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Posted on August 25th 2020 (almost 5 years)

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  • Tobacco use remains a primary contributor to disease, disability, and premature death across the globe. A recent editorial summarizes data demonstrating that smoking reduces life expectancy by approximately 20 minutes per cigarette smoked—17 minutes for men and 22 minutes for women.

    The estimate, which drew on data from long-term studies such as the British Doctors Study and the Million Women Study, accounts for factors like smoking rates and early death outcomes over several decades. It’s also grounded in better and more up-to-date data, including studies that tracked the effects of smoking for up to 50 years.

    While smoking rates have declined in recent decades, the harm caused per cigarette may not have decreased substantially, as smokers may inhale more deeply or compensate for fewer cigarettes smoked. However, urinary cotinine levels—a marker of toxicant exposure—show only modest changes, suggesting that the risks per cigarette remain consistent with earlier estimates.

    These findings emphasize that the harm from smoking is cumulative, and quitting earlier can markedly reduce the risk of early death and disease. Smokers who quit at any age can prevent substantial loss of life expectancy, with each cigarette avoided contributing to a longer, healthier life. Smokers in their 60s, for example, may experience health improvements that narrow the gap between their current health and that of a non-smoker several years younger.

    Though individual factors like smoking intensity and age of initiation vary, the general conclusion remains the same: Smoking shortens life at every stage, and cessation at any age offers considerable, tangible health benefits. Like many harmful lifestyle behaviors, smoking accelerates epigenetic aging. Learn more in this clip featuring Dr. Steve Horvath.

  • Lighting up a cigarette shaves years off a person’s life, shortening their lifespan by as much as a decade. However, a recent study found that quitting smoking, even later in life, can extend a person’s life expectancy by as much as eight years—depending on how early they quit.

    Researchers analyzed data from several large cohort studies and national death records to estimate the effects of smoking on life expectancy for people who never smoked, those who currently smoke, and those who previously smoked. They focused on people who quit at ages ranging from 35 to 75, assessing the years of life lost due to smoking and the years gained by quitting at each age.

    They found that those who continue smoking at ages 35, 45, 55, 65, or 75 could lose 9.1, 8.3, 7.3, 5.9, and 4.4 years of life, respectively, compared to people who never smoked. However, quitting smoking could save an average of 8.0, 5.6, 3.4, 1.7, and 0.7 years, depending on the age at which smoking cessation occurs. If a person quits at age 65, they have a 23.4% chance of gaining at least one extra year of life, while for someone quitting at age 75, the chance is 14.2%.

    These findings suggest that while quitting earlier provides the most substantial gains in life expectancy, even those who quit later can still extend their lives. Harmful behaviors like smoking are rooted in reward-based processes. Consequently, people often engage in these behaviors in response to triggers, such as stress or social pressures. Cognitive behavioral approaches like mindfulness can help people who engage in harmful behaviors become more mindful of these triggers. Learn more in this clip featuring Dr. Ashley Mason.

  • Genes play critical roles in determining how long a person lives, but a new study suggests that the secret to longevity may be as simple as “food as medicine.” Centenarians—people who live 100 years or more—typically eat healthy, balanced diets and require fewer medications than their shorter-lived peers.

    Researchers analyzed studies examining the lifestyles, medication use, and overall health of centenarians and near-centenarians aged 95 to 118. Their analysis included 34 studies and involved more than 59,000 participants.

    They identified several healthy lifestyle habits of long-lived adults: Engaging in regular physical activity Avoiding alcohol and tobacco Adhering to a diverse, macronutrient-balanced diet Preferring less salty foods Using few medications—with just over four taken daily, primarily blood pressure medicines or other cardiovascular drugs

    Multiple drug use—known as polypharmacy—is common in older adults. Defined as taking more than five medications daily, polypharmacy is linked with many adverse health effects, especially among older adults, who are at risk of a “prescription cascade”—where the side effects of drugs can be misdiagnosed as symptoms of another disease, creating a vicious cycle of more drug use.

    This analysis suggests that using food as medicine—through healthy, balanced diets—combined with lower drug use contributes to healthy aging and longevity. Learn how other healthy lifestyle behaviors like exercise and dietary supplementation also promote longevity in this episode featuring Dr. Rhonda Patrick.

  • Cigarette smoking is the number one risk factor for lung cancer, the second most common form of cancer and a leading cause of death worldwide. A 2017 study found that heavy smokers' lung cancer risk drops by nearly 40 percent just five years after quitting smoking,

    The study involved more than 8,900 people enrolled in two large cohort studies. Researchers tracked the participants' health for an average of 30 years and determined their cancer risk based on whether they were current, former, or never smokers.

    They found that current and former smokers had a higher risk of developing lung cancer than those who never smoked, but that risk increased tenfold if they were heavy smokers (defined as smoking one pack daily for 21 years or longer), with nearly 93 percent of lung cancers occurring in heavy smokers.

    Five years after quitting, former heavy smokers saw a 39 percent reduction in their lung cancer risk compared to current smokers, and this risk continued to decrease over time. However, even 25 years after quitting, heavy smokers' risk of lung cancer was still more than three times higher than that of people who had never smoked.

    These findings suggest that smoking, especially heavy smoking, markedly increases a person’s risk of developing lung cancer. And although quitting smoking reduces lung cancer risk, former smokers' risks remain higher than never smokers'.

    Many harmful behaviors, such as smoking or overeating, are rooted in reward-based processes. Consequently, people often engage in these behaviors in response to triggers, such as emotional or mental stressors, or external prompts, such as advertising and social pressures. Cognitive behavioral approaches like mindfulness can help people who engage in harmful behaviors become more mindful of these triggers. In turn, they can reevaluate their habits and develop strategies that help them avoid engaging in harmful behaviors. Learn more in this clip featuring Dr. Ashley Mason.

  • Cannabis, commonly known as marijuana, is a plant used for its psychoactive properties and influences on perception, mood, and consciousness. People consume cannabis for both recreational and medicinal purposes, seeking relief from pain, anxiety, and other conditions. A recent study found that regular cannabis use increases the risk of cardiovascular disease, particularly among those who don’t use tobacco.

    Researchers analyzed data collected from more than 434,000 adult participants who provided information about their cannabis use. They looked at how often participants used cannabis in the past month and whether they reported having coronary artery disease, a heart attack, or a stroke. They conducted a separate analysis for participants who didn’t use tobacco.

    They found that daily cannabis users were about 16 percent more likely to have coronary heart disease, 25 percent more likely to experience a heart attack, and 42 percent more likely to have a stroke. When they combined all three heart-related issues, they found that daily cannabis users were 28 percent more likely to face any of them than non-users.

    However, when they focused on participants who had never smoked tobacco and only used cannabis, the findings were even more striking. Daily cannabis users who had never used tobacco were 49 percent more likely to experience a heart attack and 116 percent more likely to have a stroke. When the researchers combined all three heart-related issues, they found that daily cannabis users who had never used tobacco were 77 percent more likely to face any of the cardiovascular conditions.

    These findings suggest that daily cannabis use increases the risk of cardiovascular disease, especially among non-tobacco users, indicating that cannabis use alone could contribute to cardiovascular risk. Compounds in cannabis have profound effects on the human body and can even pass into breast milk, affecting breastfed infants. Learn more in this episode featuring Dr. Rhonda Patrick.

  • Irritable bowel syndrome (IBS) is a digestive disorder characterized by abdominal cramping, gas, diarrhea, and constipation. The condition affects as many as 10 percent of people worldwide and has no cure. A recent study shows that adopting three or more healthy lifestyle behaviors may reduce the risk of IBS by as much as 42 percent.

    The study involved more than 64,000 people enrolled in the UK Biobank database. Researchers collected information about the participants' dietary intake and whether they engaged in any of five healthy lifestyle behaviors: never smoking, getting optimal sleep, engaging in vigorous physical activity, eating a quality diet, and moderating their alcohol intake.

    They found that 11.8 percent of the participants did not practice any of the five critical healthy behaviors; 32.1 percent practiced one, 34.1 percent practiced two, and 21.9 percent practiced three to five healthy behaviors. As participants engaged in more healthy behaviors, their likelihood of developing IBS decreased, with those practicing one healthy behavior having a 21 percent lower risk, those with two healthy behaviors having a 36 percent lower risk, and those engaging in three to five healthy behaviors having a 42 percent lower risk. These findings were consistent across various groups, regardless of age, sex, job status, where they lived, history of gastrointestinal infection, endometriosis, family history of IBS, or other lifestyle habits.

    These findings suggest that adopting multiple healthy lifestyle behaviors, such as not smoking, staying physically active, and getting good sleep, can significantly reduce the risk of developing IBS. Learn more about factors that influence gut health in this episode featuring Dr. Eran Elinav.

  • From the article:

    To investigate, Peng, Clapper and their colleagues examined the lungs of healthy mice and found that they contained high levels of estrogen metabolites, known as 4‑hydroxy- estrogens (4-OHEs), which are carcinogenic. Specifically, these 4-OHEs help activate processes that promote cell growth, and generate free radicals that damage cells.

    When the researchers exposed the mice to tobacco smoke for 8 weeks, they found that the levels of 4-OHEs increased. “We believe that these metabolites of estrogen can damage cells and contribute to lung cancer,” says Clapper.

    Female mice had twice as much 4-OHE in their lungs compared to male mice after controlling for the level of total estrogen present. Whether this is the same in humans remains to be determined. “While lung cancer is not more common in women, the number of nonsmokers who develop lung cancer is greater for men than for women,” explains Clapper.

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  • From the article:

    Sex hormones are thought to play a part in the development of rheumatoid arthritis, and both men and women with the condition tend to have lower levels of testosterone in their blood than healthy people. But it is not clear whether this is a contributory factor or a consequence of the disease.

    The researchers based their findings on participants of the Swedish Malmo Preventive Medicine Program (MPMP), which began in 1974 and tracked the health of more than 33,000 people born between 1921 and 1949.

    […]

    After taking account of smoking and body mass index, both of which can affect the risk of rheumatoid arthritis, **men with lower levels of testosterone in their blood samples were more likely to develop the disease.

    This was **statistically significant for those who tested negative for rheumatoid factor when they were diagnosed.

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  • From the publication:

    Data from 18,055 males with known CS status and low TT levels who received TRT at the Veterans Health Administration between December 1, 1999, and May 31, 2014, were grouped into (1) current smokers with normalized TT, (2) current smokers with nonnormalized TT, (3) nonsmokers with normalized TT, and (4) nonsmokers with nonnormalized TT.

    […]

    Our findings show that maintaining normal levels of testosterone in testosterone-deficient nonsmokers reduces all-cause mortality and MI [myocardial infarction]. Cigarette smoking negates the beneficial effects of testosterone level normalization after TRT on MI and all-cause mortality. Adequately powered randomized clinical trials would be needed for conclusive determination of the effects of CS [cigarette smoking] and TRT [testosterone replacement therapy ] on CV [cardiovascular] risk and mortality. However, conducting such a randomized clinical trial in the United States would be prohibitive because smoking is an established risk factor for CVD. Based on the present study, counseling and treatment for smoking cessation would be an important intervention before and during TRT. Acknowledging the limitations of a retrospective analysis, results presented in the article provide insight and information that may be valuable in clinical practice.

  • Exercising 30 minutes a day reduces the risk of a ruptured brain aneurysm.

    Exercise and other forms of physical activity exert profound cardioprotective effects. In fact, people who regularly engage in moderate leisure time physical activity are less likely to develop cardiovascular disease than people who are inactive. Findings from a 2019 study suggest that just 30 minutes of moderate exercise daily reduces the risk of experiencing a ruptured brain aneurysm.

    The bleeding associated with a ruptured brain aneurysm impedes the delivery of oxygen to brain tissue, potentially causing a stroke and impairing cognitive and motor function. Experts estimate that as many as 12 percent of people who experience a ruptured brain aneurysm will die immediately; as many as 45 percent will die within 30 days of the event.

    The study involved more than 65,000 adults enrolled in the FINRISK, an ongoing study of risk factors for chronic diseases among people living in Finland. The investigators collected information about the participants' physical activity, including activities performed during leisure time, commuting, and working. They also reviewed medical records and autopsy registries to identify those who had experienced a ruptured brain aneurysm.

    They found that 543 of the participants experienced a ruptured brain aneurysm during a 42-year period. However, those who engaged in regular physical activity were protected: For every 30-minute increase in weekly leisure-time physical activity, the risk of experiencing a ruptured brain aneurysm decreased by 5 percent. The protective effects of leisure-time activity were observed across all age groups and were particularly strong for smokers. Participants who had an active commute were protected as well, but this protection lessened upon retirement, when they stopped commuting. Interestingly, those who had moderate or high work-related physical activity were 34 to 41 percent more likely to experience a ruptured brain aneurysm.

    These findings suggest that just 30 minutes of moderate leisure-time exercise and physical activity daily exert robust cardioprotective effects, reducing the risk of ruptured brain aneurysm. Learn more about the benefits of exercise in our overview article.

  • From the article:

    This is a unique study in that it monitored aneurysm patients over their entire lifetimes, whereas typical follow-up studies last only between one and five years in duration.

    […]

    The new study established that approximately one third of all aneurysms and up to one fourth of small aneurysms will rupture during a patient’s lifetime. The risk of rupture is particularly high for female smokers with brain aneurysms of seven millimetres or more in diameter. What surprised the researchers most was that the size of an aneurysm had little impact on its risk for rupture, particularly for men, despite a previously presumed correlation. In addition, the risk of rupture among non-smoking men was exceptionally low.

    “This is not to say that aneurysms in non-smoking men never rupture, but that the risk is much lower than we previously thought. This means treating every unruptured aneurysm may be unnecessary if one is discovered in a non-smoking man with low blood pressure,” Juvela clarifies.

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  • From the article:

    The average age at which women in both groups had started the menopause was similar, and analysis of the results showed that later menopause and use of hormone replacement therapy (HRT) protected against the risk of a cerebral aneurysm, lessening the risk by 21% and 77%, respectively.

    Premature menopause - before the age of 40 - had occurred in one in four (26%) of the women who had had an aneurysm compared with around one in five (19%) of those in the comparison group.

    And each successive four year increase in the age at which a woman went through the menopause lessened the likelihood of a cerebral aneurysm by around 21%.

    Smoking did not seem to be linked to an increase in risk, while alcohol consumption was of borderline significance.

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  • From the article:

    During the past few decades, the genetic makeup has been regarded as playing a significant role in the development of SAH [subarachnoid haemorrhage]. Contrary to this belief, however, a twin study recently published in the journal Stroke showed that environmental factors account for most of the susceptibility to develop SAH Conducted in Finland, Sweden and Denmark, the study is the largest population level twin study in the world.

    This means that instead of screening the close family members of SAH patients, the focus of preventive treatment may now be increasingly shifted to the efficient management of hypertension and smoking cessation intervention. This is what we do with other cardiovascular diseases as well."

    The Nordic study combined data on almost 80,000 pairs of twins over several decades. All in all, the follow-up time of all of the twin pairs corresponds to a staggering 6 million person-years.

    The researchers nevertheless emphasize that there are rare cases of families among whose members SAH is significantly more common than in the overall population. In these cases genetic factors are the principal cause underlying the development of the disease.

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  • From the article:

    • If smoking women with high systolic blood pressure values have 20 times higher rate of these brain bleeds than never-smoking men with low blood pressure values, it may very well be that these women diagnosed with unruptured intracranial aneurysms should be treated. On the other hand, never-smoking men with low blood pressure values and intracranial aneurysms may not need to be treated at all.

    In this largest SAH risk factor study ever, the study group also identified three new risk factors for SAH: previous myocardial infarction, history of stroke in mother, and elevated cholesterol levels in men. The results revise the understanding of the epidemiology of SAH and indicate that the risk factors for SAH appear to be similar to those for other cardiovascular diseases.

    • We have previously shown that lifestyle risk factors affect significantly the life expectancy of SAH survivors, and now we have shown that the same risk factors also affect dramatically the risk of SAH itself.

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  • From the article:

    The study found the lifetime risk of an abdominal aortic aneurysm were: 1 in 17 among all study participants; 1 in 9 among current smokers; 1 in 9 among those in the top third of smoking pack-years (number of cigarettes smoked over a lifetime), whether a current or former smoker; 1 in 12 among current female smokers.

    Researchers also found those who had quit smoking for 3-8 years (recent quitters) still had an approximately 2.6 to 3.5 fold increased risk for both clinical and asymptomatic abdominal aortic aneurysm in the next 15 years compared to never smokers. Their lifetime risk was 6.6 percent higher than long-term quitters.

    For women, authors note the steep increase in risk is particularly concerning given the United States Preventive Services Task Force recommends that current or former male smokers undergo an ultrasound screening for an abdominal aortic aneurysm once between the ages of 65 and 75 but makes no such recommendation for women.

    […]

    The study also found that being older, white, or having high levels of bad cholesterol also increased the risk of abdominal aortic aneurysm.

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  • From the article:

    Former and current smokers had a recurrence rate of 26.3 percent, and accounted for 232 of the 296 aneurysms documented in this study. Never smokers, on the other hand, experienced a recurrence rate of 17.2 percent, accounting for the remaining 64 aneurysms. All subjects had undergone endovascular treatment.

    […]

    “We already know that smoking increases the development, growth and risk of rupture of aneurysms,” says Thompson, the John E. McGillicuddy Collegiate Professor of Neurosurgery. “We didn’t know that after endovascular treatment the risk of recurrence of an aneurysm is as clearly related to smoking as we’ve shown in this study.”

    Scientists still don’t know exactly why tobacco use leads to an initial aneurysm, but have established some theories. U-M researchers say smoking might affect how well an aneurysm is obliterated in the first place, or may impede the healing process.

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  • From the article:

    Researchers have confirmed three gene changes that raise the risk that a blood vessel in the brain will weaken and balloon out (aneurysm), creating a life-threatening chance of rupture. Smoking, the biggest risk factor for brain aneurysm, is five times more dangerous in people with these gene variations. However, a second study on the same population notes that most people with aneurysm die of cancer or heart problems.

    […]

    In one study (Broderick, abstract 156), researchers found that the chance of an intracranial aneurysm increased between 37 percent and 48 percent for people who carried one copy of an identified risky gene variation. However, when the gene variant was combined with smoking the equivalent of one pack a day for 20 years, the risk increased more than five-fold. People with two copies of the gene variant were at even higher risk.

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  • From the article:

    After taking account of influential factors, such as salt intake, working hours, weight and family history of diabetes, smokers were almost three times as likely to have a brain bleed as non-smokers.

    The impact of smoking was cumulative: the longer and more heavily a person had smoked, the greater was their risk of a brain bleed.

    Quitting smoking cut the risk of a ruptured aneurysm by 59% after five or more years – bringing it down to the level of non-smokers. But this was not the case among heavy smokers.

    Those who had smoked 20 or more cigarettes a day were still more than twice as likely to have a ruptured aneurysm as those who had never smoked. […]

    In the short term, smoking thickens blood and drives up blood pressure, both of which can increase the risk of a brain bleed. These effects can be reversed by stopping smoking. But smoking also induces permanent changes in the structure of artery walls, say the authors. These changes may be greater in heavy smokers, they say.

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  • From the article:

    Data from several genome-wide association studies were used to gauge genetic associations to lifestyle and cardiometabolic risk factors. […] According to the analysis:

    -A genetic predisposition for insomnia was associated with a 24% increased risk for intracranial aneurysm and aneurysmal subarachnoid hemorrhage.

    -The risk for intracranial aneurysm was about three times higher for smokers vs. non-smokers.

    -The risk for intracranial aneurysm was almost three times higher for each 10 mm Hg increase in diastolic blood pressure (the bottom number in a blood pressure reading).

    -High triglyceride levels and high BMI did not demonstrate an increased risk for intracranial aneurysm and aneurysmal subarachnoid hemorrhage.

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  • From the article:

    The researchers treated rats with alcohol, tobacco smoke or both twice a day for 28 days and then compared their brains with control animals that didn’t receive either substance. They found that the combined alcohol and smoking treatment increased the level of reactive oxygen species in the hippocampus compared with control animals or rats given tobacco smoke alone. In all of the brain areas studied, combined alcohol and smoking increased the levels of specific pro-inflammatory cytokines more than either treatment alone.

    Reduced levels of BDNF, another harbinger of bad news:

    And in the striatum and frontal cortex, rats with both treatments showed lower levels of brain-derived neurotrophic factor, a growth factor that helps existing neurons survive and stimulates the growth of new ones. These results suggest that alcoholics who smoke could be at additional risk for neural damage, the researchers say.

  • From the article:

    We now report that vitamin C supplementation can prevent some of the effects of maternal nicotine exposure on pulmonary function of offspring. […] Nicotine exposure significantly reduced forced expiratory flows, but supplementation of mothers with 250 mg vitamin C per day prevented the effects of nicotine on expiratory flows. Vitamin C supplementation also prevented the nicotine-induced increases in surfactant apoprotein-B protein.

    […]

    Prenatal nicotine exposure significantly decreased levels of elastin content in the lungs of offspring, and these effects were slightly attenuated by vitamin C. These findings suggest that vitamin C supplementation may potentially be clinically useful to limit the deleterious effects of maternal smoking during pregnancy on offspring’s lung function.

  • How well (and how quickly) we age depends on a confluence of genetic, environmental, and lifestyle factors. Some lifestyle behaviors, such as alcohol consumption and cigarette smoking, elicit harmful effects on multiple body systems that can accumulate over time to modulate aging. A new study demonstrates that alcohol consumption and cigarette smoking accelerate brain aging, in particular.

    Research indicates that smoking cigarettes alters multiple structural aspects of the brain. For example, smokers tend to have less gray matter density and volume in the frontal, occipital, and temporal lobes – areas related to a wide range of brain function. Similarly, heavy alcohol use is associated with reduced gray and white matter volumes in the medial-prefrontal and orbitofrontal cortices.

    The authors of the study assessed relative brain age, a comparative measure of brain aging between people of the same chronological age, to determine if a person’s brain is aging at a different rate relative to their peers. The study was based on analysis of brain-imaging data collected from more than 17,000 UK Biobank participants who were of European ancestry and were cognitively normal. After determining the participants' relative brain age, they studied the association of relative brain age with cigarette smoking, alcohol consumption, and genetic variants.

    They found that regular (daily or nearly daily) cigarette smoking or alcohol consumption increased relative brain aging. Every gram of alcohol (~20 grams in 1 fluid ounce) consumed per day was linked to one week of accelerated brain aging and each year spent smoking one pack of cigarettes per day was linked to 11 days of accelerated brain aging.

    These increases in brain aging were associated with poor cognitive function and declines in fluid intelligence, the ability to creatively solve problems without prior knowledge or learning. They also identified two single nucleotide polymorphisms associated with accelerated brain aging.

    While it is important to note that the effect of alcohol on brain aging was only seen in daily or almost daily drinkers, these findings provide useful insights into how cigarette smoking and alcohol consumption influence brain aging and highlight the need for future research to fully elucidate the factors associated with how the brain ages.