Preventive medicine
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Preventive medicine · Jul 1997
ReviewChanging smoking patterns and mortality from chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD) is the result of many years of accelerated decline in lung function in susceptible cigarette smokers. Although risk factors for the susceptibility of smokers to COPD have been established, there are still large gaps in our knowledge of the biological basis for these risk factors and of how to identify individuals at risk. ⋯ Current mortality trends indicate that COPD mortality may be leveling off among white males, but will continue to increase among women, African-Americans, and the elderly. Recent studies indicate that early identification of individuals with airflow obstruction and smoking intervention can halt the progression of COPD, but widespread screening and intervention programs have not yet been established.
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Since 1953, the sales-weighted average "tar" and nicotine yields of commercial cigarettes in developed countries have significantly declined. However, the risk for chronic obstructive pulmonary disease (COPD) and for cancer of the lung has not decreased; adenocarcinoma incidence even continues to rise faster than the rate of squamous cell carcinoma of the lung. Undiminished risk of cigarette smokers for COPD and lung cancer is largely due to more intense smoking and deeper inhalation of the smoke of "low-yield" cigarettes and to significant changes in the smoke yields of certain lung carcinogens. ⋯ The way people smoke and the total number of cigarettes consumed daily determine the uptake, i.e., the administered dose of nicotine, other toxic, and genotoxic smoke constituents. It is important to communicate this to consumers rather than letting the smokers believe that they are truly smoking a cigarette of lower smoke yields when they choose "light" or "ultralight" products.
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Sun protection behaviors are recommended to prevent skin cancer, which has increased in incidence. This study measured the prevalence of sun protection behaviors and determined personal characteristics associated with them. ⋯ A large percentage of white U.S. adults did not protect themselves from sun exposure. Additional education of the general public and persons at higher risk for skin cancer is needed.
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Preventive medicine · Jul 1997
Physician attitudes toward managing obesity: differences among six specialty groups.
The Healthy People 2000 report recommended that physicians more actively address obesity, but little is known about current attitudes and practices of physicians, particularly across specialty areas relevant to obesity as a medical risk factor. ⋯ Physicians express high concern with management of obesity but variable interest in assuming this role themselves. Mild obesity may be particularly undertreated. Research is critically needed to assess effective physician roles in weight management and to support the development of physician guidelines.
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Preventive medicine · Jul 1997
Epidemiology of low total plasma cholesterol concentration among young adults: the CARDIA study. Coronary Artery Risk Development in Young Adults.
Data on stability of plasma total cholesterol levels and its determinants among young adults are lacking. Knowledge of factors associated with low levels of plasma total cholesterol during young adulthood may help clarify the nature of associations between hypocholesterolemia and health or illness. ⋯ Young adults with low plasma total cholesterol level have characteristics generally associated with good cardiovascular health. However, adverse attributes such as current cigarette smoking (notably among black men) may confound future associations between low total cholesterol and disease.