Depression and Smoking Linked To Worse Prognosis in Oral Cancer

Dr. Eileen H. Shinn PhD Assistant Professor, Department of Behavioral Science Cancer Prevention and Population Sciences MD Anderson Cancer Center The University of Texas Houston, TX

Dr. Eileen Shinn

MedicalResearch.com Interview with:
Dr. Eileen H. Shinn PhD
Assistant Professor, Department of Behavioral Science
Cancer Prevention and Population Sciences
MD Anderson Cancer Center
The University of Texas
Houston, TX 

Medical Research: What is the background for this study? What are the main findings?

Dr. Shinn: Recent studies with leukemia, breast, lung, renal and liver cancer patients have shown that patients with depression have worsened survival.  These effect sizes are small, but independent of any of the traditional factors that are known to impact survival, such as extent of cancer, types of treatment administered and baseline health and age of the patient.  The current thinking is that cancer patients who are depressed have chronically heightened responses to stress; the constant release of stress hormones trigger changes in the tumor itself (such as noradrenergically-driven tumor angiogenesis) or may weakens the body’s immune function and ability to resist tumor growth.

When we measured depression in newly diagnosed patients with oropharyngeal cancer (cancer of the base of tongue and tonsil), we found that those patients who scored as depressed were 3.5 times more likely to have died within the five year period after their diagnosis, compared to nondepressed patients.  We also found that patients who were depressed were also 3.8 times more likely to have their cancer recur within the first five years after diagnosis.  We also found that patients who continued to smoke after diagnosis were more likely to recur within the first five years. These effect sizes were larger than those typically found in recent studies.  We believe that the larger effect size may be due to the tight eligibility criteria ( e.g., we did not include patients who already had recurrent disease, we only included patients with one specific type of head and neck cancer, oropharyngeal) and also due to controlling other known factors (all patients completed individualized treatment regimens of radiation/ chemoradiation at a comprehensive cancer center and patients with more advanced disease stage were more likely to have received treatment intensification compared to patients with early stage disease).  In all, we had 130 patients, one of the largest prospective studies with oropharyngeal cancer to examine the effect of depression on cancer outcome.

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Ads Increase Curiosity and Trial of E-Cigarettes Among Young Adults

Dr. Andrea C. Villanti PhD, MPH Director, Regulatory Science and Policy Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative Washington, DC 20001

Dr. Villanti

MedicalResearch.com Interview with:
Dr. Andrea C. Villanti PhD, MPH
Director, Regulatory Science and Policy Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative
Washington, DC 20001

Medical Research: What is the background for this study? What are the main findings?

Dr. Villanti: Awareness, interest, and use of electronic cigarettes (e-cigarettes) have increased since the products were introduced in the U.S. in 2006. Between 2012 and 2013, 8.3% of young adults reported current e-cigarette use compared to 4.2% of adults overall. One factor likely driving e-cigarette use as well as the use of other tobacco products is advertising, which has been demonstrated to promote the initiation and continued use of cigarettes. Advertising is critical for raising awareness about newly introduced products, and has been shown to influence initiation, experimentation, and progression to regular combustible cigarette smoking in youth.

This study used a randomized control trial to assess the impact of brief exposure to four e-cigarette print advertisements (ads) on perceptions, intention, and subsequent use of e-cigarettes and cigarettes among young adults (age 18-34). It found that exposure to e-cigarette ads may enhance curiosity and limited trial of e-cigarettes in never users. Other findings include:

  • Compared to the control group, ad exposure was associated with greater curiosity to try an e-cigarette among never e-cigarette users (18.3% exposed vs. 11.3% unexposed), and greater likelihood of e-cigarette trial at follow-up among never users of cigarettes and e-cigarettes (3.6% exposed vs. 1.2% unexposed).
  • Exploratory analyses did not find an association between ad exposure and cigarette trial or past 30-day use among never users at follow-up, nor cigarette use among smokers over time.
  • Curiosity to try an e-cigarette mediated the relationship between ad exposure and e-cigarette trial among e-cigarette never users.

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Smokers’ Homes Have High Air Pollution Levels

Dr. John Cherrie PhD Honorary Professor in Occupational Hygiene Institute of Applied Health Sciences Aberdeen, UKMedicalResearch.com Interview with:
Dr. John Cherrie PhD
Honorary Professor in Occupational Hygiene
Institute of Applied Health Sciences
Aberdeen, UK


Medical Research: What are the main findings of the study?

Dr. Cherrie: We set out to bring together measurements of fine particle levels in homes where smoking takes place, to compare these with smoke-free homes and then to estimate how much of these fine particles are inhaled by people at different stages in their life. We also wanted to look at the exposure to particles of non-smokers living with smokers and compare this with the exposure of people living in heavily polluted major cities around the world.
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Smoking Continues To Be Major Source Of Preventable Disease In US

Dr. Brian Rostron PhD, MPH Center for Tobacco Products US Food and Drug Administration Silver Spring, MarylandMedicalResearch.com Interview with:
Dr. Brian Rostron PhD, MPH
Center for Tobacco Products
US Food and Drug Administration
Silver Spring, Maryland


Medical Research: What are the main findings of the study?

Dr. Rostron: We estimated that Americans in 2009 had had 14 million major medical conditions such as heart attack, stroke, lung cancer, and COPD that were attributable to smoking.  COPD was the leading cause of smoking-attributable morbidity, with over 7.5 million cases of COPD attributable to smoking.
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Smoking Plus Mental Illness Leads To Substantial Economic Burden

Ms Qi Wu: Mental Health and Addiction Research Group, Department of Health Sciences University of York, Heslington York  UKMedicalResearch.com Interview with:
Ms Qi Wu:
Mental Health and Addiction Research Group, Department of Health Sciences
University of York, Heslington
York  UK

Medical Research: What are the main findings of the study?

Ms Qi Wu: At any time in the UK about one in six adults has a mental health problem, the prevalence of smoking in this group is over 33%, which is around 50% higher than in the general population. It is estimated that 3 million adults with mental disorders were smokers in 2009-10. Meanwhile, people with mental health disorders are also more likely to smoke heavily, this group accounts for as much as 42% of the total national tobacco consumption.  In this study, we calculated the avoidable economic burden of smoking in people with mental disorders.

The main finding was that people with mental disorders who smoke cost the UK economy £2.34 billion a year. The total costs are more or less equally divided among losses sustained from premature death, lost productivity, and healthcare costs to treat smoking related diseases such as lung cancer, cardiovascular disease and chronic obstructive pulmonary disease (COPD) in this group.  An estimated £719 million (31% of the total cost) was spent on treating diseases caused by smoking. Productivity losses due to smoking-related diseases were about £823 million (35%) for work- related absenteeism and £797 million (34%) was associated with premature mortality.
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E-Cigarettes Use By Adolescents May Lead to Heavier Smoking

Lauren Dutra, ScD Postdoctoral Scholar, UCSF School of Medicine Cardiovascular Research Institute San Francisco, CA 94143MedicalResearch.com Interview with:
Lauren Dutra, ScD
Postdoctoral Scholar, UCSF School of Medicine
Cardiovascular Research Institute
San Francisco, CA 94143

MedicalResearch.com: What are the main findings of the study?

Answer: Middle and high school students who used e-cigarettes were more likely to smoke tobacco cigarettes. They were also more likely to progress from experimenting with tobacco cigarettes to becoming regular smokers.

Teen smokers who used e-cigarettes were more likely to be planning to quit in the next year and less likely to have abstained from smoking recently, compared to smokers who had never used e-cigarettes. They were also more likely to be heavier smokers (smoke more cigarettes per day) than those who had never tried e-cigarettes, that being said there are eliquids available that have no nicotine content whatsoever and these are therefore a much healthier option, you can see a wide variety of these at Gourmet E-Liquid.
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