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Smoking linked to Skin Cancer?

Smoking has long been tied to a number of cancers, and now another tumor type, skin cancer, may join that list.

A new review of data finds that lighting up may boost the risk of a common type of non-melanoma skin cancer.

Researchers sifted through the results of 25 studies conducted in 11 countries worldwide. Most of the studies included middle-aged to elderly people.


Increased Risk

This analysis revealed that smoking was associated with a 52 percent increased risk of cutaneous squamous cell carcinoma skin cancer, according to Jo Leonardi-Bee, of the U.K. Center for Tobacco Control Studies at the University of Nottingham in England


Squamous cell and basal cell carcinomas -- collectively known as non-melanoma skin cancer -- account for about 97 percent of all skin cancers. The incidence of non-melanoma skin cancer is rising worldwide, with about 2 to 3 million new cases each year.

The authors said they found no clear association between smoking and basal cell carcinomas.


Early Diagnosis

This study highlights the importance for Doctors to actively survey high-risk patients, including current smokers, to identify early skin cancers, since early diagnosis can improve prognosis because early lesions are simpler to treat compared with larger or neglected lesions.

This isn't the first time smoking has been linked to skin cancer. In December, researchers reporting in the journal Cancer Causes Control said that women diagnosed with squamous cell carcinoma were twice as likely to have been smokers than those who were free of the disease.

The study, led by Dana Rollison, an associate member in the Moffitt Cancer Center department of cancer epidemiology, in Tampa, Fla., also found that men who were long-term smokers were at slightly higher risk for basal cell carcinomas.

Speaking at the time, Dr. Jeffrey Dover, associate clinical professor of dermatology at Yale University Medical School, said the findings weren't surprising because "we know cigarette smoke contains carcinogens" and smokers are "blowing the smoke and ash around their faces all day."

Squamous cell cancer occurs in the epidermis, the top layer of skin, and can spread to other organs. Basal cell skin cancer occurs in the dermis, the skin layer beneath the epidermis. While it does not spread to other organs, it is far more common than squamous cell cancer.


Increased risks of dying from strokes and emphysema

People regularly exposed to secondhand smoke may have increased risks of dying from strokes and emphysema as well as from heart disease and lung cancer, according to a study from China that followed people for nearly two decades.

A number of studies have found that non-smokers who regularly breathe in other people's tobacco smoke have an increased risk of developing heart disease or certain cancers, but the links to strokes and emphysema have been relatively weaker.

The findings, which appeared in the medical journal Chest, cannot definitively prove that secondhand smoke is the culprit, but the researchers were able to account for some other key factors, such as a person's age, education, job, and blood pressure and cholesterol levels.

"This study has shown dose response relationships between secondhand smoke and major tobacco related mortality," wrote lead researcher Yao He of Chinese PLA General Hospital in Beijing, and colleagues.

The findings are based on 910 adults who were followed over 17 years.

At the start, 44 percent said they lived with a smoker, while 53 percent said they inhaled secondhand smoke at work.

Over the following years, 249 study participants died. The risks of death from heart disease, stroke, lung cancer and emphysema were all two to three times higher among people exposed to secondhand smoke.

Among men, for example, 11 percent of the 271 men exposed to secondhand smoke died of strokes. That compared with 6.5 percent of the 168 men who lived and worked in smoke-free surroundings.

The numbers of people who died of each specific cause were fairly small, which is a limitation.

But Joanna Cohen, director of the Institute for Global Tobacco Control at Johns Hopkins Bloomberg School of Public Health, said the results support evidence that secondhand smoke may boost the risks of not only heart disease and certain cancers, but strokes and emphysema as well.

In the United States, the most recent Surgeon General's report said there was "suggestive" evidence that secondhand smoke might boost people's risk of stroke and emphysema - but the evidence was considered insufficient to say there was a "causal relationship", Cohen noted.

"This type of study is important for adding to evidence of a causal relationship," she said.

Cohen said it was "huge" that the information was coming from China.

"It's the country with the most number of smokers," she said, adding that it is trailing other nations in anti-smoking education and tobacco control



Smoking Increases the Risk of Miscarriage

There is substantial evidence that smoking increases the risk of miscarriage: the Royal College of Physicians has estimated that the risk is increased by 25 per cent.

Smoking during pregnancy is an important cause of ill-health for both mother and foetus. Besides increasing the mother's risk for potentially serious complications, smoking during pregnancy is the largest preventable cause of foetal and infant ill health and death.

For example: one study of almost 60,000 women in Canada found a clear dose response, with the risk of miscarriage increasing with the number of cigarettes smoked. An increased risk was seen even amongst women smoking nine cigarettes or fewer daily.

In a study of nearly 1,300 Japanese women with a past pregnancy, researchers found that those who smoked heavily early in pregnancy were more than twice as likely as non-smokers to suffer a miscarriage in the first trimester.

There are many reasons for women to quit smoking before becoming pregnant. The habit has been linked to increased risks of stillbirth, preterm delivery and low birth weight.



Semen Quality and Sperm Damage Caused by Smoking

Smoking reduces the quality of semen: men who smoke have a lower sperm count than non-smokers and their semen contains a higher proportion of malformed sperm.

By-products of nicotine present in the semen of smokers have been known to reduce the mobility of sperm. and to affect their normal swimming patterns.

Genetic material in sperm cells is damaged by smoking. For example, benzoapyrene , one of the carcinogenic  components of tobacco smoke, has been found to bind to DNA in sperm, inducing mutations. This damage can persist in embryos


Smoking linked to earlier menopause

Women who smoke may hit menopause about a year earlier than those who don't light up, according to a study that also notes an earlier menopause may influence the risk of getting bone and heart diseases.

Non-smokers hit menopause between age 46 and 51, on average. But smokers were younger when they hit menopause, between 43 and 50 overall.

During menopause, a woman's ovaries stop producing eggs and she can no longer get pregnant.

Five other studies that used a cut-off age of 50 or 51 to group women into "early" and "late" menopause. Out of more than 43,000 women in that analysis, women who smoked were 43 percent more likely than nonsmokers to have early menopause.

Both early and late menopause have been linked to health risks. Women who hit menopause late, for instance, are thought to be at higher risk of breast cancer because one risk factor for the disease is more time exposed to estrogen.

"General consensus is that earlier menopause is likely to be associated with the larger number and higher risk of postmenopausal health problems, such as osteoporosis, cardiovascular diseases, diabetes mellitus, obesity, Alzheimer's disease, and others,"

There are two theories for why smoking might mean earlier menopause, said Jennie Kline, an epidemiologist from Columbia University's Mailman School of Public Health in New York. Smoking make have an effect on how women's bodies make, or get rid of, estrogen. Alternatively, some researchers believe certain components of cigarette smoke might

Alcohol, weight and whether or not women have given birth may each also play a role in when they hit menopause, but the evidence for everything other than smoking has been mixed, Kline said.

It is also possible that the same factors that influence age at menopause may determine whether women have trouble with infertility or not, or how late they can get pregnant.




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