1、 Key PointExposure to environmental tobacco smoke increases the risk of heart disease among nonsmokers by 30%.Whincup et al prospectively evaluated the relationship between environmental tobacco smoke exposure (quantified by serum cotinine levels) and risk of coronary artery disease (CAD) and stroke
2、 in 4729 subjects enrolled in the British Regional Heart Study. Participants were male nonsmokers aged 40 to 59 years, initially evaluated from 1978 to 1980. Baseline examination included assessment of blood pressure and nonfasting cholesterol and cotinine levels in addition to a nurse-administered
3、questionnaire, from which data on smoking and medical history were obtained. Men were classified as “current nonsmokers” at baseline if they reported that they did not smoke and had a cotinine concentration 14.1 ng/mL. Nonsmokers were further subclassified into light and heavy passive smokers. Light
4、 passive smokers were nonsmokers who had the lowest levels of cotinine concentration (0-0.7). Heavy passive smokers were nonsmokers who had the highest cotinine concentration (0.8 to 14.0). Light active smokers were men who reported smoking 1 to 9 cigarettes a day, irrespective of cotinine concentra
5、tion.All men were followed up for all-cause mortality and cardiovascular mortality. The graph depicts the Kaplan-Meier plot showing the cumulative proportions of men with major CAD over time among the light active, heavy passive and light passive smokers. Age, systolic blood pressure, diastolic bloo
6、d pressure, total cholesterol, high-density lipoprotein (HDL) cholesterol, forced expiratory volume in 1 second (FEV1), height, preexisting CAD, body mass index, triglycerides, WBC, diabetes, physical activity (none, occasional, light, moderate, or more), alcohol intake (none/occasional, light/moder
7、ate, heavy), and social class (I, II, III non-manual, III manual, IV, V, and Armed Forces) were fitted as dichotomous variables.Heavy passive and light passive smokers had the highest incidence of major CAD. Although the groups diverged markedly in the early follow-up period, they remained almost pa
8、rallel during later years. The authors concluded that environmental tobacco smoke exposure is associated with an increased risk of CAD of approximately 25% to 30%.Key PointExposure to environmental tobacco smoke increased the risk of nonfatal acute (MI) in a graded manner.Teo et al evaluated 12,133
9、cases of first acute MI and 14,435 age-matched and sex-matched controls in the international, multicenter INTERHEART study. Trained staff administered a questionnaire to both cases and controls in which participants were asked detailed questions about their smoking status. After adjusting for age, s
10、ex, region, physical activity, and consumption of fruits, vegetables, and alcohol, nonsmokers who had no previous environmental tobacco smoke exposure showed increasing risk of nonfatal acute MI with increasing levels of exposure to environmental tobacco smoke. Although the etiology is unclear, this
11、 increase in risk was slightly attenuated in subjects with 22 hours per week of environmental tobacco smoke exposure.大量不同设计的流行病学的研究（包括针对酗酒者的病情研究以及一般人的预期研究）都表明了酗酒与胃癌间没有关联：例外的是，在大量饮用红酒的法国与葡萄牙，以及大量饮用伏特加酒的波兰，胃癌的患病率有所增加（这些研究全部是病情研究）全球青少年烟草调查结果显示，我国有43.9%的青少年在家庭遭受二手烟雾危害，55.8%的青少年在公共场所遭受二手烟雾危害。此外，“三手烟”的危害也
12、堪比“二手烟”。吸烟者“吞云吐雾”后残留在自身头发、衣服上的香烟气味和有害物微粒，以及沾染“烟 ”的 、 物 和 ，这些“三手烟”也 以 害 ， 发 吸 病，增加 发病 率。 期 这些 的有 物 ， 增加人期患癌。 在不的场所，吸烟者吸1currency1烟，不吸烟者“吸fifl currency1烟的烟量。Key PointRisk of acute MI associated with smoking is significantly reduced within a few years of quitting. Teo et al evaluated 12,461 cases of fi
13、rst acute MI and 14,637 age-matched and sex-matched controls in the international, multicenter INTERHEART study. Trained staff administered a questionnaire to both cases and controls in which participants were asked detailed questions about their smoking status.Risk of acute MI associated with smoking was markedly reduced within a few years of quitting. Risk of acute MI decreased progressively with time since becoming abstinent; however, some increased risk persisted, even in those who had quit more than 20 years prior.
