The

Health Consequences

of Smoking

January 1973

INDEX
Pages 251-261

U.S. DEPARTMENT OF HEALTH,
EDUCATION, AND WELFARE
Public Health Service
INDEX

Abortion, spontaneous
effect of maternal smoking, 123,124
Acenaphthylene
in cigar, pipe, and cigarette smoke, 178
- Acetaldehyde
as ciliatoxic agent in cigarette smoke, 31
Aerobic capacity
effect of cessation of smoking, 243
effect of exercise and smoking, 243,244
Air pollution
and bronchitis, in smokers vs. nonsmokers,
36,37
effect on mortality rates from lung cancer,
73
as factor in lung cancer development,
72,73
’ in Osaka, Japan, 44
prevalence of respiratory diseases and, 44
and smoking in military and civilian air-
craft, 45
Alcohol consumption
interaction with smoking and other risk
factors in CHD, 10
and smoking, in cancer development, 7
and smoking, in esophageal cancer devel-
opment, 76,200
and smoking, in laryngeal cancer etiology,
197
and smoking, in oral cancer etiology, 193
Alveolar macrophages
effect of cigarette smoke, 52,53
effect of nitrogen dioxide, 54
Alveolar rupture
in pipe/cigar smokers vs. cigarette smokers
and nonsmokers, 217
Angina pectoris
carbon monoxide inhalation and, 17,18
incidence in pipe and cigar smokers, 215
* Anthracene
in cigar, pipe, and cigarette smoke, 178
Arterioles
effect of smoking, 22,23
‘ Atteriosclerosis obliterans
smoking as cause, 19,20
Aryl hydrocarbon hydroxylase
effect of benzo(a)pyrene in pregnant rats,
119
tole in metabolism of chemical carcino-
gens, 82,83
Asbestos
effect on pulmonary function in smokers
vs. nonsmokers, 41
effect on radiological findings in smokers
vs. nonsmokers, 41
effect on respiratory symptoms in smokers
vs. nonsmokers, 41

and smoking, effect on mortality rates
from lung cancer, 73
Athletic performance
running, effect of smoking, 243,244
smokers vs. nonsmokers, 243,244
swimming, effect of smoking, 244
Autopsy studies
COPD and smoking, 45-48
lung cancer in U.S. veterans, 73,74

Bacterial flora
in smokers vs. nonsmokers with COPD, 54
Benzo(a)pyrene
carcinogenic effect in laboratory animals,
78-80
in cigar,
177,178
effect on DNA and RNA, 86,87
effects during pregnancy in laboratory
animals, 117,118
Bicarbonate
in pancreatic secretions, effect of smoking,
159,160

Bicycle Ergometer performance
cardiovascular parameters in smokers vs.
nonsmokers, 242-244
Birth weight
effect of maternal smoking,
119-122
effect of maternal smoking before and
during current pregnancy by cigarette
consumption, 107-109
effect of maternal smoking during pre-
vious pregnancies, 112-114
effect of maternal smoking, mechanism of
action, 119,120
effect of paternal smoking, 110,111
effect of tobacco smoke, nicotine, or
carbon monoxide in laboratory animals,
114-118
gestation duration in smokers vs. non-
smokers, 103-106
and maternal smoking, epidemiological
studies, 103-114
timing of influence of smoking, 120,121
Bladder cancer
see also Renal cancer

pipe, and cigarette smoke,

103-114,

incidence in smokers vs. nonsmokers,
77,78
smoking in etiology of, 77,78
Blood flow
effect of smoking, 19,22,23
Blood lipids

effect of smoking, 11,12

251
effect of smoking and relative weight, in
male Parisian civil servants, 11
effect of smoking in middle-aged patients
with angina pectoris, 12
effect of smoking in young Norwegian
military recruits, 1!
elevated, as risk factor in CHD, 11
Blood pressure
effect of
242,244-246
effect of pipe and cigar smoking, 216
effect of smoking in middle-aged patients
with angina pectoris, 12
Body height
interaction with smoking as factor in
cerebrovascular disease, 19
Body weight
interaction with smoking as factor in
cerebrovascular disease, 19
and smoking, as factors in CHD incidence,
44
and smoking, effect on blood lipids, 11
Bronchial epithelium
histological changes at autopsy and smok-
ing habit, 74
histological changes in cigar, pipe, cigar-
ette smokers vs. nonsmokers, 203, 204,
209
premalignant changes in smokers, 67
Bronchiolo-alveolar cancer
smoking and, 71
Bronchitis
and disability, in smokers vs. nonsmokers,
43
dust exposure as a factor, 44
mortality ratios in male pipe and cigar
smokers, 217,219
prevalence in Duisburg, Germany, by age
and cigarette consumption, 39
prevalence in ex-coal miners and non-
miners by smoking habit, 42
prevalence in miners and farmers in Hun-
gary, by smoking habit, 42
prevalence in pipe and cigar smokers,
220,221
prevalence in smokers vs. nonsmokers in
Bordeaux, France, 36
prevalence in smokers vs. nonsmokers in
mountainous or low-lying areas, 36,37
prevalence in smokers vs. nonsmokers in
Osaka, Japan, 44
prevalence in smoking vs. nonsmoking
yarn mill workers, 40
in smokers vs. nonsmokers, autopsy stu-
dies, 45,46
smoking vs. coal mining in etiology of, 42
smoking vs. dust inhalation in etiology of,
42
Bronchitis, chronic
see Bronchopulmonary diseases, chronic
obstructive

252

exercise and smoking,

Bronchopulmonary diseases, chronic ob-

structive

see also Emphysema and bronchitis

autopsy studies, 45-48

as cause listed on death certificates vs, at
autopsy, 47

epidemiological studies, 36-45

mortality and morbidity studies, 36-39

mortality rates in British citizens by migra-
tion patterns, 36

mortality ratios in male pipe and cigar
smokers, 216,217,219

summary of previous findings, 35,36

summary of recent findings, 55

Byssinosis

prevalence in cotton mill employees,
smokers vs. nonsmokers, 55

prevalence in men by index of severity and
smoking habits, 40,41

prevalence in smoking vs. nonsmoking
cotton mill workers, 39

smoking and, 39-41

Cancer
see also Specific site, e.g., Lung cancer
mortality rates in alcoholics, 71
recurrent primary, incidence in smokers
vs. nonsmokers, 71,74
summary of previous findings, 67,68
summary of recent findings, 88
Capillaries
effect of smoking, 22
Carbon monoxide
cardiovascular effects, experimental stu-
dies, 17-19
effect on birthweight and neonatal mortal-
ity in animals, 133
effect on cholesterol biosynthesis, in vitro,
18
effect on cholesterol level in aorta in
rabbits, 18
effect on coronary hemodynamics and
ventricular function in dogs, 18
effect on exercise performance in smokers
vs. nonsmokers, 246,247
effect on maximal oxygen consumption,
18
effect on platelet stickiness in rabbits, 18
effect on reflex vasoconstrictor responses,
18,23
effect on vascular resistance and reflex
vasoconstriction, 22,23
effects during pregnancy in laboratory
animals, 116,117
Carboxyhemoglobin levels
effect on exercise performance in smokers
vs. nonsmokers, 246,247
following smoking of non-nicotine ciga-
rettes, 17,18
in neonates of smoking mothers, 118,119
Carcinogenesis
cell and tissue culture studies, 84-86
effect of tobacco curing methods, 212
experimental, 78-87
initiating and promoting agents in cigar-
ette smoke, 68
mechanism of action, 78, 80-87
of respiratory tract in laboratory animals,
78-80
role of cigarette smoke condensate, 80-84
Carcinogens
effect on cell transformations, 84-86
effect on respiratory tract in laboratory
animals, 78-80
Cardiac index
effect of
242-244

Cardiovascular diseases
see also Coronary heart disease
mortality ratios in male pipe and cigar
smokers, 215,216
smoking and, 3-23
summary of previous findings, 3
summary of prospective epidemiological
studies for cigar and pipe smokers, 216
summary of recent findings, 23
Catecholamine levels
effect of cigar, pipe, and cigarette smoke
in dogs, 216
Cell and tissue culture studies
tobacco carcinogenesis and, 84-86
Cell cultures
malignant transformations induced by to-
bacco tars on carcinogens, 84-86
Cells, atypical
in ex-smokers, smokers, and nonsmokers
at autopsy, 74
Cerebrovascular disease
interaction of smoking and other risk
factors, 19
mortality ratios in pipe and cigar smokers,
215,216
Cessation of smoking
compared benefits in cigarette vs. pipe/
cigar smokers, 172,173
effect on absolute aerobic power, 243
effect on infant birth weight, 107-109
112-114
effect on pulmonary surfactant levels, 55
as preventive measure in occlusive disease,
21,22
CHD
see Coronary heart disease
Chest illness
prevalence in pipe and cigar smokers,
220,221
Cholesterol
biosynthesis, effect of carbon monoxide.
in vitro, 18

exercise and smoking,

Cholesterol levels
effect of carbon monoxide in rabbits, 18
effect of smoking and body weight, 11
effect of smoking and clinical parameters
in British business executives, 1!
in pipe and cigar smokers, 215,216
Chronic obstructive bronchopulmonary di-
sease
see Bronchopulmonary disease, chronic
obstructive
Cigarettes
definition and processing, 175
filtered, effect on respiratory symptoms,
55
modified, effect on respiratory symptoms
and ventilatory capacity, 37,38
plain vs. filtered, effect on sputum produc-
tion, 37,38
similarities with little cigars, 224,225
Cigarette smoke condensate
effect on RNA, 86
N-nitrosamines in, 87,88
role in experimental carcinogenesis, 80-84
Cigarettes, non-nicotine
effect on carboxyhemoglobin levels, 17,18
Cigars
definition and processing, 175,176
Cigars, little
chemical composition of, 224,225,228
evaluation of potential public health im-
pact, 222-228
shipment for domestic
1970-1972, 222-224,227
similarity to cigarettes, 224,225
sugar and pH differences with large cigars
and cigarettes, 222-224
tar and nicotine content, 224-226,228
Cigar smokers
relative risk in lung cancer development,
67,68
Cigar smoking
effect on mortality and morbidity com-
pared to cigarette smoking, 171-173
in esophageal cancer development,
197,200-202
gastrointestinal disorders and, 222
health consequences of, 179
histological effects on bronchial epithe-
lium, 203,204,209
histological effects on esophagus, 200

consumption

histological effects on larynx, 197

inhalation patterns and, 184-189

in laryngeal cancer development,
197-199

in lung cancer development by amount
smoked, 203-206

mortality ratios from cardiovascular di-
seases and, 215,216

mortality ratios from COPD and, 217,219

253
mortality ratios from esophageal cancer
and, 197,200
mortality ratios from laryngeal cancer and,
193,196,197
mortality ratios from lung cancer and
203-205
mortality ratios from oral cancer and
191,193
oral cancer development and, 193-195
overall mortality rates by amount smoked,
180-182
overall mortality rates from cancer and,
189
prevalence in Great Britain, 173,174
prevalence in United States, 173,174
pulmonary histological changes and, 217
Ciliary activity
effect of pipe/cigar smoke vs. cigarette
smoke in cats, 217,218
Clinical laboratory tests
effect of aging and smoking, in healthy
male veterans, 11
Coal dust
effect on pulmonary function in smokers
vs. nonsmokers, 41-43
effect on respiratory symptoms in smokers
vs. nonsmokers, 41-43
Combustion temperature
effect on tumorigenic activity of pipe and
cigarette tobacco, 210,211
Congenital malformations
maternal smoking and, 136,137
Coronary heart disease
epidemiological studies, 4-11
experimental studies, 13-19
incidence in European vs. American men,
9
incidence in farmers vs. nonfarmers by
smoking habit, 7
incidence in Hawaiian men of Japanes:
ancestry, 10
incidence in male bank employees it
Brussels, Belgium, 10
incidence in men in Yugoslavia, 9
incidence in miners in Sardinia, 10
incidence in pipe and cigar smokers,
215,216
incidence in white males by body weight
and smoking habit, 5
incidence in whites vs. blacks in Evans
County, Georgia, 4,5
in India, 11
interaction of smoking with other risk
factors, 4-11
mortality rates in Japanese men and wo-
men by cigarette consumption and age a
initiation of habit, 7,8
mortality rates in smoking men in Finland,
9
mortality ratios in pipe and cigar smokers,
215,216

e

254

in Nepal, 11
in New Zealand, 11
4 smoking, in individuals under 40
years, 10
and smoking, in myocardial ischemic pa-
tients in Italy, 10
COPD
see Bronchopulmonary diseases, chronic
obstructive
Cough
effect of asbestos exposure in smokers vs.
nonsmokers, 41
effect of coal dust exposure in smokers vs.
nonsmokers, 41,42
effect of filtered cigarettes, 55
effect of modified cigarettes, 38
prevalence in pipe and cigar smokers,
220,221
prevalence in smoking vs. nonsmoking
women in Bordeaux, France, 36
Cresols
in cigar, pipe, and cigarette smoke, 177
Curing methods
incidence of respiratory infections in rats
and, 218,219
Cyanide detoxification
in pregnant smokers vs. nonsmokers, 119

7H-Dibenz(c,g)carbazole
carcinogenic effect in laboratory animals,
79
Diet
and smoking, effect on blood lipids, 12
DNA
binding of polycyclic hydrocarbons to,
86,87
Dust exposure
bronchitis and, 44
as occupational hazard, 43,44
smoking and, 44
Dynamic compliance
in smokers vs. nonsmokers under 30, 50
Dyspnea
prevalence in cigar and pipe smokers,
220,221

Electrocardiogram
abnormalities, effect of smoking and other
factors, 13
effect of smoking, in middle-aged Dutch
men, 12
effect of smoking, in young military re-
cruits in Poland, 12
Emphysema
see also Bronchopulmonary disease,
chronic obstructive
incidence in cigar/pipe smoking coal mi-
ners vs. cigarette smokers and non-
smokers, 217

mortality ratios in male pipe and cigar
smokers, 217,219

prevalence in males by smoking category,
at autopsy, 48

prevalence in pipe/cigar and cigarette smo-
kers vs, nonsmokers, autopsy studies,
45,46

prevalence in smokers vs. nonsmokers, 55

in smokers vs. nonsmokers, autopsy stu-
dies, 45-47

Epidemiological studies

bronchopulmonary diseases and smoking,
36-45

coronary heart
4-13,23

lung cancer and smoking, 68-72

peptic ulcer and smoking, 155-157

Esophageal cancer

alcohol consumption and smoking in de-
velopment of, 200

inhalation patterns and, 197

mortality ratios for cigar, pipe, and ciga-
tette smokers vs. nonsmokers, 197,200

mortality ratios in Japanese male smokers
vs, nonsmokers, 76

relative risk in cigar, pipe, and cigarette
smokers vs. nonsmokers,
197,200-202

smoking and alcohol consumption in de-
velopment of, 76

summary of retrospective studies, 201,202

Esophagus

histological changes in cigar, pipe, ciga-

rette smokers vs. nonsmokers, 200
Exercise performance

on bicycle ergometer, effect of smoking,
242,243

cardiac index, effect of smoking, 242,243

effect of smoking and smoking abstinence,
241 242,246,247

influencing factors, 241,246,247

summary of findings and mechanism of
action, 246,247

on treadmill, effect of smoking, 243,245

Experimental studies

COPD and smoking, 48-55

coronary heart disease and smoking, 13-19

effect of carbon monoxide on pregnant
animals, 132,133

pregnancy in laboratory animals, effect of
tobacco smoke, nicotine, carbon mono-
xide, and polycyclic hydrocarbons,
114-118

Ex-smokers

compared mortality rates for cigarette vs.
pipe/cigar smokers, 172,173

histological changes in bronchial epithe-
lium at autopsy, 74

disease and smoking,

low birth weight infants of, 112-114

mortality rates from lung cancer, 71-72

prevalence of respiratory symptoms, 39

pulmonary function, 39

relative risk in lung cancer development,
71-72

survival after treatment for pharyngeal,
laryngeal, or oral cancers, 75

Fatty acid levels
effect of cigar, pipe, and cigarette smoke
in dogs, 216
effect of smoking, 12
Fetal mortality
effect of maternal smoking, 123-135
epidemiological studies in smokers vs. non-
smokers, 126-132
Fibrosis
in pipe/cigar smokers vs. cigarette smokers
and nonsmokers, 217
Fitness tests
various, smokers vs. nonsmokers, 245
Framingham study
interaction of smoking and other risk
factors in CHD, 8

‘Gastric secretion

effect of nicotine in laboratory animals,

158,159
effect of smoking in ulcer patients,
157,158

‘Gastrointestinal disorders

prevalence in cigarette and pipe/cigar smo-
kers, 222
Gestation
and low birth weight infants, effect of
maternal smoking, 103-106
Gestational age
effect on perinatal mortality rates in smo-
king vs. nonsmoking mothers, 126-132
Glucose intolerance
as a risk factor in CHD, 8
Grip strength
effect of smoking, 241,242

Heart rate
effect of
242-246
Histological studies
lung cancer in US. veterans, 73
Histopathological studies
in laboratory animals, 49,50
in smokers vs. nonsmokers, 48,49
Honolulu Heart Study
interaction of smoking and other risk
factors in CHD, 8,9

exercise and smoking,

255
Hypercholesterolemia
incidence in male British business execu-
tives, by smoking habit and clinical
parameters, 1}
as risk tactor in CHD, 8,9,11
Hypertension
interaction with smoking as risk factor in
cerebrovascular disease, 9
as risk factor in CHD, 8,9
Hypoxia
carbon monoxide induced, 18,23

Infant
small-for-date, effect of maternal smoking,
106-114
Infant mortality
of black vs. white smoking mothers,
129-132
causes of death by maternal smoking
habit, 133
effect of genetic differences and smoking,
132
effect of maternal smoking, 123-135
effect of previous obstetrical experience
and smoking, 132
effect of socioeconomic background and
smoking, 131,132
epidemiological studies in smokers vs. non-
smokers, 126-132
factors other than smoking, 131,132
risk of low-birth-weight infants of smoking
vs. nonsmoking mothers, 126-132
Influenza
prevalence in pipe and cigar smokers,
220,221
Inhalation patterns
effect of previous
186-189
frequency-per-puff in cigar and cigarette
smokers, 186,187
of pipe, cigar, and cigarette smokers,
184-189
possible determining factors, 183,184
Intermittent claudication
smoking and, 21
International Cooperative Study
interaction of smoking and other risk
factors in CHD, 9

smoking habits,

Lactate metabolism
effect of smoking, in patients with angina
pectoris, 13
Lactation
effect of maternal smoking, 138-141
effect of maternal smoking, summary of
findings, 141
epidemiological studies, 138
experimental studies, 138,139

256

Laryngeal cancer
inhalation patterns and, 193
mortality ratios for pipe, cigar, and ciga-
rette smokers vs. nonsmokers,
193,196,197
mortality ratios in Japanese male smokers
vs. nonsmokers, 76,77
recurrent, incidence in smokers vs, ex-
smokers, 71,74-77
relative risk for cigar, pipe, and cigarette
smokers vs. nonsmokers,
76,77,197-199
summary of retrospective studies, 198,199 -
Larynx
histological changes in cigar, pipe, cigar-
ette smokers vs. nonsmokers, 197
Leukoplakia
prevalence in tobacco chewing coal mi-
ners, 75
reverse smoking and, 76
Lip cancer
cigar smoking in etiology of, 190,191
cigarette smoking in etiology of, 190,191
pipe smoking in etiology of, 190,191
relative risk in pipe, cigar, and cigarette -
smokers vs. nonsmokers, 190,191
summary of retrospective studies, 192
Little cigars
see Cigars, little
Lung cancer
air pollution as a factor, 72
epidemiological studies, 68-72
race as a factor, smokers vs. nonsmokers,
70
incidence in smokers vs. nonsmokers in
Jersey, Channel Isles, 70
incidence in smokers vs, nonsmokers in La
Plata, Argentina, 70
incidence in smokers vs. nonsmokers in
Philadelphia, 70
inhalation patterns and, 203
mortality rates in asbestos workers, smo-
kers vs. nonsmokers, 73
mortality rates in British physicians vs.
general population in England and Wales,
70
mortality ratios for cigar, pipe, and cigar-
ette smokers vs. nonsmokers,
203-205
mortality ratios in Japanese by amount
smoked and age at initiation of habit, 69
occupational exposures and smoking, 67
prevalence in smokers vs. nonsmokers in
Czechoslovakia, 70
prospective study
68,69
relative risk in cigar, pipe, and cigarette
smokers vs. nonsmokers,
203,206-208
relative risk in ex-smokers vs. continuing
smokers, 72

in Japanese adults, _
relative risk in pipe/cigar smokers, 67,68
smoking as cause, 67
summary of retrospective studies, 206-208

Maternal-fetal exchange
polycyclic hydrocarbons and, 119
Maternal smoking
see Smoking, maternal
3-Methylcholanthrene
effects during pregnancy in laboratory
animals, 117
Morbidity
from chronic bronchopulmonary diseases,
36-39
Mortality
compared rates for cigarette vs. pipe/cigar
ex-smokers, 172,173
from chronic bronchopulmonary diseases,
36-39
from COPD, in cigar/pipe smokers vs.
Cigarette smokers and nonsmokers,
216,217
overall rates for cigar smokers vs, pipe
smokers, 179,180
overall rates for pipe/cigar smokers and
dose—response relationships, 180-189
overall rates for pipe/cigar smokers vs,
nonsmokers, 179,180
overall rates from cancer in pipe and cigar
smokers, 189
ratio in pipe and cigar smokers by age and
inhalation, 184,187
Mortality rates
CHD in Japanese men and women by
cigarette consumption and age at initia-
tion of habit, 7,8
Myocardial infarct
incidence in European vs. American men,
9
incidence in men in Yugoslavia, 9
incidence in miners in Sardinia, 10
incidence in pipe and cigar smokers, 215
prevalence in smoking vs. nonsmoking
men in Czechoslovakia, 10
and smoking, in patients in Leningrad
hospitals, 10

Nicotine

in cigar, pipe, and cigarette smoke, 177

clinical effects on offspring of smoking
mothers, 140,141

in duodenal ulcer
158,159

effect on cardiovascular system in dogs, 17

effect on gastric secretion in cats, 158,159

effect on gastric secretion in tats, 159

effect on heart blood flow in dogs, 17

induction in cats,

effect on lactation in laboratory animals,
138,139

effect on lactation in smokers vs. non-
smokers, 139,140

effect on lipid biosynthesis in aorta in
dogs, 17

effect on microcirculation in atrium in
cats, 17

effect on pancreatic secretions in animals,
161,162
effect on pipe/cigar smoke inhalation,
183,184
effect on rat and mouse fetus, site of
action, 121
effects during pregnancy in laboratory
animals, 115,116
experimental studies, 16,17
in little cigars compared to cigarettes and
cigars, 223-226,228
in milk of laboratory animals, 138,139
in milk of smoking mothers, 139
as potentiator of duodenal ulcers in ani-
mals, 161-163
Nicotine levels
in blood, new assay method, 15,23
Nicotine secretion
effect of cigar, pipe, and cigarette smoke
in dogs, 216
Nitrogen dioxide
effect on alveolar wall cells in guinea pigs,
50
effect on bacterial retention in hamsters,
54
effect on rat lung, 49,50
Nitrosamines
effect on lactating hamsters, 139
N-Nitrosamines
determination in cigarette and tobacco
smoke condensate, 87,88

Obesity
as a risk factor for CHD, 9
Occlusive disease
smoking and, 21
Occupation
and smoking, as factor in CHD incidence,
5,7
Occupational diseases
asbestosis, 41
byssinosis, 39-41
coal workers pneumoconiosis, 42
Occupational exposure
pancreatic cancer and, 77
and smoking, bladder cancer and, 78
Occupational hazards
asbestos exposure, 41,73
coal dust exposure, 41-43
cotton, flax, and hemp dust exposure,
39-41

257
dust exposure, 43,44

100% pure oxygen exposure, 43

radiation exposure in uranium miners, 72

smoking and, 39-44

smoking as additive risk for COPD, 55

Oral cancer

alcohol consumption and smoking in etio-
logy of, 193

inhalation patterns and, 191

mortality rates in Japanese male smokers
vs. nonsmokers, 74

mortality ratios for pipe, cigar, and cigar-

ette smokers vs. nonsmokers,
191-193
recurrent, incidence in smokers vs. ex-

smokers, 71,74,75

relative risk of development in pipe, cigar,
and cigarette smokers vs. nonsmokers,
191,194,195

reverse smoking and, 76

smoking in etiology of, 74-76

summary of retrospective studies, 194,195

Oxygen debt
effect of smoking, 246,247
exercise performance and, 246,247

Pancreatic cancer
occupational exposure and, 77
smoking and, 77
Pancreatic secretions
bicarbonate content, effect of smoking,
159,160
effect of nicotine in animals, 161,162
effect of smoking, 159,160
Passive smoking
effect on cardiovascular function in dogs,
14
Peptic ulcer
see Ulcer, peptic
Perinatal mortality
effect of maternal smoking, summary of
findings, 134,135
Peripheral arteriosclerosis
smoking and, 21
Peripheral vascular disease
smoking and, 19-23
pH
pipe/cigar smoke inhalation and, 183
of smoke in cigarettes, cigars, and little
cigars, 223,224,228
Phagocytosis
effect of cigarette smoke in laboratory
animals, 53,54
Pharyngeal cancer
recurrent, incidence in smokers vs. ex-
smokers, 74,75
Pharyngeal fungi
smokers vs. nonsmokers in South Africa,
54

258

Phenols
in cigar, pipe, and cigarette smoke, 177
Phenylmethyloxadiazole (PMO)
protection against adverse effects of cigar-
ette smoke in animals, 49,53
Physical activity
as a factor in coronary heart disease, 4,5
Pipe smokers
relative risk in lung cancer development,
67,68
Pipe smoking
effect on mortality and morbidity com-
pared to cigarette smoking, 171-173
in esophageal cancer development,
197 ,200-202
gastrointestinal disorders and, 222
health consequences of, 179
histological effects on bronchial epithe-
lium, 203,204,209
histological effects on esophagus, 200
histological effects on larynx, 197
inhalation patterns and, 184-189
in laryngeal cancer development,
197-199
in lung cancer development by amount
smoked, 203-206
mortality ratios from cardiovascular di-
seases and, 215,216
mortality ratios from COPD and, 217,219
mortality ratios from laryngeal cancer and,
193,196 ,197,200
mortality ratios from lung cancer and,
203-205
mortality ratios from oral cancer and,
191,193
oral cancer development and, 193-195
overall mortality rates by amount smoked,
180-182
overall mortality rates from cancer and,
189
prevalence in Great Britain, 173,174
prevalence in United States, 173,174
pulmonary histological changes and, 217
Pipe tobacco
definition and processing, 176
Plethysmogram
abnormalities, in smokers vs. nonsmokers,
22
Pneumoconiosis
in coal miners, smokers vs. nonsmokers,
42
Pneumothorax, spontaneous
smoking and, 37
Polycyclic hydrocarbons
binding to DNA and RNA, 86,87
effects during pregnancy in laboratory -
animals, 117,118
maternal-fetal exchange and, 119
Post-operative complications
in duodenal ulcer removal, smokers vs.
nonsmokers, 157
smoking, obesity, anesthesia and, 39
Preeclampsia
maternal smoking and, 142
in smoking vs. nonsmoking women, 142
Pregnancy
effect of maternal smoking, 103-142
effect of maternal smoking, mechanism of
action, 119,120
effect of tobacco smoke, nicotine, and
carbon monoxide in laboratory animals,
114-118
and previous smoking habits, effect on
infant birth weight, 112-114
timing of influence of smoking on birth
weight, 120,12)
Prematurity
effect of smoking, 112
Pulmonary arterioles
histological effects of pipe/cigar smoking
vs. Cigarette smoking, 217
Pulmonary clearance
effect of heavy smoking, 52,53
effect of smoking, 55
mechanical vs. bactericidal clearance in

guinea pigs, 53
mechanism, in smokers vs. nonsmokers,
§2,53

in monozygotic vs. dizygotic twins, 51
particle deposition in smokers vs. non-
smokers, $3
Pulmonary diffusing capacity
in smokers vs. nonsmokers in Berlin, New
Hampshire, 50,51
Pulmonary emphysema
see Emphysema

Pulmonary function

in asymptomatic young men in Romania,
39

in coal miners, smokers vs. nonsmokers,
42,43

in coal miners vs. nonminers, 42

effect of asbestos exposure and smoking,
41

effect of coal dust exposure and smoking,
4143

effect of lung hyperinflation in coal mi-
ners, 42,43

effect on exercise performance in smokers
vs. nonsmokers, 246,247

in ex-smokers, 39

in jet fighter pilots, smokers vs. non-
smokers, 43

in pipe/cigar smokers vs. nonsmokers,
217,221

pulmonary hypertension and, 43

in smokers vs. nonsmokers, 55

in smokers vs. nonsmokers in Berlin, New
Hampshire, 50,51

in smokers vs. nonsmokers, under 30 years
of age, 50

smoking and, 38,39
Pulmonary histology
of pipe/cigar smokers vs. cigarette smokers
and nonsmokers, 217
Pulmonary macrophages
effect of smoking, 55
Pulmonary surfactant levels
effect of smoking, 55
Pulmonary tissue
histopathological differences in smokers
vs. nonsmokers, 48,49
Pyrene
in cigar, pipe, and cigarette smoke, 178

Race
as a factor in coronary heart disease,
4,5,23
as a factor in perinatal mortality in smok-
ing vs. nonsmoking mothers, 129-132
as a factor in stillbirth rates, 124,125
Radiation exposure
and smoking, as cause of respiratory can-
cers, 72
Radioactive particles
in tobacco leaf, tobacco smoke, and smo-
kers’ lungs, 72
Renal cancer
mortality ratio in Japanese men and wo-
men, smokers vs. nonsmokers, 77
smoking in etiology of, 77,78
Respiratory symptoms
see also Cough, Sputum production
effect of asbestos exposure in smokers vs.
nonsmokers, 41
prevalence in Duisburg, Germany by age
and cigarette consumption, 39
prevalence in ex-smokers, 39
prevalence in pipe and cigar smokers,
217,220,221
prevalence in smokers vs. nonsmokers, 55
prevalence in smokers vs. nonsmokers in
Bordeaux, France, 36
in smokers vs. nonsmokers by amount
smoked, 37
Reverse smoking
leukoplakia and, 76
oral cancers and, 76
RNA
binding of polycyclic hydrocarbons to,
86,87
Running
effect of smoking, 243, 244

Sex ratio

effect of maternal smoking, 135,136
Single-breath tests

smokers vs. nonsmokers, 51

259
Smoke, cigar
chemical constituents in, 177-179
ciliotoxicity, 218
effect of curing methods, 218,219
effect of pH on inhalation of, 183
tumorigenic activity in laboratory animals,
210-214
Smoke, cigarette
chemical constituents in, compared to
pipe/cigar smoke, 177,178
effect of curing methods, 218,219
effect on bacterial retention in hamsters,
54
effect on bronchial epithelium in dogs, 49
effect on phagocytosis in laboratory ani-
mals, 53,54
effect on pulmonary clearance, §1-53
effect on rat and mouse fetus, site of
action, 121
effect on ventricular fibrillation threshold
in dogs, 13,14
experimental studies in dogs, 13,14
reduction of adverse effects in animals by
phenylmethyloxadiazole (PMO), 49,53
and sulphur dioxide, effect on glands in
laboratory animals, 49
Smoke, little cigar
pH of, compared to cigarette and cigar
smoke, 224,228
Smoke, pipe
chemical constituents in, 177,178
ciliotoxicity of, 218
effect of pH on inhalation of, 183
tumorigenic activity in laboratory animals,
210-214

Smoke, tobacco

effect on air pollution in aircraft, 45

effect on nonsmokers, in aircraft, 45

effect on stillbirth rate in laboratory ani-
mals, 125

effects during pregnancy in laboratory
animals, 114,115

pH of, effect of leaf constituents, 224

tumorigenic activity, 210-214

Smoking

effect on blood lipids, 41,12

effect on cardiac lactate metabolism, 13

effect on leg blood mean-flow capacity, 22

effect on plasma nicotine levels, 15-17

effect on precapillary sphincters, 22

health hazards of, similarities of cigarettes
with little cigars, 224,225

interaction with other risk factors in CHD,
4-11

as most important cause of COPD, 35,36

prevalence in U.S. and Great Britain,

173,174
Smoking abstinence
effect on exercise performance,

241,242,246,247

260

Smoking, maternal
as cause of birth of small-for-dates infants
106-111 ,
congenital malformations and, 136,137
effect on birth weight, 103-114,119-122
effect on birth weight, summary of find-
ings, 122
effect on gestation duration, 103-106
effect on Jactation, 138-141
effect on neonatal carboxyhemoglobin
levels, 118,119
effect on sex ratio, 135,136
effects during pregnancy, 103-142
effects during pregnancy, mechanism of
action, 119,120
indirect association with small-for-dates
infants, 110-114
preeclampsia and, 142
selective action on fetus of certain women
vs. others, 131
spontaneous abortions and, 123,124
stillbirths and, 124,125
timing of influence on birth weight,
120,121
Smoking, paternal
effect on infant birth weight, 110,111
Sputum production
effect of asbestos exposure in smokers vs.
nonsmokers, 41
effect of filtered cigarettes, 55
effect of modified cigarettes, 37,38
effect of plain vs. filtered cigarettes, 37,38
in males by amount smoked and type of
cigarette, 37,38
prevalence in pipe and cigar smokers,
220,221

Stillbirths

effect of maternal smoking, 124,125

rates in blacks vs. whites, 124,125

in smokers vs. nonsmokers, 124,125
Sudden death

incidence in pipe and cigar smokers, 215
Sulphur dioxide

and cigarette smoke, effect on glands in

laboratory animals, 49

Swimming

effect of smoking, 242,244

Tar content
effect on respiratory symptoms and venti-
latory capacity, 38
Tars
in little cigars, compared to cigarettes and
cigars, 223-226 ,228
Thrombosis
smoking and, 19
Tobacco
flue-cured vs. air-cured, effect on respira-
tory system in animals, 217,218
Tobacco chewing
leukoplakia and, 75
Tobacco leaf extracts
effect on cell cultures, 85,86
Tracheal cancer
smoking and, 71
Treadmill performance
cardiovascular parameters in smokers vs.
nonsmokers, 242-245
effect of vitamin C, 245
oxygen intake in smokers vs. nonsmokers,
245
Triglyceride levels
CHD and, 8
Tumorigenic activity
of cigar, pipe, and cigarette smoke conden-
sate in skin painting experiments in
animals, 210-214
of tobacco smoke, 210-214

Ulcer, duodenal
mortality ratios in male cigar and pipe
smokers, 222
nicotine induced, in cats, 158,159
post-operative complications in smokers
vs. nonsmokers, 157
potentiating action of nicotine, in animals,
161-163
prevalence in smokers, mechanism of act-
ion, 160
Ulcer, peptic
clinical studies, 155-157
epidemiological studies, 155-157
gastric secretion in smokers vs. nonsmok-
ers, 157,158

increased mortality in Japanese smokers
vs. nonsmokers, 155,156

mortality ratios in Japanese adults by age
at initiation of smoking habit, 155,156

mortality ratios in male cigar and pipe
smokers, 222

predisposing factors, 157

recurrence in smokers vs. nonsmokers, 157

and smoking, summary of previous find-
ings, 155

Urinary bladder cancer
see Bladder cancer

Vascular disease, peripheral

smoking and, 19-23
Vascular reconstruction

effect of smoking, 22,23
Ventilatory function

effect of exercise and smoking, 244,245
Ventricular fibrillation

effect of cigarette smoke in dogs, 13,14
Ventricular hypertrophy

as a risk factor in CHD, 8
Vitamin B, ,

in pregnant smokers vs. nonsmokers, 119
Vitamin C

effect on treadmill performance in smo-

kers vs. nonsmokers, 245
in milk of smoking mothers, 141
in pregnant smokers vs. nonsmokers, 119

Water hardness
and smoking as risk factors in CHD, 9,10

261