smokers was higher compared to adults. However, we are uncertain about the link between kiddie packs and smoking initiation. Nevertheless, since most studies were of low quality, further high-quality studies are needed to conclude about the impact of kiddie packs on smoking to assist the policymakers and stakeholders in formulating new policies and strengthening existing strategies related to the kiddie packs.
    Matched MeSH terms: Smoking/epidemiology
  19. Yang SL, Togawa K, Gilmour S, Leon ME, Soerjomataram I, Katanoda K
    Tob Control, 2024 Apr 19;33(3):295-301.
    PMID: 36100264 DOI: 10.1136/tc-2022-057262
    OBJECTIVE: This study aimed to quantify the long-term impact of implementing the WHO Framework Convention on Tobacco Control (FCTC) compliant tobacco control measures, MPOWER, on smoking prevalence and mortality in men and women aged ≥20 years in Japan.

    DESIGN: A Stock-and-Flow simulation model was used to project smoking prevalence and mortality from 2018 to 2050 under eight different scenarios: (1) maintaining the 2018 status quo, (2) implementation of smoke-free policies, (3) tobacco use cessation programmes, (4-5) health warning about the dangers of tobacco (labels, mass media), (6) enforcement of tobacco advertising bans or (7) tobacco taxation at the highest recommended level and (8) all these interventions combined.

    RESULTS: Under the status quo, the smoking prevalence in Japan will decrease from 29.6% to 15.5% in men and 8.3% to 4.7% in women by 2050. Full implementation of MPOWER will accelerate this trend, dropping the prevalence to 10.6% in men and 3.2% in women, and save nearly a quarter million deaths by 2050. This reduction implies that Japan will only attain the current national target of 12% overall smoking prevalence in 2033, 8 years earlier than it would with the status quo (in 2041), a significant delay from the national government's 2022 deadline.

    CONCLUSIONS: To bring forward the elimination of tobacco smoking and substantially reduce smoking-related deaths, the government of Japan should fulfil its commitment to the FCTC and adopt stringent tobacco control measures delineated by MPOWER and beyond.

    Matched MeSH terms: Smoking/epidemiology
  20. Ngamwong Y, Tangamornsuksan W, Lohitnavy O, Chaiyakunapruk N, Scholfield CN, Reisfeld B, et al.
    PLoS One, 2015;10(8):e0135798.
    PMID: 26274395 DOI: 10.1371/journal.pone.0135798
    Smoking and asbestos exposure are important risks for lung cancer. Several epidemiological studies have linked asbestos exposure and smoking to lung cancer. To reconcile and unify these results, we conducted a systematic review and meta-analysis to provide a quantitative estimate of the increased risk of lung cancer associated with asbestos exposure and cigarette smoking and to classify their interaction. Five electronic databases were searched from inception to May, 2015 for observational studies on lung cancer. All case-control (N = 10) and cohort (N = 7) studies were included in the analysis. We calculated pooled odds ratios (ORs), relative risks (RRs) and 95% confidence intervals (CIs) using a random-effects model for the association of asbestos exposure and smoking with lung cancer. Lung cancer patients who were not exposed to asbestos and non-smoking (A-S-) were compared with; (i) asbestos-exposed and non-smoking (A+S-), (ii) non-exposure to asbestos and smoking (A-S+), and (iii) asbestos-exposed and smoking (A+S+). Our meta-analysis showed a significant difference in risk of developing lung cancer among asbestos exposed and/or smoking workers compared to controls (A-S-), odds ratios for the disease (95% CI) were (i) 1.70 (A+S-, 1.31-2.21), (ii) 5.65; (A-S+, 3.38-9.42), (iii) 8.70 (A+S+, 5.8-13.10). The additive interaction index of synergy was 1.44 (95% CI = 1.26-1.77) and the multiplicative index = 0.91 (95% CI = 0.63-1.30). Corresponding values for cohort studies were 1.11 (95% CI = 1.00-1.28) and 0.51 (95% CI = 0.31-0.85). Our results point to an additive synergism for lung cancer with co-exposure of asbestos and cigarette smoking. Assessments of industrial health risks should take smoking and other airborne health risks when setting occupational asbestos exposure limits.
    Matched MeSH terms: Smoking/epidemiology*
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