smoking

Smoking

Compared with never smoking, persistent smoking after acute ischemic stroke was associated with an increased risk of cardiovascular events and death 1)


95 % of small-cell lung cancer arise in proximal airways, usually in mainstem or lobar brochii. Tipically younger (27-66 years) than other lung cancer. Strongly associated with cigarrete smoking

Cigarette smoke (CS) contains several carcinogens known to initiate and promote tumorigenesis and metastases. Because various genes that mediate carcinogenesis and tumorigenesis are regulated by nuclear factor kappa-B (NF-kappaB), Anto et al., postulated that the effects of CS must be mediated through activation of this transcription factor 2).


Kamal et al. conducted a meta-analysis to address the outcomes in cancer patients after oncologic surgery during the COVID-19 pandemic. The primary endpoint was the COVID-19-related mortality rate. Higher body mass index was significantly and negatively associated with higher all-cause mortality and in-hospital COVID-19 infection rates. Male sex, preoperative respiratory disease, and smoking history were positively and significantly associated with increased all-cause mortality rates. Furthermore, male sex was positively and significantly associated with the COVID-19 infection rate 3).

see Smoking and aneurysm rupture risk factor.


The intravenous thrombolysis-treated stroke patients with unruptured intracranial aneurysms were more often current smokers and had higher systolic blood pressure than the matched patients without UIAs. They were as likely to have unfavorable outcomes at 3 months but seemed less likely to achieve excellent outcomes and were more likely to have higher mRS in shift analysis 4).

Very low birth weight (VLBW) infants (< 1500 gm), cocaine-exposed infants were at increased risk of intraventricular hemorrhage, were more likely to be placed outside maternal care, and had higher incidences of cognitive and motor delays at follow-up. Cocaine-using women were also more likely to use other drugs, especially alcohol, marijuana, and tobacco 5).

In a analysis, intraventricular hemorrhage and tobacco use were associated with symptomatic vasospasm 6).

Tobacco use and a history of diabetes mellitus were associated with vasospasm 7).

CT-evident SAH, left ventricular hypertrophy (LVH), cigarette smoking, and hypertension are associated with vasospasm. In smokers or hypertensive patients, premorbid LVH appears to predict much more severe vasospasm 8).

Cocaine users were younger than control, and were more likely to smoke tobacco, drink alcohol, and have renal dysfunction 9).

Smoking is a modest risk factor for lumbar radicular pain and clinically verified sciatica. Smoking cessation appears to reduce, but not entirely eliminate, the excess risk 10)

Microdecompression for lumbar spinal stenosis

There are limited scientific data on the impact of smoking on patient-reported outcomes following minimally invasive spine surgery.

Nonsmokers experienced a significantly larger improvement at 1 year following microdecompression for LSS compared to smokers. Smokers were less likely to achieve a minimal clinically important difference. However, it should be emphasized that considerable improvement also was found among smokers 11).

Lumbar disc herniation

Considering sex, smoking and heavy works as predictors of recurrent lumbar disc herniation (LDH), surgeons should advice their patients to limit hard work and put away smoking especially in tall and male ones to prevent LDH recurrence 12).

Smoking was the strongest predictor of reoperation in patients who had undergone single level laminectomy, multilevel laminectomy, or reoperation for progression of spinal degeneration. These findings suggest that smokers have worse outcomes of lumbar decompression than nonsmokers 13).

In postlaminectomy pseudomeningocele a retrospective analyses of six cases was made including: clinical signs and symptoms, radiological findings, and possible therapeutic modalities.

In every case, there was a palpable fluctuating mass under the surgical scar, sensory loss in both low extremity, and limited leg raising; moreover, heel tapping produced pain. Also, every patient had a history of long standing cigarette smoking and multiple spinal surgeries. Radiologically dural saccular or tubular structures were noted at myelograms, magnetic resonance imaging, or computed axial tomography scan, usually at the site of the surgery. In one patient with metallic devices, diagnosis was made by ultrasound 14).

Compensation claims and smoking had very significant adverse impacts on both employment and pain results despite high fusion rates, particularly in patients under the age of 55 years 15).

Cotinine, a main metabolite of nicotine, has harmful effects on SCI via GFAP and CNP expression. The findings of the present study support the hypothesis that tobacco causes neuronal degeneration via cotinine 16).

A study found that pre-injury vascular risk factors, especially smoking, are associated with worse outcomes after TBI. Aggressive post-injury treatment of vascular risk factors may be a promising strategy to improve Traumatic Brain Injury outcomes 17).

Exposure of nonsmoking pregnant women to environmental tobacco smoke (ETS) is associated with a number of adverse perinatal outcomes including lower birthweight, smaller head circumference and stillbirth, as well as shorter birth length. This information is important for women, their families and healthcare providers, and reinforces the continued need for increased public policy and education on prevention of exposure to ETS 18).


1)
Anadani M, Turan TN, Yaghi S, Spiotta AM, Gory B, Sharma R, Sheth KN, de Havenon A. Change in Smoking Behavior and Outcome After Ischemic Stroke: Post-Hoc Analysis of the SPS3 Trial. Stroke. 2023 Mar 6. doi: 10.1161/STROKEAHA.121.038202. Epub ahead of print. PMID: 36876480.
2)
Anto RJ, Mukhopadhyay A, Shishodia S, Gairola CG, Aggarwal BB. Cigarette smoke condensate activates nuclear transcription factor-kappaB through phosphorylation and degradation of IkappaB(alpha): correlation with induction of cyclooxygenase-2. Carcinogenesis. 2002 Sep;23(9):1511-8. PubMed PMID: 12189195.
3)
Kamal M, Baudo M, Shmushkevich S, Geng Y, Hanna E, Goepfert RP, Lewis CM, Rahouma M. COVID-19 infection and its consequences among surgical oncology patients: A systematic analysis, meta-analysis and meta-regression. J Surg Oncol. 2022 Jan 11. doi: 10.1002/jso.26787. Epub ahead of print. PMID: 35014703.
4)
Virta JJ, Strbian D, Putaala J, Kaprio J, Korja M. Characteristics and Outcomes of Thrombolysis-Treated Stroke Patients With and Without Saccular Intracranial Aneurysms. Stroke. 2022 Oct 18. doi: 10.1161/STROKEAHA.122.040151. Epub ahead of print. PMID: 36254706.
5)
Singer LT, Yamashita TS, Hawkins S, Cairns D, Baley J, Kliegman R. Increased incidence of intraventricular hemorrhage and developmental delay in cocaine-exposed, very low birth weight infants. J Pediatr. 1994 May;124(5 Pt 1):765-71. PubMed PMID: 7513757; PubMed Central PMCID: PMC4181569.
6)
Wilson TJ, Stetler WR Jr, Davis MC, Giles DA, Khan A, Chaudhary N, Gemmete JJ, Xi G, Thompson BG, Pandey AS. Intraventricular Hemorrhage Is Associated with Early Hydrocephalus, Symptomatic Vasospasm, and Poor Outcome in Aneurysmal Subarachnoid Hemorrhage. J Neurol Surg A Cent Eur Neurosurg. 2014 Dec 29. [Epub ahlow birth weight (VLBW) infants (< 1500 gm), cocaine-exposed infants were at increased risk of intraventricular hemorrhage, were more likely to be placed outside maternal care, and had higher incidences of cognitive and motor delays at follow-up. Cocaine-using women were also more likely to use other drugs, especially alcohol, marijuana, and tobacco ((Singer LT, Yamashita TS, Hawkins S, Cairns D, Baley J, Kliegman R. Increased incidence of intraventricular hemorrhage and developmental delay in cocaine-exposed, very low birth weight infants. J Pediatr. 1994 May;124(5 Pt 1):765-71. PubMed PMID: 7513757; PubMed Central PMCID: PMC4181569.
7)
Kilbourn KJ, Levy S, Staff I, Kureshi I, McCullough L. Clinical characteristics and outcomes of neurogenic stress cadiomyopathy in aneurysmal subarachnoid hemorrhage. Clin Neurol Neurosurg. 2013 Jul;115(7):909-14. doi: 10.1016/j.clineuro.2012.09.006. Epub 2012 Sep 26. PubMed PMID: 23021080.
8)
Inagawa T, Yahara K, Ohbayashi N. Risk factors associated with cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Neurol Med Chir (Tokyo). 2014 Jun 17;54(6):465-73. Epub 2014 Mar 27. PubMed PMID: 24670311.
9)
Alaraj A, Wallace A, Mander N, Aletich V, Charbel FT, Amin-Hanjani S. Effect of acute cocaine use on vasospasm and outcome in aneurysmal subarachnoid hemorrhage. World Neurosurg. 2010 Apr;73(4):357-60. doi: 10.1016/j.wneu.2010.01.011. PubMed PMID: 20849793.
10)
Shiri R, Falah-Hassani K. The Effect of Smoking on the Risk of Sciatica: A Meta-analysis. Am J Med. 2016 Jan;129(1):64-73.e20. doi: 10.1016/j.amjmed.2015.07.041. Epub 2015 Sep 25. PubMed PMID: 26403480.
11)
Gulati S, Nordseth T, Nerland US, Gulati M, Weber C, Giannadakis C, Nygaard ØP, Solberg TK, Solheim O, Jakola AS. Does daily tobacco smoking affect outcomes after microdecompression for degenerative central lumbar spinal stenosis? - A multicenter observational registry-based study. Acta Neurochir (Wien). 2015 May 6. [Epub ahead of print] PubMed PMID: 25943982.
12)
Shimia M, Babaei-Ghazani A, Sadat BE, Habibi B, Habibzadeh A. Risk factors of recurrent lumbar disk herniation. Asian J Neurosurg. 2013 Apr;8(2):93-6. doi: 10.4103/1793-5482.116384. PubMed PMID: 24049552; PubMed Central PMCID: PMC3775189.
13)
Bydon M, Macki M, De la Garza-Ramos R, Sciubba DM, Wolinsky JP, Gokaslan ZL, Witham TF, Bydon A. Smoking as an independent predictor of reoperation after lumbar laminectomy: a study of 500 cases. J Neurosurg Spine. 2015 Jan 2:1-6. [Epub ahead of print] PubMed PMID: 25555058.
14)
Aldrete JA, Ghaly R. Postlaminectomy pseudomeningocele. An unsuspected cause of low back pain. Reg Anesth. 1995 Jan-Feb;20(1):75-9. PubMed PMID: 7727333.
15)
Schnee CL, Freese A, Ansell LV. Outcome analysis for adults with spondylolisthesis treated with posterolateral fusion and transpedicular screw fixation. J Neurosurg. 1997 Jan;86(1):56-63. PubMed PMID: 8988082.
16)
Dalgic A, Okay O, Helvacioglu F, Daglioglu E, Akdag R, Take G, Belen D. Tobacco-induced neuronal degeneration via cotinine in rats subjected to experimental spinal cord injury. J Neurol Surg A Cent Eur Neurosurg. 2013 May;74(3):136-45. doi: 10.1055/s-0033-1337607. Epub 2013 Mar 19. PubMed PMID: 23512588.
17)
Schneider ALC, Barber J, Temkin N, Gardner RC, Manley G, Diaz-Arrastia R, Sandsmark D. Associations of Preexisting Vascular Risk Factors With Outcomes After Traumatic Brain Injury: A TRACK-TBI Study. J Head Trauma Rehabil. 2022 Jun 9. doi: 10.1097/HTR.0000000000000798. Epub ahead of print. PMID: 35687893.
18)
Crane JM, Keough M, Murphy P, Burrage L, Hutchens D. Effects of environmental tobacco smoke on perinatal outcomes: a retrospective cohort study. BJOG. 2011 Jun;118(7):865-71. doi: 10.1111/j.1471-0528.2011.02941.x. Epub 2011 Mar 23. PubMed PMID: 21426481.
  • smoking.txt
  • Last modified: 2023/03/06 18:56
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